4 Troubled Teens Blog

Diagnosing a child with "severe mood dysregulation" or "temper dysregulation with dysphoria" may be a better idea than diagnosing them with bipolar disorder, according to an article in the Journal of Child and Adolescent Psychiatry and Mental Health.

If agreed upon, these terms would replace bipolar disorder in the new edition of the Diagnostic and Statistical Manual used by physicians to diagnose and treat mental disease.

"Physicians do not know exactly what is wrong with these children or how to treat it," the authors wrote. "Facing up to these limitations could lead to better treatment recommendations and more accurate long-term prognosis."

Even children as young as two and three years old displaying severe mood swings and violent temper tantrums are being diagnosed with bipolar disorder, a disease that physicians formerly believed began in late adolescence.

Health insurance companies can demand certain diagnoses such as bipolar disorder in order to pay for treatment.

Labels: children, dsm-v, bipolar

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The number of preschoolers diagnosed with bipolar disorder doubled in the past ten years, according to new research in the Journal of the American Academy of Child and Adolescent Psychiatry. The number of children under 18 years old diagnosed with the disorder has increased by forty times over in the same period.

• About 1.5 percent of children ages two to five years old are now taking some kind of psychotropic drug, according to the new study by Dr. Mark Olfson, professor of clinical psychiatry at Columbia University.
  
• These drugs may include antipsychotics, mood stabilizers, stimulants or antidepressants.
• Bipolar disorder, which involves severe mood changes, was once thought only to appear in late adolescence.
  

It is hard to diagnose psychiatric disorders in very young children because bipolar disorder, Attention Deficit Hyperactivity Disorder, sexual abuse and family dysfunction can produce similar symptoms.

Dr. Olfson said that physicians should prescribe drugs to preschoolers only after they have tried other interventions, "but that's not happening if you look at the billing records" from insurance and drug companies.

Labels: bipolar, mental_health, mental_illness

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A new study found that European doctors are less likely to diagnose children with bipolar disorder than are their American counterparts. About one-fourth of European children with the disorder have delays in their medical diagnosis of up to three and a half years.

• Professor Immaculada Canales and her colleagues found that part of the problem is the difficulty in analyzing the symptoms of bipolar disorder in children.
• Symptoms can include irritability, behavioral disorders, lack of attention, hyperactivity, and depression.
• These symptoms are similar to other pediatric mental disorders.
• Children with bipolar disorder are less likely to show classic bipolar symptoms like euphoria and expansiveness that adult patients do.

Some studies have shown that 60 percent of adults with bipolar disorder had symptoms of the disorder before age 20.

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Doctors should consider irritability as a symptom of bipolar disorder in children, according to a new study from Bradley Hospital and the Warren Alpert Medical School of Brown University:

• Dr. Jeffrey Hunt studied 361 children ages seven to 17 years old, when they were in the manic stage of bipolar disorder.
• He classified their symptoms into elation-only, irritable-only or elation-irritable.
• Only 10 percent of these children fell into the irritable-only category, and elation-only was 15 percent.
• The vast majority (75 percent) were in the elation-irritable category.

"Diagnosing children with bipolar disorder is challenging," Dr. Hunt said. "One of the chief controversies is whether irritability should be included among the criteria for the diagnosis because it can overlap with a number of other psychiatric disorders such as Attention Deficit Hyperactivity Disorder. Our findings confirm that irritable-only mania is uncommon, but it does exist -- particularly in younger children -- and should be considered in a bipolar diagnosis."

The number of children diagnosed with bipolar disorder has increased dramatically over the last decade. Bipolar disorder is characterized by dramatic mood swings.

Dr. Hunt's study appeared in the Journal of the American Academy of Child and Adolescent Psychiatry.

Labels: bipolar, mental_illness, irritability

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Three drug companies have asked the Federal Drug Administration's review board to approve the use of antipsychotic drugs for children as young as 10 years old who have bipolar disorder or schizophrenia.

A June 5 Reuters article by Lisa Richwine and Susan Heavey provided the following details about the request:

The Food and Drug Administration is considering whether to approve AstraZeneca's Seroquel, Pfizer's Geodon and Eli Lilly and Co's Zyprexa for children and teens with schizophrenia or bipolar disorder. All three are blockbuster medicines already sold for adults.

An FDA panel meets next week to make recommendations on the companies' bids to promote the drugs for children and teens.

Doctors can already prescribe them for children, but FDA approval would allow companies to promote the drugs, with combined sales of over $10 billion a year, more widely.

The request was followed by criticisms from organizations who are concerned about the effects of antipsychotic drugs on children.

"The studies done so far on these drugs provide almost no information about the long-term effects of them on children," said Diana Zuckerman of the National Research Center for Women and Families.

Labels: schizophrenia, children, bipolar, antipsychotic, medications, fda

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A University of Colorado professor has received a grant from the National Institute of Mental Health to design "family focused" therapy for young people who have bipolar symptoms.

Dr. David Miklowitz, a leading expert on bipolar disorder, will be working with young people ages 8 to 17 years old, who have risk factors but who may not necessarily been diagnosed with bipolar disorder.

"One of the key questions we are asking is if you intervene early with family-focused treatment, do you actually delay the onset of the full disorder or perhaps reduce its severity once it has manifested?" Dr. Miklowitz said.

People usually do not undergo treatment until after they are diagnosed as bipolar.

Read more about Bipolar Disorder in Teen Girls at BoardingSchoolsforGirls.com.

Labels: bipolar, treatment_programs, diagnosis

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Psychiatrist Candida Fink, MD, and Joe Kraynak, MA, have released a book titled Bipolar Disorder for Dummies (Wiley, 340 pages, $19.99). Developed as a practical guide to understanding, treating and living with bipolar disorder, the book offers an explanation of the brain chemistry that causes the disease, and discusses the latest medications and therapies available.

"It offers sound advice and self-help techniques that you and your loved ones can use to ease and eliminate symptoms, function in times of crisis, plan ahead for manic or depressive episodes and feel better. Topics covered include: diagnosis and treatment, selecting a mental health specialist, mood charting, managing employment-related issues, and how bipolar disorder affects children."

The sound advice and techniques offered in Bipolar for Dummies can help families navigate this often unpredictable disease, and help them do it together - rather than letting the disease tear them apart.

Learn about Bipolar Disorder in Girls.

Labels: brain_chemistry, bipolar, girls

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A study of college students and mental illness found that more students are coming to campus with pre-existing conditions such as bipolar disorder and depression. Although these are serious illnesses, the research indicates that better treatments may be enabling more of them to overcome their illnesses and succeed at college.

• Researchers from Hofstra University in New York studied the records of 3256 college students who used counseling services between 1997 and 2009.
• In 1998, 93% of the students had at least one mental disorder, but by 2009, that had increased to 96%.
• The number of students on psychiatric medicines increased by ten percentage points in the 12-year period.

"The percentage of students with moderate to severe depression has gone up from 34% to 41%," said Dr. John Guthman, lead author. "These outliers often require significantly more resources and may contribute greatly to the misperception that the average student is in distress."

One positive finding was that the number of students who thought about suicide declined by more than half.

The study was presented at the annual convention of the American Psychological Association.
 

Labels: bipolar, mental_health, depresion, college

Posted By: Jane St. Clair 0 Comments

Depressed people may actually have bipolar disorder even if they don't experience full-blown episodes of mania, according to a new study from the National Institute of Mental Health. The study found that depressed people who have short episodes of increased energy and activity and especially those with a family history of bipolar disorder are at risk for the disease themselves.

• The old thinking was that bipolar disease is characterized by depression followed by episodes of mania that last several weeks or months.
• During the "manic" phase of bipolar disease, the person may go without sleep, have increased levels of energy and activity, speeded-up thinking and euphoria.
• Then the person "crashes" into depression, often accompanied by suicidal thoughts.
• This new study indicates that depressed people who experience low levels of mania, even an episode lasts just a few hours or days, may actually have bipolar disease.
• Dr. Kathleen Merikangas, an investigator with the Intramural Research Program at the National Institute of Mental Health in Maryland, used information about mood disorders gathered from more than 5000 households in her study.
• Dr. Merikangas said that people who have up-and-down shifts in moods, even ones that are short, should be evaluated by mental health professionals.

"There is a continuous shading from pure depression to classic bipolar disorder," said Dr. Gregory Simon, a psychiatrist and chair of the scientific advisory board of the Depression and Bipolar Support Alliance. "This study gives stronger evidence for that continuous shading and demonstrates more clearly that milder symptoms of hypomania are truly related to bipolar disorder."

The study appears in the American Journal of Psychiatry.
 

Labels: depression, bipolar, mental_health

Posted By: Jane St. Clair 1 Comment

A concerned mother recently wrote to psychiatrist Dr. Charles Raison regarding her son’s mental health. He’s been diagnosed with bipolar disorder and says he hears voices telling him to kill himself. The mom is understandably scared and unsure what to do.

“Of the problems you list, the two I worry about most as a psychiatrist are the suicidal thoughts and the psychotic symptoms (i.e. hearing voices)… So job one is to make sure your son is safe. I realize this is easier said than done, but I want to highlight that first and foremost.” [Source: CNN]

Dr. Raison goes on to encourage the mother to continue seeking treatment for her son, even if past treatments haven’t worked. There’s always hope that something else will work, and her son will get better. In the meantime, he advises her to keep an eye on her son and ask for as much help from family and friends as she needs.
 

Labels: suicide, bipolar

Posted By: Stefanie Hamilton 1 Comment