Bipolar Spectrum Disorders
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Bipolar Spectrum Disorders (BD) are a family of disorders including Bipolar I, Bipolar II, and Bipolar Not Otherwise Specified (NOS). These disorders are distinguished by the length and severity of symptoms. Bipolar disorders are characterized by vacillations between states of mania and depression. In practice the presence, of a manic/hypomanic episode is often the catalyst for a diagnosis, although depression is almost always present as well. Mania is a period of abnormally and persistently elevated, expansive, or irritable mood. This is not just a brief period of "feeling on top of the world" on a good day, but rather a marked deviation from normal day-to-day functioning. It is a pattern of behaviors that may include feelings of grandiosity, extreme talkativeness, decreased need for sleep, racing thoughts, attention deficits, extreme goal oriented behavior, and risk-taking behaviors. In more severe cases it, may include psychotic features and significantly interfere with daily functioning. The depressive episode will include low mood and/or irritability consistent with major depression. Children with bipolar are at elevated risk for suicide, making it very important for them to adhere to their pharmacological treatment and monitored if they are displaying potential risks.
The first-line treatment for Bipolar Spectrum Disorders is medicine management with a trusted psychiatrist. This typically involves the prescription of a mood stabilizer such as lithium or other anti-convulsants, which have been shown to be effective in managing manic symptoms and lowering the incidence of both manic and depressive episodes. However, cognitive behavioral therapy has been shown to be an effective adjunct to assist children in identifying triggers, regulating emotions, tolerating distress, and improving treatment adherence. Additionally, families can be taught how to monitor their child's symptoms and reduce stress as a means to reduce the risk of future episodes. Given the relatively high risk of suicide, our clinicians work with families to identify risk factors and develop a prevention plan.