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Harold can be contacted by phone or email:
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| | | | | | Dear Dr. Harold, A student at Santa Clara recently asked me, "My nephew has been diagnosed as bipolar disorder. What does that mean and what do I do?"
At its core, bipolar disorder is a mood disorder with mania and depression as the two actors. For mania, think super elevated mood, like a child that is having a laughing attack for several days and reduced need for sleep, aggressiveness, hyper-sexuality, massive tantrums and irritability. In adolescents, drugs like speed or cocaine in their different forms will need to be ruled out because they can cause this type of increase in mood. For depressed mood, you may need to think differently for children and adolescents. Children and adolescents are more likely than adults to act out when depressed, although they can have typical depressive symptoms as well. If you have evidence of these types of mood disorders, then take your child directly to your medical doctor. This is not a time to see if the behavior is a phase or to wait it out. Although bipolar disorder is rare in children and adolescents, early diagnosis and treatment can greatly improve the prognosis.
What is it?
Presently, there are two main types of bipolar diagnoses; Bipolar I and Bipolar II. Bipolar I is diagnosed once a person has at least one manic episode or mixed episodes (manic and major depressive episode). Bipolar II is diagnosed when there are recurring depressive episodes with at least one hypomanic episode (an episode of elevated mood not reaching as high a degree or duration as a full manic episode).
Treatment
This is a disorder that will most often be treated with medication and psychotherapy. The medications have significant side effects, so be sure you ask a lot of questions and monitor the side effects closely. As far as a therapist, interview and chose a therapist whose practice includes young people with this diagnosis. In school, the child or adolescent may qualify for Special Education services under the category of Emotional Disturbance. See what resources the schools have for the child as they spend a good percentage of their young lives in school.
What can you do?
Educate yourself and your family as to the challenges. The Child and Adolescent Bipolar Foundation is a great source of information (http://www.bpkids.org). Catching a manic or depressed mood before it becomes an episode can be very important. There can be other issues like ADHD or oppositional behavior present so make sure you get a full picture of the challenges that your child faces. The children I have worked with who have this disorder have real challenges. At their core, these kids are beautiful individuals with challenges in their moods and emotions.
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Lamorinda Weekly, Moraga CA