Abstract
Childhood depression and bipolar disorder are common occurrence in childhood although extensive research on the same started in 1970s. Depression is generally a condition distinguished by sadness, worthlessness as well as inability to experience happiness and any type of pleasure while bipolar disorder is a mood disorder characterized by intense changes in the level of energy, behavior as well as mood. Since both conditions are characterized by depressive symptoms, the same are used during diagnosis.
Nevertheless, diagnosis is usually difficult because most symptoms are also present in other mental disorders and therefore, tests are performed before hand to avoid misdiagnosis. Once a child is diagnosed, treatments are carried out immediately to avoid further complications. Treatment options are inclusive of drug therapy as well as behavioral and cognitive therapy. The field calls for more research especially on drug therapy in order to come up with the most effective drugs.
Childhood depression and bipolar disorder is a common occurrence in children though initially children were not being treated for depressive illnesses. Definition of depression is controversial but it is generally a condition distinguished by sadness, worthlessness as well as lack of the ability to experience happiness and any type of pleasure.
However, there are many types of depression that are inclusive of major depression, bipolar disorder and dsythymia. Studies indicate that extensive research on childhood depression started in 1970s and prevalence rate ranges from about 2.5% in young children (Miller, 1999).
Moreover, researchers and scientists believe that although around 7% of all the children that visit psychiatrists are diagnosed with bipolar disease, the number may actually be higher as the disease is usually under diagnosed. In most cases, childhood depression displays both maniac and depressive symptoms and the reason why it is grouped together with bipolar disorder.
Bipolar disorder is generally a mood disorder characterized by intense changes in the level of energy, behavior as well as mood. Mostly, children suffering from bipolar disorders experience low moods marked by depressive symptoms and high moods marked by maniac symptoms. Depressive symptoms as illustrated in Diagnostic and Statistical Manual for Mental Disorders may include sadness, thoughts of death and suicide that are recurring as well as being over sensitive to rejection and worthlessness, to name just a few.
According to Kring, Johnson, Davison, & Neale (2009), maniac symptoms are inclusive but not limited to risky behaviors such as sexual activities and abuse of substances, irritability, extreme happiness, aggression and general hyperactivity. With that background in mind, this essay shall discuss more about childhood depression and bipolar disorder, diagnosis of the same as well as treatment methods.
Before embarking on diagnosis, it is important to discuss its origin and the cause. According to NARSAD (n. d.), bipolar disorder is influenced by genetics since about 85% of all the victims happen to have family members suffering from the same. Although there is no single gene which is responsible for the disorder, it is believed that it results from multiple genes and environmental factors.
The disorder affects the brain as it results from chemical imbalances caused by either irregularity in the production of certain hormones or a problem with neural transmitters. Nonetheless, research on how the disorder affects the brain is still ongoing (American Academy of Child Adolescent Psychiatry, 2008) and (Durand & Barlow, 2005).
Diagnosis of bipolar disorder is usually complicated and a difficult exercise to most physicians. The complexity is attributed to the fact that most of the symptoms in children are taken to be normal occurrences. In addition, some symptoms are also similar to symptoms of certain mental illnesses that affect children like attention deficit disorder. Consequently, it becomes quite difficult to recognize the disorder during early childhood as studies of Geller & DelBello (2005) and Weiner (2003) indicate.
Nevertheless, physicians have come up with some symptoms which are uncommon in other disorders to help in the diagnosis. Grandiose behaviors marked by a belief that it is possible to act in certain ways without being hurt and high moods like being happy without any apparent reason are used in diagnosis. Additionally, failure to sleep with no effect, hyper sexuality marked by inappropriate sexual behaviors and language are also used by physicians during diagnosis.
Lastly, since such children also talk in excessive jumping from one topic to another, the same is also used in diagnosis. It is also common for children suffering from bipolar disorder to experience many mood cycles such as suicidal depressions. On the same note, it is important to mention that a complete diagnosis evaluation requires psychological, psychiatric and medical testing in order to rule out any other psychological or mental condition (NARSAD).
Similar to bipolar disorder, childhood depression is also diagnosed using some specific symptoms although the criterion has been changing in reference to the research that is being conducted. For example, in the year 1971, the condition was being diagnosed using symptoms such as low self esteem, dysphoric mood and some other depressive symptoms such as poor performance, lack of appetite and difficulties in interaction, to mention just a few.
In 1978, further research proposed depression to be characterized by depressive mood and some other symptoms like thoughts of suicide, excessive guilt and obsessions were included in diagnosis. As highlighted earlier, such criterion is complicated and not specific at all (National Institute of Mental Health, 2009 ).
Treatment of bipolar disorder is very important because when done effectively and in time, it helps children live normally and achieve their full potentiality. A comprehensive treatment plan should not only involve professionals, but also the care takers and the sick children.
The disorder can be treated using medications and can also involve behavioral as well as cognitive therapy. There are various medications that are used in treatment of bipolar disorder and it is important to note that since research is still ongoing, children are treated with drugs that are used to treat the same disorder in teenagers and adults. Antipsychotic drugs that have been approved by FDA include quetiapine, risperidone, olanzapine and aripipazole (American Academy of Child Adolescent Psychiatry, 2008).
There are other drugs which are not antipsychotics but have been approved by Food and Drug Administration (FDA). For instance, a mood stabilizer like lithium is also used although it affects the kidneys. Various antidepressants are also used although FDA advices that using them for a long time is risky and should be limited.
Anticonvulsants like valproic are used although they are not approved by FDA. Biological treatment is also an effective method of treatment which makes use of electroconvulsive therapy. However, although the method is effective, it is only used as an end result incase the other treatment fail to yield favorable results (Lima, 2004).
Based on the fact that people suffering from depression or bipolar disorder are marked by distorted views on the world and future, cognitive behavioral therapy can be used effectively as a treatment method. It aims at reducing or eliminating any distortions that victim may be having. Studies conducted indicate that cognitive behavioral therapy is effective more than family or even supportive therapy. In addition, patients going through psychotherapy are more responsive to other forms of treatment.
Interpersonal therapy can also be used although it is more effective in older children. It is important to note that even after symptoms of depression have disappeared, it is necessary to continue with psychotherapy due to the fact that the process equips the parties involved with skills that can help them deal with the aftermath of the disease. (Carson, Butcher, & Mineka, 1999)
Childhood depression and bipolar disorder is a serious condition that calls for attention of researchers and other scientists. Although it has been difficult to carry out epidemiological studies, available research indicates that it is caused by genes as well as by personal and environmental factors (Hersen & Van Hasselt, 2001).
Bipolar disorder is just a single diagnostic category of childhood depression though it is characterized by both maniac and depressive symptoms. Since there are many childhood disorders that concur with depression, it is important to rule out all other underlying conditions to avoid misdiagnosis.
Upon diagnosis, treatment should starts immediately to curb development of other complications. Treatment options include either family or personal therapy as well as drug therapy. However, scientists and researchers indicate that since some drugs like tricyclics have got serious side effects, it is important to use drugs with few effects like the selective serotonin reuptake inhibitors.
References
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Carson, R. C., Butcher, J. N., & Mineka, S. (1999). Abnormal psychology and modern life. Boston: Allyn and Bacon.
Durand, V. M., & Barlow, D. H. (2005). Essentials Of Abnormal Psychology. Stamford: Cengage Learning.
Geller, B., & DelBello, M. P. (2005). Bipolar Disorder in Childhood and Early Adolescence. New York: Guilford Press.
Hersen, M., & Van Hasselt, V. B. (2001). Advanced abnormal psychology. Chicago: Springer.
Kring, A., Johnson, S., Davison, G. C., & Neale, J. M. (2009). Abnormal Psychology. Hoboken: John Wiley and Sons.
Lima, D. (2004). Bipolar disorder and Depression in Childhood and in Adolescents. Journal de Pediatria , 80 (2), S11-S20.
Miller, J. A. ( 1999). The childhood depression sourcebook. Lincolnwood: McGraw-Hill Professional.
NARSAD. (n.d.). Bipolar Disorder in Children. Web.
National Institute of Mental Health. (2009). Depression in Children and Adolescents. Web.
Weiner, I. B. (2003). Handbook of Psychology: Clinical psychology. Hoboken: John Wiley and Sons.