Buy essay on Bipolar disorder in children and the hardships in diagnosis

This essay critically reviews the issue of bipolar disorder in women. It is known that bipolar disorder occurs in both men and women. However while the rate of bipolar I disorder is equal for men and women, the rate of bipolar II is somewhat higher in females. This essay analyses some sourced related to this issue.
Bipolar disorder in children
First of all it is necessary to define the bipolar disorder and it types.
“Bipolar disorder is a complex chronic condition, recognized as a leading cause of disability and is associated with high health care costs (Lopez, 1998).”
In the modern terms bipolar disorder means the manic-depressive illness. Its history started in 1899 with the sixth edition of psychiatric textbook by Emil Kraepelin, when he introduces this term. Douglas Double, the editor and the author of the introduction to the book “Bipolar disorder” writes:
“For Kraepelin, manic-depressive illness was a single morbid process. It included manic, mixed and depressed states. (Double, 2002)” In the middle of 20th century Karl Kleist proposed to distinguish unipolar and bipolar disorders. Later, in 1960s, Jules Angst, Carl Perris, and George Winokur developed the modern concept of bipolar disorder in their monographs. They defined the concept in its modern meaning and included mania without depression into the bipolar disorders.
According the modern concept, there are four main types of bipolar disorder: Bipolar I, Bipolar II, Cyclothymic Disorder, or Bipolar Disorder Not Otherwise Specified.
Symptoms of Bipolar Disorder
There are two main groups of symptoms of bipolar disorder, depending on the part of the cycle a patient is experiencing: the symptoms of mania and the symptoms of depression. First group includes difficulty concentrating, low energy levels, slower mental and physical functions, feelings of despair, and extreme fatigue. Second group includes irritability, talkativeness, sudden feeling of happiness, insomnia and racing thoughts.
Case
This case was taken from the website of Doctor Erin Elster, D.C. According the case description, the patient, “8-year-old female, was diagnosed with rapid-cycling bipolar disorder at age 3 (Elster, 2003)”. There is no information about the symptoms in case description; however, it can be supposed that they were sufficient for five-year-long treatment. The girl had been prescribed different kinds of treatment: pharmaceutical treatment including mood stabilizers and anti-psychotics, and alternative therapies. Some of these therapies are known with their possibility to improve the patient’ state: diet, chiropractic, massage, ayurveda, etc. No treatment achieved the success or improvement so the parents of the girls began looking for other options. At least they selected the vitamin and mineral supplement program.
The question of diagnosis accuracy in this case is rather important. It is known that even the existence of bipolar disorders as mental illness is the object of hot debates. Italian researcher, Franco Benazzi in his article in “The Lancet” reviews the concepts, definitions, and classifications of bipolar and related disorders. He notices that the treatment itself can be the reason of disorder symptoms. This suggestion was proved by some patients taking antidepressants as the disorder treatment. The results of the research of Dr. Altshuler and the group from Brentwood VA Medical Center, Los Angeles, USA, show the following:
“Thirty-five percent of the patients had a manic episode rated as likely to have been antidepressant-induced. No variable was a predictor of vulnerability to antidepressant-induced mania. (Altshuler et al, 1995).”
The same research proves that in 26% of the cases assessed the antidepressant treatment became the reason of the cycle acceleration. “Younger age at first treatment was a predictor of vulnerability to antidepressant-induced cycle acceleration. Forty-six percent of patients with antidepressant-induced mania, but only 14% of those without, also showed antidepressant- induced cycle acceleration at some point in their illness (Altshuler et al, 1995).”
Thus, it can be concluded that some symptoms could be treatment-induced. Besides, the case doesn’t describe the difference between bipolar disorder in children and adults. The bipolar disorder in children is difficult to diagnose for two reasons. First, the symptoms of different mental disorders, like Tourette’s syndrome, panic disorder, etc, are almost similar. Second, children generally experience faster mood swings than adults, and it isn’t always means the mental disorder. Pediatric cases of bipolar disorders have the sadly high statistics of substance abuse and suicide. That is why proper diagnosis is substantial for early treatment.
The treatment of bipolar disorder I children and adolescents usually includes psychopharmacological treatment and psychosocial treatment. The pharmacological treatment usually based in the lithium-group drugs, the psychosocial treatment is focused on the family surrounding or a combined intervention into social and interpersonal rhythm. As was stated above, different alternative therapy can also be implemented for bipolar disorders treatment, like ayurveda, massage, nutrition, acupuncture, general chiropractic. The result of these alternative therapies usually questionable but it can hardly be denied that these therapies can be useful together with psychopharmacological and psychosocial treatments.
Returning to the case, it is necessary to mention that the main contradiction in the studying of bipolar disorders is the bias that it “is either an emotional illness or a biological illness caused by brain dysfunction. (Downing-Orr, 1998)”. In the studied case an upper neck injury was discovered in 8-years-old patient. This injury was the result of trauma in the early age. The injury was adjusted, and the behavior of the girl changed.
“In the first month, her parents reported some improvement in her condition but that her mood still fluctuated quite extensively. By the third month, her parents reported a substantial improvement in her mood in that she could easily handle situations that previously had set off episodes of mania, such as birthday parties, sleepovers, etc. In addition, they reported that she had also experienced improvement in her motor development in that balance and coordination had also dramatically improved (Case study).”
Thus it can be seen that the disorder in child’s behavior was caused with the neck injury, so the treatment reasonably was unsuccessful. The reason of the incorrect diagnosis was, however, related to the general difficulty in bipolar disorder diagnostics. It is known that child under examination shouldn’t pass blood test or brain scans that can diagnose bipolar disorder. Generally the main basis for the diagnosis is the result of interview considering child’s mood and sleeping patterns.
Conclusion
Bipolar disorder in children and adolescents are widely spread and can be successfully treated. However, the diagnostics of the bipolar disorder in children is difficult because of the specific features of children character development and because of many mental disease having similar symptoms. The case study proved that the reasons of disorder can be different and sometimes hardly revealed.

 
References
Akiskal HS, Downs J, Jordan P, Watson S, Daugherty D, Pruitt DB (1985), Affective disorders in referred children and younger siblings of manic-depressives. Arch Gen Psychiatry 42:996-1003
Double, D. Review – “Bipolar Disorder” by Mario Maj, Hagop S. Akiskal, Juan José López-Ibor and Norman Sartorius. John Wiley & Sons, 2002.
Downing-Orr, K. (1998) “Rethinking the depression why current treatments fail.” Plenum Press, New York.
Elster, E. “Upper Cervical Chiropractic Care for a Nine-Year-Old Male with Tourette Syndrome, Attention Deficit Hyperactivity Disorder, Asthma, Insomnia, and Headaches: A Case Report” DC. Journal of Vertebral Subluxation Research. July 2003.
Joffe H, Cohen LS, Suppes T, McLaughlin WL, Lavori P, Adams JM, Hwang CH, Hall JE, Sachs GS. Valproate is associated with new-onset oligoamenorrhea with hyperandrogenism in women with bipolar disorder. Biol Psychiatry. 2006 Jun 1;59(11):1078-86.
Lopez AD, Murray CC. The global burden of disease, 1990–2020. Nat Med 1998;4:1241–1243.
Weissman, Myrna M., et al. Cross-National Epidemiology of Major Depression and Bipolar Disorder. JAMA. 1996;276(4):293-299.