Can My Child Have Bipolar Disorder? Pediatric Bipolar Disorder: Fact or Fiction

By Molly McVoy, M.D.   



Can children really have bipolar disorder?  Or, is it a parenting issue?  Is this mental illness overly-diagnosed?



Many of these questions have been raised in the media with increased frequency over the last several months.  What's most concerning is, that instead of focusing on diagnosis and treatment for children with serious mental illness, the debate has focused on who is to blame: is it parents, psychiatrists, drug companies, schools?  The bottom line is that children are suffering, and parents are struggling to keep their children safe, healthy, and happy.  More attention should be paid to actually helping these children, not to pointing fingers of blame.
Pediatric bipolar disorder is a rare but very real illness.  The most recent statistics indicate the mental illness affects approximately 1.5% of children.  Contrary to popular reports, the most recent studies also indicate the rates of pediatric bipolar disorder are not increasing over time, and the rates do not vary between US and non-US populations.1
When pediatric bipolar disorder occurs, it can be very impairing.  Affected children have extreme mood swings – not for minutes at a time but for days.  Children can become suicidal, violent, and often feel quite out of control.  When properly diagnosed and treated, the lives of these children and their families can improve dramatically.  Treatment often involves a combination of mood stabilizing medication and intensive psychotherapy.  But when missed or misdiagnosed, these children may go on to suffer for a lifetime.



Stigma continues to be associated with a mental health diagnosis, and nowhere is that truer than in pediatric mental illness.  Perhaps, in the future, efforts will focus on how to help, not who to blame.



Links:
References:
  1. VanMeter, AR, Moreira, AL, Youngstrom, EA. Meta-analysis of epidemiologic studies of pediatric bipolar disorder. J Clin Psychiatry. 2011, May 31.



Family Game Night Can Make You Smarter



My daughter brought two treats when she came home for college break.  A new game, Bananagrams, and a new book by Richard Restak, M.D. and puzzle master Scott Kim called The Playful Brain: the surprising science of how puzzles improve your mind. 


In this collaboration, Kim shares some of his favorite puzzle formats, and Dr. Restak explains the science behind the games.  Together they cover a wide variety of puzzles that have been shown to keep us alert, thinking, and youthful in mind and spirit.  fMRI data (which shows electrical activity in different parts of your brain) helps to tease out which areas of the brain are activated as people solve different types of puzzles.  


Scientists have not been able to prove a direct link between these forms of brain exercise and prevention of various forms of dementia.  But the puzzles, and games like Bananagrams, provide a focus for interpersonal interaction – playing with your family, talking with your neighbors – which does have a powerful effect on mood and our sense of well-being. 


Summer is the perfect time to bond with your kids in a board game challenge.  How do you get your family to put down their cell phones and turn off the TV to play a game?  Please share suggestions!

Seeing Stars is a Serious Deal - Sports-Related Concussions

By Claudia L. Reardon, M.D.



Concussions in athletes have received increased media attention recently.  More and more evidence shows that there can be serious short- and long-term consequences of concussions if athletes return to physical activity too soon.  A concussion is a brain injury and must be treated very seriously. 


How do you know if someone has sustained a concussion?  Signs and symptoms of a concussion after an athlete hits his/her head include:
  • Headache

  • Nausea/vomiting

  • Dizziness

  • Vision changes

  • Sensitivity to light and sound

  • Feeling confused or groggy

  • Concentration difficulties

  • Inability to remember events before or after the hit

  • Mood, behavior, or personality changes

Importantly, most athletes with concussions won’t experience all of these signs and symptoms.  Some of them might not appear for hours or even days.  If you, a coach, a game official, or medical provider suspect a concussion, take the following steps:
  • Remove the athlete from the game/practice immediately.

  • Seek medical attention.

  • Do not return to physical activity until cleared by a physician.  Returning to activity too soon can cause long-term physical and psychiatric problems and even death.

  • When returning to play, do so gradually, under the guidance of your health care provider.

Sports participation has many positive physical and mental health benefits for children and adults alike.  In the spirit of competition, athletes and coaches often want to do everything they can to win.  However, if a concussion is suspected, it is not worth it to risk long-term brain damage to stay in the game to help the team.   

What does Archbishop Desmond Tutu say about Mental Illness Stigma?

Watch exclusive interviews with Archbishop Desmond Tutu and actress Lorraine Bracco who attended this year's APA Annual Meeting in May.  Also included, video posts from HealthyMinds.org bloggers Dr. Claudia Reardon, Dr. Gariane Gunter, and Dr. Molly McVoy.  Have a mental health issue on your mind? Our Healthy Minds bloggers will anwser right here! Let us know what you want to know

Towards A Healthier View of Happiness: Human Fulfillment

By Roberto A. Blanco, M.D. 



I believe that mistaking what one would call pleasure or joy with happiness is causing people a lot of unnecessary pain.  In popular culture and the media, “happiness” is the feeling when you open a brand new bottle of soda, when you have a party with your friends, or when you get a new car.  Consumer culture has subtle but noticeable effects on people’s beliefs to the point where most people buy into these images or ideals consciously or unconsciously to some extent.  
But, this is not the meaning of happiness for which we should be striving.  This is because pleasure, while it may be fun, is superficial and impossible to sustain.  Even for people who live a “charmed life," it is impossible to find pleasure or joy in all events in life.  In fact, unless there is some larger or longer-lasting definition of happiness such as human satisfaction that fills our lives, it is likely that we won’t be able to find joy in anything.  Events that should provide joy will lose their effect eventually without some deeper meaning.
This may be why many people become depressed.  A lot of us put pressure on ourselves to be “happy” all of the time.  Because we confuse pleasure for happiness at times, the fact that we are not “happy” all of the time can lead to more dissatisfaction with life or lack of fulfillment.  If happiness equates with pleasure or joy, how can we be happy and happy with ourselves when we are going through difficult but worthwhile transitions?  What about during periods of grief? 
It is often very difficult to sustain superficial happiness especially when the inevitable thoughts of ‘why am I feeling bad?’ or ‘why am I not happy?’ creep into the mind.  These thoughts often cause people to feel guilt and then as if they are failures.  To be joyful and smiling all of the time is just an unrealistic goal and we should not feel bad about ourselves if we happen to be in a difficult stage of life.  We need to keep in mind that it is all part of a larger plan or goal of development, human fulfillment or self-actualization.
The search for a good definition of happiness is not a new idea and certainly not one that I thought of.  Over 300 years before Christ and in his book entitled NicomacheanEthics, Aristotle proposed his definition of happiness to the ancient Greek people and laid out his arguments for the meaning of happiness.  He argued that having true happiness is the best and final aim for human activity.  Aristotle called true happiness “eudaimonia” which was a type of long-lasting happiness more consistent with human fulfillment or satisfaction.  Aristotle also believed that happiness should be human fulfillment and not confused with joy or pleasure when he wrote:



For one swallow does not make a spring, nor does one sunny day;

similarly, one day or a short time does not make a man blessed and happy.



I agree that human fulfillment is a loftier goal than joy because when someone is having a difficult time or fallen on hard times, they can still be working towards human fulfillment. During these formative or growing experiences, we can still feel as we are fulfilled or fulfilling our own self-actualization even if we aren’t joyous.  When we take into consideration human fulfillment, we no longer need to feel guilty or as failures during difficult times, transitional periods, or episodes of grief.  We begin to see life from the wide angle of human fulfillment rather than from the small picture of pleasure.
Kahlil Gibran, the famous Christian mystic poet from the early 20th century, also believed in eudomainia.  When Almustafa, the all-knowing visitor in the poem The Prophet, answers a woman’s question on pain, he exemplifies this belief in the beauty of human fulfillment and long-lasting satisfaction despite these painful episodes:



And could you keep your heart in wonder at the daily miracles of your life, your pain would not seem less wondrous than your joy;

And you would accept the seasons of your heart, even as you have always accepted the seasons that pass over your fields.

And you would watch with serenity through the winters of your grief.
As people living in a society where mental illness is so common, we must seek to understand happiness and human fulfillment.  In the hopes of making happiness something more meaningful and sustainable, what we should be striving for is an eternal, longer-lasting form of happiness which is known as human fulfillment or as the Greeks called it eudaimonia.  This is because human fulfillment rather than joy or pleasure allows for the different stages of our lives and growth without having to feel guilt or as if something is wrong.  If we make human fulfillment the goal, we will live happier and more satisfying lives.  Now the obvious question becomes, how do we achieve it?
1.  Aristotle (1999).  Nicomachean Ethics. (Martin Ostwald Trans.)  Upper Saddle River, New Jersey: Prentice Hall, Inc.

2. Gibran, Kahlil (1964).  The Prophet .  New York: Alfred A. Knopf.