Bipolar disorder is characterized by periods of manic behavior often preceded or followed by major depression. In lay terms, bipolar is identified by periods of very low feelings and periods of unrealistically expansive (or, often, irritable) moods. According to the DSM-IV, completed suicide occurs in 10-15% of individuals with bipolar. Suicidal ideation and attempts are more likely to occur when an individual is in a depressive state, or a state of mixed emotions. School failure, truancy and episodic antisocial behavior are sometimes features of bipolar disorder.
Bipolar, like depression, is often misdiagnosed as, or hidden by, attention deficit-hyperactivity disorder. A grave danger is that drugs prescribed for ADHD, such as Ritalin and Adderall, as well as most antidepressants, increase the risk of suicide in a bipolar child. In fact, the ADHD drugs and antidepressants are deemed contraindicated for bipolar disorder.
According to the DSM, manic episodes must be accompanied by at least three additional symptoms from a list including inflated self-esteem or grandiosity, decreased need for sleep, agitated fast speech (which also is a side effect of ADHD drugs), flight of ideas, distractibility, increased involvement in goal-directed activities or psychomotor agitation, and excessive involvement in pleasurable activities with a high potential for painful consequences.
The elevated mood is often described as euphoric, unusually good, cheerful or high. It is recognized as excessive by those close to the patient, but may seem infectious or simply overly friendly to casual acquaintances.
Bipolar disorder is obviously a heartbreaking mental illness. A child may be depressed for a time, then magically seem to "recover" by becoming the most optimistic, active person in the house. The euphoria may remind the parent of their child as he or she "used to be". The mania may not be identified for a few days, and then a parent is understandably reluctant to conclude the excessively positive behavior may only be a sign of a more difficult illness than the depression it seemed the child only ended a few days earlier. If the disease originally was misdiagnosed as ADHD, the manic phase in which a child may even become extremely interested in a school project, perhaps dominating classmates, may be mistaken for an end to the attention "deficit."Bipolar disorder is very serious, different from depression and even major depression without manic
[Source note: These are summaries prepared by the Webmaster from various materials, the most important of which are the DSM IV (4th ed.), published by the American Psychiatric Association, and Bright Futures in Mental Health, a joint publication of the U.S. Department of Health and Human Services Maternal and Child Health Bureau and the National Center for Education in Maternal and Child Health at Georgetown University. Editorial comment is by the Webmaster.]
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