Unlocking ADHD writer Shreya Jolly describes bipolar disorder, its comorbidity with ADHD and shares some ways to manage this.
Bipolar disorder (BD) refers to a brain disorder that causes the individual to experience intense emotional states.
How does bipolar disorder manifest in children?
In children BD often causes difficulties in paying attention, processing speed and solving abstract problems. It also results in impairment of visuospatial memory, interference control and or executive function.
Sometimes a child with BD feels extremely happy. He/she also appears more energetic and active than usual. This is known as a manic episode. The same child can also experience periods of extreme sadness or lows. This is known as a depressive episode.
These highs and lows are not the same as the normal highs and lows every child goes through during the natural process of growing up. The mood changes in children with BD are typically much more extreme. Unfortunately, BD can make it difficult for children to perform well in school and get along with people in general. In older children and teens, BD can also increase tendency towards self-harm and suicide.
How to differentiate between ADHD and Bipolar disorder?
Although ADHD and BD are often difficult to differentiate given that both involve:
- Irritability
- Hyperactivity
- Restlessness
There are some ways in which the two differ. For instance, children with ADHD often talk a lot while children with BD often talk so fast that they sometimes appear incomprehensible.
Typically, if one experiences the onset of ADHD symptoms at an early age and the symptoms continue without any depressive, manic or hypomanic episode then it is likely that they solely suffer from ADHD.
Alternatively, if an individual experiences an increase in goal-directed activity, grandeur and or reduced sleep without displaying symptoms of ADHD he/she may be experiencing a manic or hypomanic episode characteristic of bipolar disorder rather than ADHD.
What does ADHD and Bipolar disorder look like in children?
If your child suffers from both ADHD and BD, they are likely to experience behavioral outbursts, act impulsively and display extreme mood swings. A child suffering from ADHD may also demonstrate the following symptoms if he/she has BD:
- Grandeur
- Self-harm
- Lack of sleep
How can parents help?
Early diagnosis of BD and differential diagnosis of ADHD are crucial. Hence parents should bring their child to a child psychiatrist as soon as possible.
In addition, parental commitment and support towards their children are also considered extremely important when it comes to treatment and recovery.
What are the treatment options?
Since the effects of BD are usually more severe, initial treatment typically focuses on stabilizing mood prior to treating symptoms of ADHD. This is because many of the stimulants which are given to treat ADHD can exacerbate mania.
Usually, BD treatment includes psychotherapy coupled with hospitalization (in some cases). On the other hand, ADHD treatment can in addition to stimulants involve behavioural therapy and counselling. For both these disorders, it can help to enter a residential treatment program.
Conclusively, although people with both BD and ADHD demonstrate more severe symptoms of ADHD, acquire BD younger and have more psychiatric disorders than those with ADHD alone, differential diagnosis coupled with proper medication, life management and therapy can enable the patient to live a full healthy life.
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