Helping Children and Teenagers to Cope with Life
Bi-Polar Disorder
CONTENTS
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SECTION 1        Introduction

SECTION 2        Symptoms of Bi-Polar Disorder

SECTION 3        Help and Treatment, and How to Get It

SECTION 4        Further Information and Support
SECTION 1                Introduction

Bi-Polar Disorder is the modern name for what used to be called "Manic Depression".

As the old name suggests, people with Bi-Polar tend to have severe mood swings between intense feelings of depression and despair, on the one hand, and wild bouts of mania where they feel "on top of the world", elated and bursting with energy.  For a more complete list of symtoms, see below. 
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This can be a serious illness, BUT (and it's a very big "but") it is important to remember that anyone who is suffering from ("ordinary") Depression will also find themselves at times feeling happier, somewhat elated and with more energy.  These relatively minor mood swings are very common, and they are not -- repeat, NOT -- a sign that you have Bi-Polar Disorder.  Indeed, it is one of the most frequent questions that Doctors are asked by patients being treated for Depression: "Doctor, I'm getting these mood swings, does that mean I have Bi-Polar?"  And, in the vast majority of cases, the answer is, "No, it does not!"
SECTION 2                Symptoms of Bi-Polar Disorder

The Depression

The feeling of depression is something we all experience from time to time. It can even help us to recognise and deal with problems in our lives but in clinical depression or bipolar disorder, the feeling of depression is worse. It goes on for longer and makes it difficult or impossible to deal with the normal things of life. If you become depressed, you will notice some of these changes:

Emotional:-

  -- feelings of unhappiness that don't go away
  -- feeling that you want to burst into tears for no reason
  -- losing interest in things
  -- being unable to enjoy things
  -- feeling restless and agitated
  -- losing self-confidence
  -- feeling useless, inadequate and hopeless
  -- feeling more irritable than usual
  -- thinking of suicide 

Thinking:-

  -- can't think positively or hopefully
  -- finding it hard to make even simple decisions
  -- difficulty in concentrating
 
Physical:-

  -- losing appetite and weight
  -- difficulty in getting to sleep
  -- waking earlier than usual
  -- feeling utterly tired
  -- constipation
 
Behaviour:-

  -- difficulty in starting or completing things -- even everyday chores
  -- crying a lot -- or feeling like you want to cry, but not being able to
  -- avoiding contact with other people


The Mania

Mania is an extreme sense of well-being, energy and optimism. It can be so intense that it affects your thinking and judgement. You may believe strange things about yourself, make bad decisions, and behave in embarrassing, harmful and -- occasionally -- dangerous ways.

Like depression, it can make it difficult or impossible to deal with life in an effective way. A period of mania can affect both relationships and work.

When it isn't so extreme, it is called 'hypomania'.

If you become manic, you may notice that you are:

Emotional:-

 -- very happy and excited
 -- irritated with other people who don't share your optimistic outlook
 -- feeling more important than usual 

Thinking:-

 -- full of new and exciting ideas
 -- moving quickly from one idea to another
 -- hearing voices that other people can't hear

Physical:-

 -- full of energy
 -- unable or unwilling to sleep

Behaviour:-

 -- making plans that are grandiose and unrealistic
 -- very active, moving around very quickly
 -- behaving in unusual ways
 -- talking very quickly
 -- other people may find it hard to understand what you are talking about
 -- making odd decisions on the spur of the moment, sometimes with disastrous consequences
 -- recklessly spending your money
 -- over-familiar or recklessly critical with other people
 -- less inhibited in general

If you are in the middle of a manic episode for the first time, you may not realise that there is anything wrong although your friends, family or colleagues will. You may even feel offended if someone tries to point this out to you. You increasingly lose touch with day-to-day issues and with other people's feelings.

Psychotic Symptoms

If an episode of mania or depression becomes very severe, you may develop psychotic symptoms.

In a manic episode:-

 -- these will tend to be grandiose beliefs about yourself - that you are on an important mission or that you have special powers and abilities.

In a depressive episode:-

 -- you may feel that you are uniquely guilty, that you are worse than anybody else, or even that you don't exist.

As well as these unusual beliefs, you might experience hallucinations - when you hear, smell, feel or see something, but there isn't anything (or anybody) there to account for it.
SECTION 3                Help and Treatment, and How to Get It

As for most forms of illness, physical or mental, the first thing you should do is to go and see your Doctor.  With mental illness in particular, many people feel unwilling to do this: they may feel it's a sign of weakness or "moral failing" to do so.  Please read our section on Seeking Help for more advice on this.  [NB: Add link!]

These are some of the ways you can obtain help:-

Medication

A number of drugs are available to help reduce both the depression and mania with Bi-Polar Disorder.  Probably the most effective and most frequently prescribed is Lithium.

Lithium has been used as a mood stabiliser for 50 years but how it works is still not clear. It can be used to treat both manic and depressive episodes.

Treatment with Lithium should be started by a psychiatrist. The difficulty is getting the level of Lithium in the body right -- too low and it won't work, too high and it becomes toxic. So, you will need regular blood tests in the first few weeks to make sure that you are getting the right dose. Once the dose is stable, your GP can prescribe your Lithium and arrange the regular blood tests.

The amount of Lithium in your blood is very sensitive to how much, or how little, water there is in your body. If you become dehydrated, the level of Lithium in your blood will rise, and you will be more likely to get side-effects, or even toxic effects. So, it's important to:
 -- drink plenty of water -- more in hot weather or when you are active;
 -- be careful with tea and coffee: they increase the amount of water you pass in your urine.

It can take three months or longer for Lithium to work properly. It's best to carry on taking the tablets, even if your mood swings continue during this time.

Psychological Treatments

In between episodes of mania or depression, psychological treatment can be helpful.  This may include:-

 -- psychoeducation finding out more about bipolar disorder
 -- mood monitoring helps you to pick up when your mood is swinging
 -- mood strategies to help you stop your mood swinging into a full-blown manic or depressive episode
 -- help to develop general coping skills
 -- cognitive behavioural therapy (CBT) for depression
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Helping Yourself

1)        Self-monitoring

Learn how to recognise the signs that your mood is swinging out of control so you can get help early. You may be able to avoid both full-blown episodes and hospital admissions. Keeping a mood diary can help to identify the things in your life that help you -- and those that don't.

2)        Stress

Try to avoid particularly stressful situations - these can trigger off a manic or depressive episode. It's impossible to avoid all stress, so it may be helpful to learn ways of handling it better.
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If you get too stressed you may bring on a manic episode.

Make sure that you have enough time to relax and unwind.  Make sure you regularly do things that you enjoy and that give your life meaning.

3)        Exercise

Reasonably intense exercise for 20 minutes or so, three times a week, seems to improve mood.

4)        Continue with your medication

You may want to stop your medication before your doctor thinks it is safe -- unfortunately this often leads to another mood swing. Talk it over with your doctor and your family when you are well.

Help and Support from Family and Friends

It's helpful if you have at least one person that you can rely on and confide in. When you are well, try explaining your illness, and how it makes you feel, to people who are important to you. They need to understand what happens to you -- and what they can do to help you cope.
SECTION 4                Further Information and Support

The Bipolar Organisation

"The BiPolar Organisation works to enable people affected by bipolar disorder / manic depression to take control of their lives. We aim to fulfil this mission by:

 -- Supporting and developing self-help opportunities for people affected by manic depression;

 -- Expanding and developing the information services about manic depression;

 -- Influencing the improvement of treatments and services to promote recovery;

 -- Decreasing the discrimination against, and promoting the social inclusion and rights of people affected by manic depression;

 -- Being an effective and efficient organisation with sufficient resources to sustain and develop our activities, thereby ensuring members receive a unique, high quality service."


UK based, but this site offers a wealth of advice for both sufferers of Bi-Polar Disorder and their parents/families/carers.  Click here.

BiPolar Children And Teens

"Information to help parents deal with BiPolar Disorder in their Children and Teens."

Click here.

Facts About Childhood-Onset Bipolar Disorder

NAMI (National Alliance on Mental Health) fact sheet details symptoms, treatment, prognosis.  Click here.

Parenting Bipolar Children

"This website was set up BY parents and caregivers FOR parents and caregivers of children with bipolar disorder, mental illness, emotional problems, behavioral problems, troubled teens."

Click here.
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