Sunday, 20 July 2014

Symptoms of Teen Bipolar

Guidance for doctors in the recognition of bipolar disorder in teens comes mainly from the treatment of adults. Yet, when bipolar symptoms begin before or soon after puberty they are frequently in the form of rapid-cycling moods and disruptive behavior. It is only in later adolescence that onset tends to begin with a manic episode and is interspersed by more stable periods between episodes, a pattern more similar to adults.

The National Institute of Mental Health points to some differences between bipolar symptoms seen in teens to those of adults. For example, during a manic episode, young people are more likely to be destructive rather than creative or speculative in their behavior. When depressed, they are more likely to complain about headaches, stomach pains, fatigue and other physical symptoms. Young people may also have problems in making and retaining friends and seem to have an extreme sensitivity to perceived rejection or failure.

Even if diagnosed, many teens fear the stigma that may result with both their treatment and the signs they are taking medication. Many resist treatment altogether because they dislike the side effects of medication and often the weight gain that comes with taking them. Drugs and alcohol may be turned to as more acceptable ways of trying to keep the symptoms under control.

Various experts have suggested that modern living contributes to the onset of bipolar disorder in teens who might previously have avoided it. A teen with a genetic predisposition to bipolar does not need much in the way of stress or the use of alcohol or recreational drugs to tip them towards bipolar, or so the argument goes. Structure and routine do appear to help with the symptoms of bipolar and for this reason parents of teens with suspected or diagnosed bipolar disorder are encouraged to set firm boundaries when it comes to routines such as bedtime and getting up for breakfast. Unfortunately these routines are fairly vulnerable when, for example, teens leave home for college or are strongly influenced by peers to participate in late night parties involving alcohol and possible drug use.

It can take a long time before a diagnosis of bipolar disorder is reached. If it is suspected then support in the form of counseling, cognitive behavioral therapy, family therapy or other methods may be helpful to provide meaning and structure. From what is known, a predictable and stable lifestyle appears to be a critical feature in reducing the frequency and severity of bipolar episodes or possibly even preventing their onset.

Saturday, 19 July 2014

Depression: Work, Family, Relationships

Depression is a debilitating disease and its effects are not restricted to the individual suffering with it. I touch on three specific areas that repeatedly appear in any documentation about depression: work, family and relationships.

Work. People with a major depressive episode are five times more likely to miss work than people experiencing other physical symptoms. One study found that 11 disability days in the previous three months were as a result of depression. Even people who do force themselves to work are likely to have a diminished level or quality of performance.

Family. Several studies have been undertaken that look at the effect of parents with depression. There is almost universal recognition that children of a depressed mother are at risk of developing depression themselves. The main problem seems to hinge on the difficulty a depressed mother has in consistently providing a responsive, warm and supportive relationship with their children. In fact depressed mothers tend to be more critical and uninvolved. Despite this, depressed mothers frequently yearn to be good mothers. However, the sheer energy draining effect of depression depletes any reserves, so it is hardly surprising the effect is felt by children.

Marriage. Depression and marriage can be something of a two way process. It is quite possible for a bad marriage to cause depression, or for depression to affect a marriage. As much as depression is an unwanted and difficult disease, it is not easy living with a depressed person. During their depression the person frequently feels withdrawn, irritable, unloved and useless. The effect on their partner, who may not even recognize or understand the nature of depression, is often negative. Partners frequently worry this is a sign of marriage failure. They are disappointed that encouragement fails, they feel worried, they become irritated by their partner’s irritation and so on.

When we see the incidence of depression, the effects it has on the individual and the things around them, it is a little surprising to see how slowly the official response to this disease has been.