Bipolar Disorder (cont.)
What is the course of bipolar disorder?
Episodes of mania and depression typically recur across the life span. Between
episodes, most people with bipolar disorder are free of symptoms, but as many as
one-third of people have some residual symptoms. A small percentage of people
experience chronic unremitting symptoms despite treatment.
The classic form of the illness, which involves recurrent episodes of mania
and depression, is called bipolar I disorder. Some people, however, never
develop severe mania but instead experience milder episodes of hypomania that
alternate with depression; this form of the illness is called bipolar II
disorder. When four or more episodes of illness occur within a 12-month period,
a person is said to have rapid-cycling bipolar disorder. Some people
experience multiple episodes within a single week, or even within a single day.
Rapid cycling tends to develop later in the course of illness and is more common
among women than among men.
People with bipolar disorder can lead healthy and productive lives when the
illness is effectively treated. Without treatment, however, the natural course of
bipolar disorder tends to worsen. Over time a person may suffer more frequent
(more rapid-cycling) and more severe manic and depressive episodes than those
experienced when the illness first appeared. But
in most cases, proper treatment can help reduce the frequency and severity of
episodes and can help people with bipolar disorder maintain good quality of
life.
Can children and adolescents have bipolar disorder?
Both children and adolescents can develop bipolar disorder. It is more likely to
affect the children of parents who have the illness.
Unlike many adults with bipolar disorder, whose episodes tend to be more clearly
defined, children and young adolescents with the illness often experience very
fast mood swings between depression and mania many times within a day.
Children with mania are more likely to be irritable and prone to destructive
tantrums than to be overly happy and elated. Mixed symptoms also are common in
youths with bipolar disorder. Older adolescents who develop the illness may have
more classic, adult-type episodes and symptoms.
Bipolar disorder in children and adolescents can be hard to tell apart from
other problems that may occur in these age groups. For example, while
irritability and aggressiveness can indicate bipolar disorder, they also can be
symptoms of attention deficit hyperactivity disorder, conduct disorder,
oppositional defiant disorder, or other types of mental disorders more common
among adults such as major depression or schizophrenia. Drug abuse also may lead
to such symptoms.
For any illness, however, effective treatment depends on appropriate
diagnosis. Children or adolescents with emotional and behavioral symptoms should
be carefully evaluated by a mental health professional. Any child or adolescent
who has suicidal feelings, talks about suicide, or attempts suicide should be
taken seriously and should receive immediate help from a mental health
specialist.
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