Juvenile Bipolar Disorder
...s rapid thinking and extreme energy to the point that the need to sleep is minimal. The adult in the phase has delusions of grandeur and experiences great sexual urges. Unfortunately, adults experiencing the highs make reckless decisions like shopping sprees or irresponsible sexual activity. This manic phase may last weeks or even months. Once the high is over, from the “peak”, they fall into deep depression with all its signs. Depression brings a dejected mood, lack of energy, insomnia or too much sleep (Papolos, 2002, P.5). With kids, things are not nearly so clear. (Kluger, 2002, P. 42) Children cycle back and forth from depression and elation with few discernable well periods in between. Some cycle so rapidly they have frequent spikes of highs and lows within a twenty-four hour period. These children veer from irritable, easily annoyed, angry mood states to silly, goofy, giddy elation, and then just as easily descend into low energy periods of intense boredom, depression and social withdrawal, fraught with self-recriminations and suicidal thoughts. (http://www.jbrf.org) Children with JBD have trouble falling asleep and waking up in the morning. Kept awake by their brain’s high activity, the night terrors they experience are extremely graphic and violent. They dream of, for example, being chased by sharks or monsters, but where typically nonbipolar child wakes up just before the teeth pierce an arm or leg, a bipolar child doesn’t. Dreams of fighting filled with blood and gore are also quite common. Dr. Popper explains that “In these individuals, its is as though their unconscious sensors or painful affect are not working, even in their dreams.” This may explain why some children with bipolar disorder say such shocking and almost sadistic things during the day. (Papolos, 1999, P. 11) They also suffer from paranoia or a fear of death or persecution. Nighttime can be terrifying for a bipolar child, but so can the day, when rages seem erupt. In the morning, bipolar children have difficulties waking up and are either irritable, with tendencies towards snapping and griping, or sullen and withdrawn. By midday, the darkness lifts, and bipolar children enjoy a few clear hours at school. But by 3 or 4p.m., the kids become wired, euphoric in a giddy, and strained way. (Kluger, 2002, P.43) This is the time when they suffer the most rages. These almost seizure-like tantrums can be triggered by a simple “no,” from parents. The child seems to have no control over the rage, going into a trance-like state. Tantrums can last for three hours at a time, several times a day, and can persist through adolescence if the child is not treated. (Papolos, 1999, P. 12, 15) Many parents of children suffering from bipolar disorder recall their child being “difficult” or “uneasy” from early infancy, or even in the womb. They tend to be inflexible and oppositional, extraordinarily irritable, and almost experience explosive rage. (Papolos, 1999, P. 6) Characteristically, the child’s separation anxiety is so extreme mothers can’t put the babies down. Indeed, this anxiety seems to arise long before and persist after its appearance and disappearance in nonbipolar children. (Papolos, 1999, P. 9) Some children with JBD show agonizing sensitivity to stimuli such as pockets in clothing, background noises or unpleasant smells. Though they tend to be verbally skilled and often creative, children with JBD find school difficult because the background noise of the disorder makes it hard for them to master such executive functions as organizing, planning, and thinking problems through. (Kluger, 2002, P. 43) For most kids, the consequences of not identifying the illness can be severe, since the bipolar steamroller gets worse as children get older. (Kluger, 2002, P. 43) Diagnosing the condition at a very young age is new and controversial, but experts estimate that an additional 1 million preteens and children in the US may suffer from the early stages of bipolar disorder. (Kluger, 2002, P. 40) No one symptom identifies a child as having Juvenile Bipolar Disorder, but if hyperactivity, irritable and shifting moods, and prolonged temper tantrums co-occur – and there is a history of mood disorders and/or alcoholism coming down either or both the mother’s or father’s line – the index of suspicion should be high. (Papolos, 1999, P. 7) Children with one bipolar parent have a 10% to 30% chance of developing the condition; a bipolar sibling means a 20% risk; if both parents are bipolar, the danger rises as high as 75%. (Kluger, 2002, P. 43) Obtaining treatment and services has been a struggle at times due to lack of parity in mental health insurance coverage, a lac...