Bipolar disorder usually begins during adolescence or early adulthood, but it takes on average 10 years between the onset of symptoms and correct diagnosis and treatment. A recent article in the New York Times looks more deeply into the issues and controversies surrounding early diagnosis and treatment of bipolar disorder.
Dr. Boris Birmaher, professor of psychiatry at the University of Pittsburgh School of Medicine, is quoted as saying: “Pediatric bipolar disorder severely affects normal development and psychosocial functioning, and increases the risk for behavioral, academic, social and legal problems, as well as psychosis, substance abuse and suicide. The longer it takes to start appropriate treatment, the worse the adult outcomes.”
Yet young people with mood dysfunction are often treated for other disorders, such as ADHD, and may experience higher rates of prescription medication usage, even though psychiatrists who work with pediatric bipolar disorder find that, if the symptoms are identified early enough, young people may respond well to family and behavioral therapy that can help them avoid medication.
Parents trying to distinguish between mood dysregulation and normal teenage highs and lows should consider the following:
- grandiose thinking,
- decreased need for sleep,
- rapid or pressured speech and/or flight of ideas,
- racing thoughts,
- excessive goal-driven activity,
- impulsive or reckless behavior.
In the case of major depression, they should look for in impairment in functioning, which may include:
- suddenly not going to school or going late,
- not finishing homework,
- sleeping through classes,
- a drop in grades,
- not wanting to eat with anyone else,
- talking about suicide,
Young people with symptoms like these, if caught early, may be able to be treated with therapy and may not need medications, or may only need very low doses of medication (not overly sedating). However, doctors also warn, in severe cases, medication can sometimes be a necessary and life-saving intervention.
Involvement of the family is also critical, so that all family members may gain an understanding of the disorder and the treatment. Since bipolar disorder often runs in families, the more family involvement, the earlier it may be recognized and treated.