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Childhood Onset Bipolar Disorder (COBPD) is one of the most debilitating mental disorders affecting children today. Bipolar Disorder is a mood disorder usually affecting adults that causes sometimes severe changes in mood. Childhood Onset Bipolar disorder is just what it sounds like, a bipolar disorder that occurs during childhood. Persons suffering from a bipolar disorder experience mood swings ranging from depression to mania. During a depressive episode patients can experience feelings of extreme hopelessness or sadness, inability to concentrate and trouble sleeping. Symptoms of mania include rapidly changing ideas, exaggerated cheerfulness and excessive physical activity.
Hypomanic symptoms are the same as in mania, however, they are not so severe as to require The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) outlines the diagnostic criteria for mood disorders. According to the DSM-IV, a person must have at least 5 of the following symptoms during the same 2 week period to qualify as a major depressive episode: a depressed mood lasting most of the day for several days; a significant weight gain or weight loss; a loss of interest in activities; difficulty sleeping (insomnia) or an increased need for sleep (hypersonic); restlessness or slowed pace observable by others; daily fatigue; feelings of guilt or worthlessness; inability to concentrate; or recurrent thoughts of death. These symptoms can only be diagnosed as a depressed episode if they are not better explained by grief, effects of a drug, or a medical condition. The person experiencing these symptoms must, also report an interference in their daily functioning because of the symptoms. Finally, the persons symptoms do not meet the The criteria for a mixed episode state that the person must display symptoms of depression and mania every day For an episode to be categorized as manic, the patients mood has been irritable or abnormally elevated for at least 1 week. A person must also exhibit at least 3 of the following symptoms (4 if the mood is only irritable): extreme feelings of personal greatness; a decreased need for sleep, marked talkativeness; destructibility; extreme focus on a goal-directed activity; reports of racing thoughts or a flight of ideas; or excessive involvement in pleasurable activities that have a high potential for painful consequences (i.
e. sexual indiscretions or unintelligent business investments). As in the criteria for a depressed episode, the DSM-IV specifies that these symptoms should not be better explained as being a side effect of a drug or illness to qualify as a manic episode. These symptoms must interfere with the persons normal functioning and must not meet the criteria for a mixed episode. As with adults, childhood-onset bipolar disorder has many faces. Children with Bipolar I Disorder have episodes of mania and episodes of depression, sometimes there are long periods of normal moods between episodes.
Adults usually tend to have more depressed episodes than manic episodes. However, some children will have chronic mania (symptoms of mania lasting for long periods of time or marked by frequent recurrence) and seldom experience a depressed episode. Bipolar II Disorder causes depressive episodes, sometimes lasting for long periods of time. It can also cause hypo manic episodes, but manic episodes are not present. Unlike Bipolar I Disorder, for persons with Bipolar II Disorder, periods of normal moods are virtually nonexistent.
Cyclothymia is characterized by frequent hypo manic episodes and occasional episodes of mild depression only. Some children have repeated hypo manic episodes a year. Persons showing signs of depression and mania at the same time is referred to as being in a mixed state. Bipolar I Disorder, Bipolar II Disorder, Cyclothymia, and Mixed State Bipolar Disorder are all very rare in For many years it was assumed that children could not suffer the mood swings of mania or depression, but as more research has been done, we have realized that bipolar disorder can occur in children, and it is much more common than previously thought. Although, the DSM-IV does touch on the subject of children with mood disorders, they are still diagnosed according to adult criteria. In children, mania and hypomania appear as more of an irritable mood.
These features come and go throughout the day and are not as persistent as in adults. When bipolar disorder is present in children it is more severe and harder to treat. Children tend to experience extremely rapid mood swings, often cycling from mania to depression and back to mania several times a day. The most typical pattern of cycling among those with COBPD, called ultra-ultra rapid or ultra dian, is most often associated with low arousal states in the mornings followed by increases in energy towards late afternoon or evening (Facts about COBPD; web Difficulties with early onset bipolar disorder begin with diagnosis. The rapid cycling of moods in children with COBPD make it difficult to fulfill the duration criteria of Bipolar Disorder. The DSM-IV states that depressive or manic episodes are to last a specific length of time, at least 4 days in a manic episode and at least 2 weeks in a depressive episode.
The majority of children suffering from COBPD do experience these ultra-ultra rapid patterns of mood swings. The DSM-IV does include a section entitled Bipolar Disorders Not Otherwise Specified (NOS), which allows for mood swings not lasting the full duration criteria (DSM-IV- Sub affective disorders: Dysthymic, Cyclothymia, and Bipolar II Disorders in the borderline realm). However, this is still not an accurate description of COBPD. Many parents of children with COBPD report that their children have seemed different from infancy. They describe difficulties calming their babies, and they relate that their children have always been very sensitive to sensory stimulation, i. e.
sounds, lights, touches. Many children have extreme difficulty sleeping and some experience night terrors (Facts about Childhood-Onset Bipolar Disorder). A child suffering from COBPD may be easily frustrated and have terrible temper tantrums lasting until the child is literally exhausted. These children tend to be bossy and have trouble adjusting to new situations, especially situations that they have no control over. Some children with a bipolar disorder are extroverted and very charismatic while other children experience bouts of social phobia (extreme discomfort in a social situation). Without closer observation, hyperactive, irritable, distract ible children are believed to have Attention Deficit Disorder with Hyperactivity (ADHD).
As a matter of fact, a million children and adolescents in the United States may have COBPD, of these 1 million people, an estimated 23 percent are currently diagnosed with ADHD (Mitzi Waltz, Bipolar Disorders, 1 st Edition January 2000) Attention Deficit disorder with hyperactivity and COBPD do have many of the same warning signs and symptoms. Persons diagnosed with ADHD experience an inability focusing attention on a task, or difficulty organizing tasks. They do not seem to listen when spoken to, have difficulty following instructions, avoid tasks that require mental effort, are easily distract ible, experience recurrent forgetfulness, and repeatedly lose materials necessary to complete a task, i. e.
books, tools, pencils. Dr. Dmitri Papolos has stated that over eighty percent of children who have COBPD will meet the full criteria set by the DSM-IV for ADHD (Papolos and Papolos, The Bipolar Child). What differentiates the two disorders is the fact that children with a bipolar disorder exhibit much more irritability, unstable mood, and sleep disturbances than children with There are many theories as to what may cause COBPD. Alan S. Brown, MD, and colleagues have proposed that there may be a relationship between prenatal malnutrition and COBPD.
Brown and his colleagues studied hospitalization records of Dutch psychiatric patients who were exposed inter to the harsh climate and extreme food shortage of the 1944 Dutch winter. By looking at hospital records of people exposed to this environment during the first trimester, second trimester, third trimester and a control group (who were not exposed at all), Brown and his colleagues found that men and women exposed inter to famine and harsh climate during the second and third trimester were more likely to develop a bipolar disorder than those exposed during the first trimester or not exposed at all. Also, the incidence for unipolar disorder (a mood disorder in which a person experiences only depressive episodes) was more significant than for bipolar disorder (Brown AS, Summer ES, Lin SP et al. 1995) in those exposed during the first trimester or not exposed at all. According to more recent studies, one of the main factors in establishing a diagnosis of COBPD is family history. This means that there is a significant link between COBPD and genetics. Dr.
Richard Todd and his colleagues at Washington University in St. Louis found increased rates of COBPD when family histories reveal a mood disorder and / or alcoholism on both the maternal and paternal sides. By transferring information from questionnaires into a database, it was found that over 80 percent of children diagnose...
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Research essay sample on Childhood Onset Bipolar Disorder
