The Bipolar Parent’s Saturday Morning Mental Health Check in: The Future Edition

Hello, hello! Welcome to the Bipolar Parent’s Saturday Morning Mental Health Check in: The Future Edition! Thanks for stopping by.

How are you doing this week? What parenting challenges have you been facing? Are you getting enough sleep? Are you practicing self-care? How has the coronavirus affected your life lately? I hope you don’t have it! Let me know in the comments; I genuinely want to know about you and your struggles.

The Bipolar Parent's Saturday Morning Mental Health Check in: The Future Edition - CassandraStout.com

My (Two) Weeks — And the Future of The Bipolar Parent

I didn’t update last week, and for that I apologize. I was waiting on some news that was time-sensitive.

But now I can share it: I have a job! My friend and frequent commenter, author and mental health blogger Dyane Harwood, was approached by an editor at Verywell. Part of Dotdash (previously About.com), Verywell is a website focused on health and medicine that boasts 17 million unique visitors per month.

Dyane was told by the editor that Verywell needed a contributing writer for their articles re: bipolar disorder. Dyane, bless her, said she was overextended, and passed my contact information and blog onto the editor.

The editor contacted me, and asked if I would be willing to blog for them on a regular basis. After discussing the challenges of being a working parent with my husband, I agreed to take the job.

I am so excited! This is a wonderful opportunity to expand my writing resume and add feathers to my cap. A million thank yous to Dyane!

All of this means there will be some changes to The Bipolar Parent, my personal blog. I will be writing four articles per month for Verywell, and I don’t know if I will be able to continue blogging here as frequently.

My children will be out of school for the summer, and my husband is not comfortable with drop-in daycare for either of them. Rather than writing blog posts while they are in school, I will be writing in my very limited free time after the kids go to bed.

That being said, I need to discontinue the Saturday Morning Mental Health Check ins. I apologize in advance, but I already know that I won’t be able to keep posting on Saturday on The Bipolar Parent while writing for Verywell.

I hope to continue posting on Fridays, but I am uncertain if I will be able to keep up the quantity of quality posts while blogging four times a month for the other site.

I will check in with myself in April (next month) and make an honest decision. After that, whatever I decide, I will check in again in August, three months later, and see if I need to reevaluate my ability to post to both sites.

Whatever happens to The Bipolar Parent, I plan to continue blogging for the International Bipolar Foundation, so you can see me both there and at Verywell. If I’m not producing original content here, I will be linking to both my Verywell posts and my IBPF posts.

I appreciate that you’ve all supported me in my writing. The journey from beginning blogger to contributing writer at IBPF and Verywell has been long, but you all have been there for me. Thank you so much.

I wish you well in your own journeys.

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The Bipolar Parent's Saturday Morning Mental Health Check in: The Future Edition - CassandraStout.com

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How to Shield Your Children from the Effects of Your Bipolar Disorder

A version of this post appeared on the International Bipolar Foundation website.

As a parent with bipolar disorder, you might worry about the effects of your unchecked mental illness on your loved ones, especially your children. The devastating mood swings of bipolar disorder–ranging from manic “highs” to depressive “lows” and everything in between–can cause instability for your kids. One example, a 2014 study, showed teenaged children of parents with bipolar disorder are more susceptible to risky sexual behavior and emotional problems than young adults who do not have parents with bipolar disorder. As has been seen in many other cases, dysfunction in the home causes dysfunction in the child. This is equally true in cases of children with parents who suffer from mental illness, like bipolar disorder.

children
A picture of four cheerful kids with brown skin. Credit to flickr.com user Adam Lai. Used with permission under a Creative Commons license.

But there is good news. You can learn how to shield your children from the effects of your psychiatric condition. How? Let’s dig in.

Treat Your Disorder Properly

One of the most effective ways to shield your children from your bipolar disorder is to treat the disease properly. Try to eat a healthy diet and work exercise into your life. Adequate sleep is another requirement to keep you healthy and keep things from spiraling out of control. Make sure you get your forty winks, and if you have trouble, talk to your doctor. Taking medication regularly and working through emotional problems through therapy will help you manage your disorder and aid you in positively impacting your kids.

If your disorder is treatment-resistant, don’t give up hope. Dyane Harwood, author of Birth of a New Brain: Healing From Postpartum Bipolar Disorder, thought she’d exhausted all of her options to treat her bipolar depression, including electroconvulsive therapy. Then her doctor prescribed a monoamine oxidase inhibitor (MAOI). The drug worked, and Harwood is now engaged with her children and husband, living life the way she wants to.

Get Help

Bipolar in the family needs a whole family solution. The entire household needs to learn coping skills to handle a parent’s disorder. Ask your therapist for ways to teach your partner and children to deal with the ups and downs of your bipolar disorder. If your children start showing symptoms of emotional problems, such as anxiety, phobias, or intolerance to frustration, find a child behavioral psychologist or a therapist willing to see children. Make a list of the symptoms you’ve seen in your kids, and be sure to include your family history as well.

Cultivate a Support Network

One aspect of getting help is relying on a support system of healthy adults. They can spot you when you’re feeling too up or too down. They can offer your children a more stable environment during manic or depressive episodes by taking the children to a different place, like your friends’ homes, or coming over to yours. Your kids need adults they can consistently rely on, even if you can’t provide that reliability sometimes. Try to develop that support if you don’t have it. When you are well, cultivate reciprocal friendships with other adults you can trust with your children. Easier said than done, of course, but try to be a reliable source of childcare for your parent friends, so they will pitch in when you need them.

Prepare Your Kids

Shielding your kids from bipolar disorder doesn’t mean hiding the illness from them. Preparing your children to accept what’s happening around them can be difficult, but it is worthwhile. Communication with your children is crucial when managing their understanding of bipolar disorder. You might think explaining your disease to them is wrong. There’s an instinct to hide uncomfortable situations from your children, but kids are intuitive. They will know if someone in the family is suffering, even if they can’t put their finger on why. If the problem isn’t explained to them, they may assume the worst, even to the point where they think it’s their fault. Letting your children know up front what to expect if you’re suffering from a mood episode will help your kids roll with the punches. Keep the explanation simple, and be ready to revisit the conversation anytime your children have questions.

When explaining your bipolar disorder to your children, stress that this disease is not your kids’ fault. Also stress that taking care of a parent suffering from mental illness is not their job. They will probably appreciate your candor and feel more secure in their relationship with you and their place in the world. If things don’t go well, talk to your therapist for ways to help your children understand bipolar disorder and their relationship with you as a parent with a mental illness.

If your older children are concerned about developing bipolar disorder themselves, tell your preteens honestly that they are not destined to have the disease. Studies put the inheritance rate at about 30% with a single parent affected by bipolar disorder, and around 60% for both. You don’t need to quote the statistics to a younger child, but a teen might be interested. Because of the instinct to hide uncomfortable situations from your children, you might want to keep this from your children. But knowing even uncomfortable statistics, like the 30%, is better than the unknown.

Final Thoughts

When you suffer from mental illness, taking care of yourself is a tall order. Taking care of a child as a parent with bipolar disorder adds additional complications, but it’s worth it. You can shield your children from bipolar disorder in several ways. Make sure that you treat your disease with professional help. Cultivate a support system. And it’s paramount that you communicate with your children about your disorder, so they know what to expect and what their place is.

You can do this.

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Common Pitfalls When Communicating With Your Kids About Your Bipolar Disorder, Part II

This is part one of a two-part post. [Part I | Part II]

Communicating with your children about your bipolar disorder is crucial for managing their relationship with your and your mental illness. In part I, we looked at common pitfalls, including your kids being too young and disrespecting your children’s boundaries. Read on for one more common pitfall of communicating about your psychiatric condition.

Waiting Too Long

teens
A picture of three teenaged boys in swim trunks sitting outside. Credit to flickr.com user Mighty mighty bigmac. Used with permission under a Creative Commons license.

On the flipside of your kids being too young, you might have put off having this discussion until your kids are teens. Then your kids might be too old to listen to you properly. Some teens think they know everything, and refuse to hear out their parents or other authority figures, however well-meaning.

A friend of mine, a mother of four, related her experience of being rebuffed by her teenagers when she brought up serious subjects, and what she did to handle that. She said to them, “Just let me do the ‘mom thing’ for thirty seconds, and then I’ll let you go, okay?” She said they’d roll their eyes, but acquiesce to listen to whatever she had to tell them.

Tips For Communicating With Your Kids About Your Bipolar Disorder

You might not know where to start the conversation when speaking to your kids for the first time about mental illness. That’s okay. You can simply say something like, “you may have noticed that I have been erratic lately. I have a disease, bipolar disorder, which causes me to have different mood episodes, called mania and depression.” As long as you have their attention, be concrete and pragmatic.

If you’ve waited until your children are teenagers to talk to them about your bipolar disorder, there is a danger of their being angry, especially if the discussion arises from comments on your behavior, and not by your choice. If this is what happened, you haven’t ruined anything, but do expect to deal with your children’s anger. The best way to handle that is to prepare for it, by thinking about what they might say ahead of time, and making sure to listen to what they actually do say. Chances are, your kids already know about your bipolar disorder. You want to make sure that what they know is the truth, and not whatever desperate version they’ve decided on.

Some teens can benefit from statistics. For example, your kids are between 15-30% likely to develop bipolar disorder if one parent suffers from the disease, whereas they’re 45-60% likely if both parents do. You might be tempted to hide this information, so as not to freak them out. But knowing accurate facts about mental illness helps them to understand you better, and possibly themselves.

Knowledge, even uncomfortable knowledge, is better than the unknown. In addition, if they know common symptoms of bipolar disorder, they can be on the lookout for those symptoms in themselves and their friends, and understand you when you’re experiencing mood episodes.

Final Thoughts

Try not to hide information from your kids, especially teenagers. If you don’t inform them about your mental illness, they’ll probably turn to friends to ask why their mom or dad is acting strange. Or they might hide the dysfunction entirely, blaming themselves and growing up in a culture of shame. Reassure your kids that you will always love them, regardless of how your bipolar disorder makes you feel in the moment. And above all, be honest.

I wish you luck in your journey.

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National Maternal Depression Awareness Month: My Experience, and How to Get Support

Trigger warning: This post contains discussions of suicide. If you or someone you know is at risk of suicide, please call the U.S. National Suicide Prevention Lifeline at 800-273-8255, text TALK to 741741 or go to SpeakingOfSuicide.com/resources for additional resources.

postpartum depression
A picture of a black typewriter, above which are typed the words “Postpartum Depression” in capital letters. Credit to flickr.com user Twitter Trends 2019. Used with permission under a Creative Commons license.

May is National Maternal Depression Awareness Month. While up to 80% of mothers experience “baby blues,” up to 20% of mothers suffer from postpartum depression (PPD), a pervasive condition which sucks the life out of them. I’d like to share my experience with PPD in order to help destigmatize the condition and add to the conversation. I will also offer some tips on how to get support for PPD.

Women suffering from PPD endure a deep, pervasive sadness, fatigue, trouble sleeping and eating, thoughts of hurting themselves or the baby, and may isolate themselves. Symptoms may occur a few days after delivery, or up to a year afterwards, and can last for years. Treatments such as antidepressants can help.

My Experience

My experience was a little different. Within a week after the birth of my first child, a son, I suffered postpartum psychosis (PPP), which is the most severe form of PPD and only affects 1-2 mothers out of every 1000 births. Symptoms of PPP include hyperactivity, hallucinations or delusions, bizarre behavior, rapid mood swings, and thoughts of hurting the baby. If you or a loved one are suffering any symptoms of PPP, contact a mental health professional or the American Pregnancy Association immediately.

During my run with PPP, I didn’t sleep for a week. I ate/drank only chocolate milk, and couldn’t stop talking. I had pressured speech, racing thoughts, and other symptoms of mania, like irritability. I often vacillated from euphoric explanations of my “plan” for the baby’s care to intense anger at nothing at all. I also suffered from hypergraphia, writing over a hundred to-do lists with multiple items on them during the first few days. I was obsessed with breastfeeding my son, and attempted suicide when the breastfeeding relationship was threatened.

I committed myself to a local mental hospital, where I was very lucky to find a bed on the day my therapist asked for one, and earned a bipolar diagnosis. The doctors there treated me with Olanzapine, a tranquilizer which knocked me out, and 1500mg of Depakote, which toned down my mania.

After enduring the harrowing PPP experience, which I’ve covered in my upcoming memoir, Committed, I suffered from two years of standard PPD. I was constantly exhausted despite sleeping well, cried often, and spent my waking hours writing suicide notes. I often thought of plans to hurt myself, and had thoughts of hurting my infant son.

I was still obsessed with breastfeeding him, and refused to take medication that would have endangered the breastfeeding relationship, like lithium. When he turned two and a half, I weaned him, and started taking ,a href=”https://cassandrastout.wordpress.com/2013/01/10/1227/”>lithium, which utterly changed my life. The depression lifted, the sun came out, and I stopped wanting to die by suicide. I was happy again, and started properly loving my baby.

I can now happily say I’ve not suffered a bipolar mood episode, either depression or mania, for the past six years. In order to reach that stability, I tried over a dozen medications until I found a combination that worked. I changed psychiatrists seven times because they kept moving to different practices, and changed therapists twice because of the same reason. I attended weekly counseling sessions for years. I learned how to never miss a dose of my life-saving medication, and how to practice good sleep hygiene. I recently gave birth to a second child, with no ill effects.

Tips on How to Get Support

If you or a loved one are suffering from PPD, or especially PPP, find a mental health professional as soon as possible. If you have a therapist, ask him or her to refer you to a psychiatrist, if you’re interested in pursuing medication. If you don’t have a therapist or a psychiatrist, ask your primary care physician or ob-gyn for a referral to one of those. If you don’t have a primary care physician, go to urgent care or call Postpartum Support International at 1-800-944-4773. Their website, postpartum.net, enables you to find local resources to get treatment, and support groups for new moms like you. You can also ask your ob-gyn if the hospital in which you delivered offers services to treat PPD.

Above all, fight stigma, especially self-stigma, which can creep in without you realizing it. You might feel ashamed or confused that you’re obsessed with your baby’s safety, or that you’ve had thoughts of harming your infant. Don’t be afraid of these feelings. They’re a sign of a mental illness which can be treated.

The difference between you as a mother suffering from PPD or PPP and the mother you can be on the other side of them is like night and day. You are not alone, either. Try to avoid isolating yourself. A therapist will understand, as will people in your support groups. Do everything you can to survive this, not only for yourself, but for your child.

You can do this.

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What Are the Differences Between Bipolar in Children and Bipolar in Adults?

In the past five to ten years, bipolar disorder has been identified in more and more children. Up to 5% of American children suffer from bipolar disorder.

Bipolar disorder is a mood disorder that affects 2.6% of American adults–about 5.7 million people–according to the National Institute of Mental Health. The disease is characterized by mood episodes: “highs” called mania and “lows” known as depression.

children
A picture of four white toddlers seated next to each other. Credit to flickr.com user rjp. Used with permission under a Creative Commons licen

In past posts, I’ve looked at how bipolar disorder specifically manifests in women, how men and women have different brain biomarkers, and how the illness shows up in children. But what are the differences between bipolar disorder in children and bipolar disorder in adults?

Let’s dig in.

Symptoms of Mania and Depression in Children and Adults: A Side-by-side Comparison

Check out the following chart to see a side-by-side comparison of symptoms of bipolar disorder in children and adults:

Adults Children
Depression
  • Sad, empty, or hopeless feelings
  • Anhedonia – Loss of interest in pleasurable activities
  • Insomnia or sleeping too much
  • Fatigue, loss of energy
  • Weight gain or loss
  • Feelings of worthlessness
  • Guilt
  • Inability to concentrate
  • Thinking about, planning, or attempting suicide
  • Sad, empty, or hopeless feelings
  • Anhedonia – Loss of interest in pleasurable activities
  • Insomnia or sleeping too much
  • Irritability
  • Failure to gain weight
  • Change in grades, getting into trouble at school, or refusing to go to school
  • Frequent crying
  • Withdrawing from friends
  • Acting out suicide in play
Mania
  • Excitement, or abnormal cheerfulness
  • Decreased need for sleep
  • Euphoria, exaggerated self-confidence
  • Increased energy
  • Pressured speech
  • Racing thoughts
  • Distractability
  • Hypersexuality
  • Spending sprees and other poor decisions
  • Irritability
  • Decreased need for sleep
  • Silliness or excessive goofiness
  • Grandiosity, including statements about superpowers
  • Distractability
  • Hypersexuality
  • Aggression

These symptoms are similar, but the way they manifest is different for children than adults. For example, during both manic and depressive phases, children are much more likely to be irritable and aggressive.

Let’s take a detailed look.

First Symptoms

Childhood-onset usually refers to children who develop bipolar disorder at age 12 or younger. The first signs of bipolar disorder in adults are usually manic or hypomanic episodes. But in children, depression is often the first indication that anything is wrong. Studies show that up to 30% of children who suffer from clinical depression will develop manic symptoms later in life, which can lead to a diagnosis of bipolar disorder. For a more detailed overview of what depression looks like in children, even toddlers, click here.

Pattern of the Disorder

The most striking difference between childhood-onset and adult-onset bipolar disorder is the patterns of the illness. Adults generally vacillate between defined episodes of mania and depression that last weeks or months. They can also have periods of wellness that last from months to years in between.

Kids are the opposite: they experience prolonged periods of rapid cycling, which means they bounce between mania and depression daily, if not multiple times per day. And there are no periods of respite in children with bipolar disorder; they are always suffering from a mood episode.

One study of pediatric bipolar patients examined children with bipolar disorder who suffered more than one hundred mood episodes over a short period of time. The manic periods were called “mini-manias.” According to the study, none of the patients under 9 years old endured a single mood episode lasting two weeks or more. Short, frequent episodes was the way the illness presented in the children.

Genetic Predisposition

Kids who end up with bipolar disorder were usually genetically predisposed to develop the disease. One of the many causes of bipolar disorder can be family history of the illness, though sometimes the disease can occur without any history present. But, in the case of children who develop the disorder, there are typically more family members with bipolar in their lives than those children without the disorder. The kids are also much more likely to have relatives–such as parents, aunts and uncles, and grandparents–on both sides with the disorder.

Adults who develop bipolar disorder may or may not be genetically predisposed. Genetic loading is less common in adults than children. If the adults are predisposed, the disease may or may not be more severe. It’s a lottery.

Difficult Time Adjusting

Pediatric bipolar disorder presents unique difficulties compared to the adult-onset form of the disease. Kids are still developing mentally and physically, so when they suffer from the rapid cycling moods of bipolar disorder, life can become very difficult. These children are establishing their identities, and enduring vacillating episodes of bipolar disorder makes that very hard.

Adults usually have their identities established, or at the very least, are set in their ways, so figuring themselves out is not as much of a struggle. Adults are also more emotionally mature than children, and can better handle shifts in mood.

Chronic Irritability and Mixed States

Instead of the euphoric highs of mania typically experienced by adults, kids are much more likely to suffer chronic irritability, a state where they are grouchy all of the time. This is because children tend to suffer from mixed states, where they endure extreme episodes of mania and depression at the same time. Treating mixed states can be very difficult. Even lithium, the gold standard medication that is used to treat bipolar disorder, is often ineffective at handling mixed states. Lithium is able to treat both depression and mania in bipolar patients, but it’s totally ineffective at handling mixed states.

Adults can also suffer from mixed states, but children are much more likely to experience them.

Difficulty Diagnosing

Often, childhood-onset bipolar disorder is missed or inaccurately diagnosed until the kid becomes an adult. Children are also more prone than adults to conditions that occur at the same time, such as attention deficit hyperactivity disorder (ADHD), learning disabilities, or anxiety disorders, which can make accurately diagnosing bipolar disorder difficult. If you weren’t diagnosed with bipolar disorder until adulthood, but suspect you have had it since you were a child, this information may help you sort out your own childhood.

The Bottom Line

If your child suffers from two or more of bipolar disorder symptoms, call your pediatrician to get a referral to a pediatric psychologist. Refer to the symptom chart to present daily examples of bipolar disorder symptoms to the doctors. Anhedonia is especially important to note, as it’s not typical of most healthy children. If you have a family history of bipolar disorder, make sure to bring that up.

When children with bipolar disorder grow up, their diseases are worse than people who suffer from an adult-onset version of the illness. The mood episodes are more intense in childhood. But early therapy and other interventions can help your child deal with their condition. The earlier a treatment team can intervene, the better.

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How to Spot Depression in Children, Even Preschoolers

Trigger Warning: Brief discussion of suicidal ideation.

Preschool depression is often overlooked, because the symptoms are difficult to spot or may be explained away by hopeful parents and teachers. Depression in adults is widely known, but can preschoolers suffer clinical depression? Science says they can.

Scientists began studying depression in preschoolers 20 years ago, and the research continues today. According to the conclusion of a new study led by Dr. Joan Luby of the Washington University School of Medicine in St. Louis, preschoolers suffer depression. Luby’s team examined 306 children ranging from 3 to 6 years old. This study demonstrated that 23% of the 3-year-olds endured depressive symptoms every day for two consecutive weeks. As the age of the child increased, the rate of major depressive disorder diagnoses also increased. The 4-year-olds suffered depressive symptoms at a rate of 36%, while the 5-year-olds showed a rate of 41%. The children who had suffered extremely stressful or traumatic events in their lives also had a higher incidence of depression than the controls.

Preschoolers generally can’t describe their emotional states. They’re still learning what emotions are and they lack the ability to vocalize them. This is the difficulty in diagnosing depression in preschoolers, and why you may need help spotting it. In order to allow the study participants to express how they perceive themselves and get a sense of what young children were feeling, Dr. Luby’s team asked a series of questions using puppets. How the children responded gave the researchers a clue about how the kids were feeling.

Further complicating the picture is the prevalence of other conditions along with depression, like Attention Deficit Hyperactivity Disorder (ADHD). In Dr. Luby’s study, about 40% of the study participants also dealt with ADHD, which tends to drown out symptoms of depression, because the symptoms are similar. This can even persist later in life. Children who suffer depression are more than four times as likely to suffer an anxiety disorder later in life than kids who don’t suffer depressive symptoms.

preschooler
A preschool-aged boy in blue hoodie sprawling on a parent’s lap. Credit to flickr.com user Quinn Dombrowski. Used with permission under a Creative Commons license.

But what does depression look like in a 3-to-6-year-old?How can you, as a parent, spot it? Well, depression in children looks a lot like depression in adults. For example, anhedonia, the inability to experience pleasure from normally enjoyable activities, can show up in adults as a lack of enjoyment in things like golfing or writing. Preschoolers with anhedonia find little to no joy in their toys. Both adults and children with depression are restless and irritable. Depressed kids whine a lot, and don’t want to play.

When they do play, children may decide that their stuffed animals decided to “die” today and decide to bury them. Anytime you see a preschooler demonstrate methods of suicide or death with a stuffed animal without mimicking an episode of your life, such as a death in the family, your antennae need to come up. That could indicate suicidal thoughts.

But the most common symptom of depression in children is deep sadness. Not someone who’s sad for a day, but all the time, no matter who he or see is with or what he or she is doing. Sadness in the face of goals that have been thwarted is normal. But depressed children have difficulties resolving the sadness to the point where the misery affects their ability to function regularly. If your child appears to be sad to the point of inability to enjoy anything or regulate their other emotions, then get a recommendation from your pediatrician for a child psychologist or a behavioral therapist.

Other notable symptoms of childhood depression are an exaggerated sense of guilt, shame, and insecurity. Depressed preschoolers generally feel that if they do a naughty thing or disobey, that means they are inherently bad people.

Here’s a breakdown of the symptoms of depression in children of any age, including preschoolers:

  • Deep and persistent sadness
  • Irritability or anger
  • Difficulty sleeping or focusing
  • Refusing to go to school and getting into trouble
  • Change in eating habits
  • Crying spells
  • Withdrawing from friends and toys
  • Fatigue
  • Anhedonia – inability to derive pleasure from enjoyable activities, like playing with toys
  • Whining
  • Low self-esteem and insecurity
  • Shame and guilt
  • Timidity

Preschoolers may be especially vulnerable to depression’s consequences. Young children are sensitive to emotions, but lack the ability to process strong feelings. Early negative experiences–including separation from a caregiver, abuse, and neglect–affect physical health, not just mental. Multiple studies have linked childhood depression to later depression in adulthood.

This is why properly diagnosing and treating these children early is so vital. One established intervention for treating childhood depression is called Parent-Child Interaction Therapy, or PCIT. Originally developed in the 1970s to treat violent or aggressive behaviors in preschoolers, PCIT is a program where, under the supervision of a trained therapist, caregivers are taught to encourage their children to manage their emotions and stress. The program typically lasts from 10 to 16 weeks.

The Bottom Line

Dr. Luby’s research is met with resistance. Laypeople typically think the idea of preschoolers suffering depression ridiculous, and even some doctors and scientists don’t believe children are cognitively advanced enough to suffer from depression. Preschool depression remains a controversial topic, which makes it harder to diagnose in your child.

But depression in children 6 years and older has been well established by decades of data. Is it really so hard to think that preschoolers might suffer depression as well? Dr. Luby and her team have been looking at the data for 20 years, and have concluded that preschoolers can suffer depression, just like older children and adults.

Admitting that your child is depressed may make you feel like you’re a failure. After all, if you can’t protect your children from depression, who can? But clinical depression is chemical. This is not your fault. You may have been told that depression doesn’t exist in preschoolers, or that you’re overreacting. You may be called a helicopter or hovering parent. But trust your instincts. You know your child better than anyone else. Don’t be afraid to go against stigma for your child’s benefit.

Up to 84,000 of America’s 6 million preschoolers may be clinically depressed. If your child is one of them, you are not alone. There is no shame to depression. The condition is not your child’s fault, just as in adults. No parent likes to see her child suffer, and getting help for depressed children is vital to their well-being.

If your child suffers depressive symptoms, especially anhedonia, ask your pediatrician for a recommendation for a behavioral therapist or child psychologist. Typically, the earlier the intervention, the more successful the results.

Good luck.

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Children with Bipolar Disorder May Be Diagnosed with Vitamin D Blood Test In the Future

blood test
Credit to flickr.com user CEHURD CEHURD. Used with permission under a Creative Commons license.

Researchers at Ohio State University are searching for a way to and quickly and accurately test for bipolar disorder in children. The scientists think they may have found it: a blood test which looks for a protein associated with vitamin D.

 

Finding a blood test could reduce the current average diagnosis time of ten years, said Ouliana Ziouzenkova, the study’s lead author and an associate professor of human nutrition at Ohio State.

In the study of 36 young people, levels of the vitamin D binding protein were 36 percent higher in those with bipolar disorder than in those without a mood disorder. The study appears online in the journal Translational Psychiatry.

Ziouzenkova said it made sense to look at vitamin D binding protein because it potentially plays a role in brain inflammation. The researchers also looked at inflammatory markers in the blood, but found no significant correlations. Looking for the nutrient vitamin D in the blood, as opposed to the binding protein, appears to have low diagnostic power, she said.

Confirming that the blood test works will take time, but Ziouzenkova and her colleagues are excited about the potential to help kids and their parents.

Materials provided by Ohio State University.

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Children at High Risk for Bipolar Disorder Genetically Vulnerable to Stress

children
Credit to flickr.com user tanitta. Used with permission under a Creative Commons license.

Genetic alterations that regulate stress have been found in children at high risk for bipolar disorder, according to research done by scientists at The University of Texas Health Science Center at Houston (UTHealth). The study was published in Translational Psychiatry, a Nature Publishing Group journal.

 

Researchers have long known that children who experience stressors in their lives are more likely to develop bipolar disorder. Parents with bipolar may struggle with their disorders, thus placing stress on their children. But this study shows that children at a high risk for developing bipolar–due to having family members with a history of psychiatric illness–are genetically vulnerable to stress.

The scientists at UTHealth took blood samples from eighteen children, consisting of a set of bipolar patients, a set of apparently neurotypical patients with bipolar parents, and a set of neurotypical controls with parents that have no history of mental illness. The blood samples revealed that, compared with the control group, bipolar children and unaffected kids with bipolar parents have genetic alterations that regulate the response to stress.

So, children with bipolar parents are more vulnerable to stress, and when stressed, tend to develop the disorder. This may sound like bad news all around, but there is a positive approach to this study. Future research may reveal the effects of reducing stress, as well as whether medication might be able to reverse the genetic alterations in children before bipolar disorder matures.

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What to do if Your Child has Bipolar Disorder

So you’ve discussed your child’s symptoms with a pediatric mental health specialist, and have a diagnosis of bipolar disorder. What now? Thankfully, there are some suggestions you can take, and taking care of your child with bipolar disorder is similar to taking care of an adult with the disorder.

1. Pay attention to medications and therapy appointments

As a parent, you are responsible for making sure your child follows their treatment plan. Use whatever reminders you can to remember to give him or her the medication that he or she needs.  If your child must take their pills at school, then open a line of communication with his or her teachers and school nurse. Appointments with his or her therapist are also important. Make sure your child attends their appointments

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Credit to flickr.com user Cristyan González Alfonso. Used with permission under a Creative Commons license.

2. Monitor side effects

Some side effects of atypical antipsychotics, like weight gain and blood sugar changes, are awful in adults–and children do seem to be more prone to them. These drugs were originally formulated for adults, and few have been tested on kids. Ask your child’s psychiatrist what side effects you need to keep an eye on.

3. Work out agreements with your child’s teachers

Some children with bipolar disorder need more help at school, such as more breaks during manic episodes, or less homework. During especially bad episodes, your child may need to be removed from school until he or she stabilizes. Talk to your child’s teachers. Keeping an open line of communication is the best way to ensure your child has success at school.

4. Keep a schedule

Try to be consistent with mealtimes and bedtimes, as well as waking your child up at the same time every day. This will help keep stress in the home to a minimum. Try to be patient with your child as they adjust to new routines.

5. Go to family therapy, if needed

Taking care of a child with bipolar disorder may put a lot of stress on the family as a whole. Your marriage might suffer, and the child’s siblings might be jealous of all the attention he or she gets. Attending therapy as a family may help you handle these issues.

6. Don’t ignore threats of suicide

Suicide threats are extremely serious, even in young children who may not understand what it means. Talk to your children, and if they do have suicidal ideation, give them a safe environment. Remove all the weapons or pills from the house. And talk with their mental health specialists. Crisis lines are always open.

7. Communicate with your teenager

Teenagers may become irritated or resentful if they feel that you’re compelling them to be treated. Talk to them about why you’re giving them medication and taking them to therapy appointments. Educate your kids about their mental illness. Also, it’s important that your teenager avoid substance abuse, as the risks of developing a problem are much higher in teens with bipolar disorder. Alcohol and drugs can interact with medications poorly and worsen mood episodes, so it’s important that your teenager be made aware of the risks.

All in all, taking care of your child with bipolar disorder requires an extra level of parenting. But you can do it. There are steps you can take to help you.

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Bipolar Disorder in Children

Bipolar disorder affects people of all ages, including children as young as six. The disorder has periods of elevated mood, called mania, as well as periods of depression.

Common symptoms in children are:

  • Mood swings ranging from depression to irritability to elation, sometimes up to several times a day
  • Racing thoughts (while manic)
  • Hyperactive or aggressive behavior
  • Casual sex or spending sprees that are out of character
  • Decreased need for sleep
  • Inflated ego
  • Suicidal ideation in older children
  • Separation anxiety
  • Carbohydrate cravings
  • Difficulty waking in the mornings
  • Oversensitivity to emotional situations
  • Bed-wetting (especially in boys)
  • Obsession with gore or other socially inappropriate topics
  • Night terrors

 

children
Credit to flickr.com user Vladimir Pustovit. Used with permission under a Creative Commons license.

Symptoms in children look slightly different than those of adults. Children can be more irritable than adults during a manic phase, with less elevated mood, and are more likely to experience psychotic features, such as auditory hallucinations. As for depression, children are more likely to complain about physical pain. Between episodes, kids return to their normal mood. Something of note is that they cycle between these episodes several times a day, as opposed to weeks or months.

Some experts believe the disorder is rare and thus over-diagnosed; others believe the opposite, so there’s little agreement. It’s also difficult to diagnose the disorder in children, because symptoms can overlap with other diagnoses like conduct disorders or Attention Hyperactivity Deficit Disorder (ADHD)–which can occur in conjunction with bipolar disorder, making an accurate diagnosis even more tricky.

So, if you suspect your child has bipolar disorder, please speak with a mental health professional specializing in disorders in children. Ask your pediatrician for recommendations.

Stay tuned for next week’s post: What to do if Your Child has Bipolar Disorder.

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