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... d with COBPD had this bilinear transmission (Todd et Childhood-Onset Bipolar Disorder is a somewhat of a new concept. The DSM-IV is not scheduled for revision in the near future, but there have been some guidelines set that experts can use to make recognition of COBPD a bit easier. For example, a Washington University team of researchers use a structured diagnostic interview called Wash U KIDDE-SADS, which is more sensitive to the rapid cycling patterns of children with a bipolar disorder (CABF Learning Center- About Early Onset Bipolar Disorder). The criteria, though not formal, are the same as in adult bipolar disorder but there are two differences. First, the cycling between mania, hypomania and depression occurs many times each day.
Second, these episodes are short, rarely lasting more than a day before cycling to another state (Childhood Onset Bipolar Disorder; web For children with COBPD, a correct diagnosis is extremely important. This disorder, left untreated or improperly treated due to a misdiagnosis, can lead to severe impairments. Children who are not treated, or not treated properly experience an increase of symptoms. The behavior exhibited by children with COBPD, if not understood and dealt with, can lead to a removal from school, hospitalization, and sometimes even placement in the juvenile justice system. Misdiagnosis can lead to personality disorders and perhaps drug abuse. Childhood Onset Bipolar Disorder is extremely difficult to deal with for the child suffering.
Most children report guilty feelings, and feelings of not belonging anywhere. Left untreated, COBPD worsens and a correct diagnosis is the only way to start an effective treatment plan. There is no miracle cure for bipolar disorder. There is, however, reasonable probability that a good treatment plan can lead to a virtually symptom free life.
A good treatment plan includes medication, close monitoring of symptoms, education about the illness, counseling or psychotherapy for the child and their family, stress reduction, good nutrition, regular sleep and exercise, and participation in a network of support (CABF Learning Center- Facts about Early Onset Bipolar Disorder). Medication is usually the first course of action in an effective treatment plan. Similar to the differences between COBPD and bipolar disorder affecting adults pertaining to diagnosis, there are drugs that have been proven to work on adults that are not as effective in children. One of these drugs is the mood stabilizer, Lithium. Lithium and other mood stabilizers cause changes in the balance of chemicals in the brain. The difficulty with prescribing a mood stabilizer to a child with COBPD is that, while being effective on manic and hypomania episodes, they are not effective in decreasing depressive episodes.
In other words, taking a mood stabilizer may cause a childs cycling pattern to stop, but the child will still experience the depressive episodes. Lithium, as with other mood stabilizers, is also not as effective in children as it is Recently, mood stabilizers have become the second string of drugs used to combat bipolar disorder. The reasons being that the newer drugs (called Atypical Antipsychotics) are more effective, they work faster, are easier to use, and The most studied of the newer atypical antipsychotics is Risperdal (Risperidone). This drug has been found to be 85 % effective in combating the symptoms of Childhood Onset Bipolar Disorder (CABF Learning Center). Risperdal not only treats the mood swings occurring with bipolar disorder, but it also calms down the irritability and rages that these children often experience. As with all drugs, there are some side effects with Risperdal, with most people reporting a significant weight gain, but they are not common.
With bipolar disorder affecting over a million people in this country, researchers are constantly looking for safer, faster, more effective drugs. In a recent study, Dr. Michael H. Allen composed a group study of fifty-nine hospitalized patients exhibiting manic episodes. Dr.
Allen was interested in finding a treatment that would work rapidly and prevent hospitalization (Keck PE Jr. , Hirschfeld RMA, Allen MH et al. , Safety and efficacy of rapid-loading divalproex sodium For comparison, patients were assigned randomly to a ten day treatment schedule of loading doses of Depakote (a mood stabilizer), or non-loading doses of Depakote or Lithium. In the loading strategy, 20 patients received 30 mg per day of Depakote for days 1 and 2, and then dropped back to 20 mg per day in divided doses. In the non-loading strategy, 20 patients received 750 mg of Depakote daily in divided doses. In the Lithium strategy, 19 patients received The researchers found that all of the patients showed decreased signs of manic symptoms by day 3 of the study, but the patients assigned to the loading doses of Depakote showed improvement by day 2.
In addition, the difference between treatment groups was accentuated in patients with more severe manic symptoms (Keck et al. , 1999). Of course, no one medication works for all children with COBPD. Sometimes 2 or more are needed collectively to reach and maintain mood stability. Parents should expect a trial and error period in which their childs doctor may have to try many different medications in different combinations before the best treatment is found.
One way to speed up the trial and error process toward an effective medication is through the use of cycle charts. Cycle charts are a way of keeping track of your childs mood throughout the day, along with what medication is given and how often. These charts can be extremely important to the doctor when prescribing the medications as well as to the therapist conducting the psychotherapy. Recording a childs moods in the form of a simple graph, these cycle charts provide a visual display of the course of the illness and brings into focus the symptoms and behaviors that define the condition (Papolos and Papolos, 1999).
The second phase of treatment is psychotherapy. This is a very important stage and the reason it usually occurs after medication has stabilized the childs mood is because children experiencing rapid mood swings have not been found to benefit from counseling alone. Therapy issues include dealing with the stress that may trigger or worsen manic and depressive episodes. Counseling can also ensure the patients willingness to follow the prescribed course of treatment.
A good therapy plan should include support and education about Children with a bipolar disorder have other needs that need to be taken into consideration. One of the main problems facing these children is the difficulties they face in school. The medication necessary to stabilize their moods often leaves them feeling fairly sedated. The childs functioning can vary throughout the school year, sometimes it varies daily, and they can easily fall behind other students. Parents should suggest a meeting between the special education staff of their childs school, the childs therapist, and themselves.
Together, the best way to insure the childs educational development progresses smoothly is to put into action an Individualized Educational Program (IEP). This plan contains goals and objectives based upon the childs present educational level. The IEP also includes when the plan will begin, how long it will last, and the way in which the childs progress will be evaluated (LD OnLine: Bipolar disorder has left its mark on history. Many famous people have had symptoms of bipolar disorder; Abraham Lincoln, Theodore Roosevelt, Tolstoy, and Hemingway to name a few.
In fact, the biography of Beethoven discloses severe, recurrent mood swings beginning in childhood. In short, coming to a correct diagnosis of Childhood Onset Bipolar disorder can be very difficult and finding an effective treatment plan can be a long, drawn out process. However, if these obstacles are overcome, children suffering with a bipolar disorder can lead very normal, productive Bibliography: RESOURCES Todd, Richard D. The link between parental alcoholism and childhood mood disorders: A family / genetic perspective. Medscape Mental Health 2 (1997) DSM-IV. Journal of clinical psychopharmacology 16, supplement 1. (1996) Keck PE Jr. , Hirschfeld RMA, Allen MH et al. (1999), Safety and efficacy of rapid-loading divalproex sodium in acutely manic patients.
Ryan, Neal MD; Bhatara, Vinod S. MD; Per, James M. PhD. Mood stabilizers in children and adolescents.
Journal of the American academy of child & adolescent psychiatry, Volume 38, Number 5 (May 1999) Papolos, Dmitri MD; Papolos, Janice. The Bipolar Child. (1999) Waltz, Mitzi. Bipolar Disorders. (1 st edition Jan. 2000) CABF Learning Center- About Early Onset Bipolar Disorder: web Bipolar Affective Disorder (Manic Depressive Disorder) in Children and Adolescents: web pamphlet / bipolar /bipolar pamphlet. htm Child and Adolescent Bipolar Disorder; An update from the national Institute of Mental Health: web gov / publicat /bipolar update. cfm Facts About Childhood Onset Bipolar Disorder: http: //www. mh source.
com / hy /bipolar ch. html LD OnLine: IEP Individualized Education Program: The Process- web indepth / iep / iep progress. html
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Research essay sample on Childhood Onset Bipolar Disorder
