Manic-Depressive Illness
Manic-depressive illness is a disorder in which periods of intense elation and excitation alternate with periods of depression and despair.
Children normally have fairly rapid mood swings, going from happy and active to glum and withdrawn. These swings rarely indicate mental illness of any kind. Manic-depressive illness (also called bipolar disorder) is far more severe than these normal mood changes and is rare in children, but more common than previously thought. More typically, it begins in adolescence or early adulthood (see Section 7, Chapter 101).
The cause is unknown, but a tendency to the disorder can be inherited. Rarely, drugs with stimulant effects, such as amphetamines, which are sometimes used for attention deficit/hyperactivity disorder (ADHD) (see Section 23, Chapter 269), produce symptoms in children similar to manic-depressive illness.
Symptoms
Many children with manic-depressive illness exhibit a mixture of mania--a state of elation, excitation, racing thoughts, irritability, and grandiosity (in which the child feels he has some great talent or has made an important discovery)--and depression. The mania and depression occur simultaneously or in rapid alteration. During manic episodes, sleep is disturbed, the child may become aggressive, and school performance often deteriorates. Children with manic-depressive illness appear normal between episodes, in contrast to children with hyperactivity, who have a constant state of increased activity. Because ADHD can produce some similar symptoms, differentiating between the two conditions is important.
Treatment
Manic-depressive illness is treated with mood-stabilizing drugs, such as lithium, carbamazepine, and valproate. Individual and family psychotherapy help children and their families cope with the consequences of the disorder.
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