pediatric bipolar

Medication Challenges for Pediatric Bipolar: Discovering Effective Medication without Research

Although there are research studies designed to study the effectiveness of mood stabilizers for adults with bipolar disorder, there are no studies designed specifically for children. With this in mind, psychiatrists need to infer which adult medications may be effective for children and at which dose from studying the pharmacological research studies in adults.

Medications are tried and discontinued based on how well the child responds to the medication rather than on baseline research studies utilizing children as the subjects. This in and of itself is a frustrating and long journey for families. Months can be spent experimenting with different medications before a medication is found that is effective.

Setting the Medication Dosage

Once a medication is found effective, the problems are not over. The next challenge is setting the medication dosage. Again, this can take months of readjusting the dosage before an effective dose is found. Even once a dose is found, it may not be effective for very long because children are growing and their body mass is constantly fluctuating.

Psychiatrists are often very conservative with raising the dosage because of the unknown side effects of some of these medications on children. Again, with adult pharmacological studies, side effects are documented and are posted with the medication description. The side effects of these medications on children are unknown.

Family members, teachers, and medical professionals need to constantly monitor bipolar children for any changes in behavior that might suggest that the children have outgrown their current dosage. Unfortunately, bipolar behavior can spiral quickly out of control before the cause is identified as a decrease in effectiveness of the medication.

Over-Sedating is Not the Answer

Another concern with children is that the doses need to be carefully balanced so that the medication is maximally effective without the side effect of drowsiness. Children diagnosed with bipolar disorder need to be alert in school and able to function at an optimal level. Over-sedating a child is not the answer.

Children need to be able to interact with their peers and work through the daily challenges of their emotions. Sedating the child to keep the child from over-reacting to the stimulation around him/her will not help the child to learn to function in society.

However, children with bipolar do have difficulty with sleep patterns and may be over tired from time to time. If this occurs, allow the child a quiet place to rest. When the child awakes, allow the child to continue with his/her classroom activities.

Hormone Surges and Medication Dosage

Another concern when working with medication and children is the effect of hormone surges as the child approaches puberty. Hormones can exacerbate a child’s bipolar condition. Careful attention needs to be paid to extreme fluctuations in behavior as the child approaches puberty. This might also indicate the need for an increase in the dosage of medication.

Managing medication for pediatric bipolar disorder is an on-going challenge. Fluctuations in body mass and hormones can make an effective medication ineffective very quickly. Close observation by all involved in the child’s care is critical to catching a potential medication problem early.

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manic symptoms

Manic Symptoms in Bipolar Disorder

Bipolar disorder is a mood disorder marked by intense shifts in a person’s mood. Formerly called manic-depression, bipolar disorder can affect many aspects of a person’s life, including their sleeping and eating habits, their day-to-day functioning, their relationships, and even their job and financial situation. While the hopelessness of depression may cause patients to seek treatment, patients who experience symptoms of mania may be unable to recognize their illness.

What Is Mania?

A person who is manic will experience a dramatic upswing in their mood and feeling of well-being. They may feel more outgoing than usual, need less sleep, and feel capable of taking on many ambitious projects. Some common manic symptoms are:

  • racing thoughts, which may cause the person to speak more quickly than usual
  • becoming very easily distracted and having many ideas on the go
  • feeling restless and needing much less sleep than usual
  • having delusions of grandeur or inflated confidence about their abilities
  • impulsive, risky behaviour, such as increased sexual activity, driving too fast, making impulsive investments or spending a lot of money on shopping sprees
  • severe manic episodes can also include psychotic symptoms such as seeing or hearing things that aren’t there, or false beliefs like being famous or having magical powers

Bipolar disorder symptoms can drastically affect a person’s life, and can sometimes be so severe that the patient requires immediate inpatient care. There are varying degrees of severity within bipolar disorder, and not every patient will experience the same symptoms. Full-blown mania is often a symptom of Bipolar 1 disorder.

Manic Symptoms Are Not Always Enjoyable

While bipolar patients are frequently portrayed as being overly happy and confident, this is not always the case. Mania can also manifest itself as extreme irritability. Some people with bipolar disorder also experience mixed episodes, which include symptoms of both depression and mania at the same time.

What Is Hypomania?

Hypomania is a less extreme expression of mania which does not include psychotic features like hallucinations and delusions. Patients experiencing hypomania may feel that they have more energy than usual, and may feel more productive. Hypomania does not require emergency care, but without treatment a patient’s symptoms may escalate into mania, or tumble into depression. Hypomania is often a symptom of Bipolar 2 disorder, or of cyclothymia. Because hypomanic patients are often high-functioning, it can be difficult for them to recognize their behaviours as symptoms of bipolar disorder.

Seeking Treatment

Bipolar disorder is a serious mental illness. Manic symptoms can not only wreak havoc in a patient’s life, but can also put them at risk for seriously harming themselves. Fortunately there is treatment available to help bipolar patients manage their illness. Anyone who is concerned that they or a loved one may be experiencing manic symptoms should talk to their doctor for further investigation of their symptoms.

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managing bipolar disorder

Management of Bipolar Disorder: Find strategies to help cope with symptoms on a daily basis.

The treatment for Bipolar Disorder often includes a combination of medication and psychotherapy. However, it is important for the patient to take responsibility for his recovery and to find strategies that will allow him to manage the symptoms of bipolar disorder on a daily basis. Although Bipolar Disorder can be different in each person, there are some common ways in which people can better control their illness.

Learn About the Disorder

Become an expert in the illness: what are the major symptoms, what treatments are available, how it impacts daily life. Find out as much as you can by reading books and articles. Keep up with medical research and advances in the treatment of bipolar disorder. Understand medications, learn what medications are available and read package inserts for any medications you are taking to learn about side effects, interactions with other medications and what to expect from the medication.

Track Your Moods

Understanding and tracking your own moods will help you to understand the triggers that may bring on an acute episode of either mania or depression. There may be certain times of the year or certain situations that will start an episode. Learning these triggers can help you to reach out for support or more intensive treatment during these periods.

Bipolar.com offers useful mood charts and mood questionnaires to help you with this.

Join a Support Group

Check with your local mental health center or hospital and ask about support groups in your area. Support groups can provide you with a way to share experiences and give you the emotional support you may need. Support groups are also a way of sharing coping strategies to find out what has worked for other people.

The Depression and Bipolar Support Alliance can also provide information on support groups in your area.

Stay Away From Alcohol and Illicit Substances

Alcohol and some illicit substances (those that are mind or mood altering) can interfere with your current treatment. They can alter your emotional balance and can interact with your current medication. Although they are sometimes used as a way of “self-medicating” they do not help to manage symptoms correctly and can send you into depression or trigger mania.

Create an Emergency Plan

Keep the number to a crisis center in your wallet. Talk with friends and relatives about symptoms of acute episodes and what they can do to help you in that situation. Remember that you can go to a hospital emergency room for treatment when necessary. Discuss signs with loved ones, such as not sleeping or high emotions and let them know what they can do to help during these times.

Keep a Journal

Keep track of your moods, your medications and any problems you may have. This journal will help you talk with your physician and determine if changes in medication should be made. Include stressful situations, sleeping patterns and triggers you may have noticed.

Eat a Healthy Diet

Medications for bipolar disorder often cause weight gain. Eating right cannot only help you feel better physically; it can help to reduce the chances of gaining weight. Avoiding caffeine or limiting sugar helps some people to feel better.

Understand Your Medication

Learn about side effects and be aware of what side effects warrant contacting your physician, which require immediate medical attention and which should disappear within a week or two. Talk to your pharmacist or doctor about any interactions with other medications, even over-the-counter medications.

Although Bipolar Disorder is difficult to live with, there are many successful people that have battled the symptoms and have managed to cope with daily struggles and succeed. It is hard work, but it can be done.

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bipolar disorder

Living With a Mood Disorder – Bipolar Disorder: Facts About Manic Depression Symptoms and Treatments

The diagnosis of a mental health issue like bipolar disorder may be met with many reactions. The patient may be saddened by the news; they may also feel scared, uncertain of what the future holds as a Bipolar Disorder sufferer. Some may even feel a sense of relief because they finally have a diagnosis. Whatever the reaction, the next step involves developing an understanding of the illness so that it can be treated.

Definition of Bipolar Disorder

Bipolar Disorder is a serious mental illness. It used to be known as Manic Depressive Disorder or Manic Depression. Bipolar Disorder involves swings in mood from mania to depression. Mania is characterized by energetic, talkative, reckless and restless states. These can spiral into feelings of irritation,confusion,anger, and feelings of being trapped. Periods of mania can result in impulsive and risky behavior.

Depression is defined by periods of sadness, crying, feelings of worthlessness, loss of energy, loss of enjoyment and sleep problems. These mood swings can last months, even years or be very frequent and dramatic. Sometimes patients manages to function well with the disorder because the manic swings can be productive. The danger comes when symptoms worsen because of risk taking behavior associated with mania and the thoughts of self-harm or suicide that often come with depression.

Symptoms of Bipolar Disorder

Unpredictable and dramatic mood swings are the primary symptom of bipolar disorder. The person with the disorder may display symptoms of mania which in addition to those already stated may include: excessive happiness,excitement,less need for sleep, high sex drive and making grand and unattainable plans.

The person may also show these additional signs of depression: anxiety, changes in appetite, weight gain or loss, and difficulty making decisions.

Types of Bipolar Disorder

In Bipolar type one the affected individual has had at least one manic episode in their life. In Bipolar type two moods cycle between high and low but the highs never reach full mania. In the rapid cycling type of bipolar disorder experiences four or more episodes of depression or mania in a year.

Mixed Bipolar patients experience highs and lows simultaneously or in rapid sequence. Cycothymia is a milder mood disorder with symptoms that are less severe than full blown Bipolar Disorder.

Treatment of Bipolar

Often, Bipolar Disorder is treated with a combination of medication and psychotherapy. Anti-psychotic medications are often used to treat both depressive and manic symptoms. Mood stabilizers are often used as well. Lithium is often used to treat both types of mood swings. Anti-convulsion medications can also be used to stabilize depression. The disorder is manageable with the correct treatment and support.

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