We hear from many parents of children and adolescents who are afraid that their son or daughter may have bipolar disorder.  Most of the time they are terrified and at their last wits end.  They do not know where to turn.  We refer them to professional help, but for the most part they have already done that.  They want something more.  They want contact with people who  have lived it and survived.  They want to know that it is not their fault.  They want hope.

Neither Linda or I are professional therapists and nothing we say should ever be interpreted to say that professional care is anything less than absolutely essential.  We claim no special expertise.  Our goal is first of all to be a clearinghouse of information for places to go for help.  We will share information we have found and try to point people to other places to look.  One of the biggest things that I hear from parents is that they simply do not know where to look.  We hope to help with that.

 We invite and hope for your participation.  In many ways our hope is that this page will act as an online support group for parents of kids who have issues with mood disorders.   If you are struggling with these issues with your children then you have an expertise of experience that I hope you will share with others.

Some entries will be based on our personal experience.  Like all families where one of the adults has bipolar disorder we worry what has been passed on to our children.  You will hear about some of the issues we have dealt with.   On a professional level I have been involved in the children's mental health field for over 35 years.  I have worked in psychiatric hospitals, therapeutic wilderness programs, special schools, and drug rehabs.  I have worked as therapist, social worker, front-line counselor, and family therapist.  One of the concerns I have for example is how effectively adolescences with bipolar issues are treated in residential treatment programs.

Eventually we hope that Hopeworks will be offer a support group for parents of bipolar kids.  Until that happens our hope is that this space will be something that helps those in need of such support.

Thanks

Larry

 

August 15,08

 

 Adolescent Issues with Bipolar:

 

How do you know?

 

 

 

Much of the material for the succeeding discussion is based on information you can find in  The Bipolar Teen by Dr. David Miklowitz and Dr. Elizabeth George.   For a more complete discussion of these issues refer to these book.

 

 

If anything it is even harder to diagnose bipolar in  adolescents than it is with adults.  So many things look alike and it takes an experienced professional to give an accurate diagnosis.  Diagnosis is so important, because treatment that might make one thing better makes another worse.  For example, medication that might help ADHD or depression better may have a disastrous effect on bipolar disorder causing people to have manic episodes.  The question “How do you know?” is probably the most important one if you are a parent and worried about what you think your child’s problems stem from.  Again let me caution diagnosis is a task for professionals.  Information below is  that like only intended to make you an educated consumer.  By becoming such you can become the best advocate possible for the children you love.

 

This post is the first in a series that attempts to deal with this question.  I hope you find it helpful.

 

In their book, The Bipolar Teen, Miklowitz and George talk about some of the symptoms of bipolar for adolescents who are in the manic phase:

 

1. Euphoria and Elation:  The up part of bipolar disorder takes one of two shapes for adolescents—elation or irritability.  Some studies have shown that for adolescents that often irritability is the way mania is experienced.  Kids who do get elated have a sense of well being and power that does not match their life experiences.  For some parents this may be one of the first clues something is wrong.  Elated teens display an inability to reality check their own contentment.  They may feel like any questioning of how they are doing is just trying to be “picky” and over-critical.

2. Grandiosity:  As many as 80% of kids have an inflated sense of self or of their ability in the manic phase.  This may be hard to distinguish from just childishness.  The key thing to look for is the unreality of the perception and their refusal to consider any feedback that they are wrong.

3. Decreased need for sleep:  This is not the same thing as insomnia.  In the manic phase it means the ability to function on what seems like little or no sleep.  They just don’t slow down.  But sleep deprivation in the end does great damage to both mental and physical health.  Just because you feel like you don’t need sleep, doesn’t mean that is  true.

4. Racing thoughts and Flight of Ideas:  Racing thoughts mean thoughts come one at a time, but they come so fast that you can’t concentrate or focus on them when they occur.  Flight of ideas mean to be flooded with multiple ideas all at once and being unable to order them and deal with them.  These kids feel like they are on fast forward all the time.  Trying to slow down and think clearly may be very hard for them.  Adults normally just tell them to try harder and that may make things worse rather than better.  A lot of kids will talk about wanting to “think like a normal person.”  My experience has been that this is an very common symptom for kids who end up trying to medicate their moods with alcohol or drugs.

5. Hypersexuality:  This is one symptom with some of the most serious consequences.  Again it may be hard to distinguish from ordinary adolescent behavior for some parents.  The key characteristic is the driven quality.  It is not just that they want to act out sexually.  They experience themselves as having to be sexually active.  They end up doing things that put themselves in very dangerous circumstances and doing things that later cause them a lot of shame and guilt.

6. Irritability:  This is one of the more troubling things to deal with.  At times it feels like everything makes them mad.  They are a bad episode getting ready to happen.  When the irritability spills into anger, the anger quickly becomes rage and their rage seems to know no limits.  This is one of the most difficult things for families to deal with.  As one parent told me, “I think obnoxiousness is the terminal illness of adolescence.”  Chronically irritable kids can be extremely difficult to be around, and at times feel dangerous and scary.

7. Increase energy and activity:  They feel like they have to do and can’t stop.  It is kind of the physical parallel of racing thoughts.  Trying to get them to stop or to slow down is difficult and frustrating for them as well as to the people around them.

8. Poor judgement and impulsivity:  90% of bipolar kids have this symptom.  They tend to make a lot of poor, ill-considered decisions that often put them in dangerous situations.  The chronic refrain is, “It seemed like a good idea at the time.”  Anyone who tries to limit them is seen as being unfair and rigid.

9. Alcohol, drug abuse,  and other self-destructive patterns:  Kids try to medicate their moods by the experiences they undergo.  Many bipolar kids have problems with substance abuse.   Attempts to get them to stop using without dealing with the underlying disorder are normally unsuccessful.

 

They also talk about some of the hallmark symptoms of depression:

 

1. Decreased energy and activity:  This is very hard for parents to deal with frequently and starts a many a round of criticism and argument.  For kids many experience bipolar depression as almost a leaden feeling.  In their mind they can’t do anything.  For them moving may be a task.

2. Insomnia:  They never feel rested, because of sleep deprivation.  Unlike the manic phase they do not feel like they can function without sleep.  They feel like they can’t sleep.

3. Fatigue and agitation:  The agitation may be a result of their extreme internal discomfort.  They may be figidity etc.  At other times they may feel like they don’t have enough energy to have a conversation.

4. Suicidal thoughts and impulses:  In one study 44% of kids with bipolar disorder had made a suicide attempt.  It is a real danger and must carefully be monitored.

 

Life for bipolar kids, as you might be able to tell by reading the previous information is difficult and full of danger and problems.  The above like I said is only a sketch.  To get more information follow up with books like The Bipolar Teen.

 

Bipolar is easily confused with other adolescent problems.  The following posts will deal with some of the things that professionals look for to tell the difference.

 

I hope this post was helpful.  If you have questions or comments please let us know.