Bipolar Affective Disorder, also called "bipolar disorder" or "manic depressive disorder", is seen in 1% of adolescents. During adolescence, symptoms can be confused with Attention Deficit and Hyperactivity Disorder (ADHD) or conduct disorder symptoms. Experts point out that in many cases, attacks become more frequent in various seasons and give important advice to parents.
Üsküdar University NPISTANBUL Hospital Psychiatry Specialist Asst. Assoc. Prof. Dr. Emel Sarı Gökten said that in Bipolar Affective Disorder, also called "bipolar disorder" or "manic depressive disorder", significant deviations from normal occur in the mood of the person, and the disease can also be seen in adolescence.
Stating that the most important diagnostic episodes of the disease are manic or hypomanic episodes, Assist. Assoc. Prof. Dr. Emel Sarı Gökten said, "During these episodes, the person sleeps much less than usual, yet feels quite energetic, talks more than normal, feels quite cheerful, pleasant, and sees himself as strong enough to do anything. He/she acts impulsively and sometimes gets angry and outbursts very quickly. During manic episodes, the symptoms are so severe that the person often needs to be hospitalized. A milder form of manic episodes is called a hypomanic episode. People with bipolar disorder have depressive episodes in addition to manic episodes. When they are depressed, they have low energy, sleep a lot but do not feel rested, are restless, have difficulty concentrating, feel depressed and pessimistic. Apart from these attacks, the person returns to normal functionality and continues his/her life."
It is seen differently from adults
Stating that Bipolar Affective Disorder is seen in approximately 1% of adolescents, Asst. Assoc. Prof. Dr. Emel Sarı Gökten said, "Symptoms in adolescence may be confused with symptoms of Attention Deficit and Hyperactivity Disorder or Conduct Disorder".
Noting that Bipolar Disorder in adolescence is different from adulthood, Asst. Assoc. Prof. Dr. Emel Sarı Gökten listed these differences as follows
"It has a faster cycle. Attacks are mostly seen in mixed type (depressive and manic symptoms at the same time). Irritability (irritability, easy reaction) is the leading symptom, accompanied by symptoms of attention deficit and defiance. It has a chronic course, there may not be normal periods between attacks."
Noting that in mania during adolescence, the state of being happy for no reason (euphoria) may not be seen as in adults, and that the more common symptom is irritability and sudden anger and reaction, Assist. Assoc. Prof. Dr. Emel Sarı Gökten said, "As the age progresses, the frequency of euphoria (state of being happy for no reason) increases in Bipolar Disorder manic episode as in adulthood. The mixed type manic episode, in which both depression and mania symptoms are together, is more common in children."
It has many common features with ADHD
Stating that Attention Deficit and Hyperactivity Disorder (ADHD) and Bipolar Disorder have many similar characteristics such as distractibility, impulsivity and hyperactivity, Assist. Prof. Dr. Emel Sarı Gökten said, "However, Bipolar Disorder has several distinctive features. Disorders of reality assessment, depression, tension, arousal, mood fluctuations, grandiosity, inappropriate emotional expression symptoms are more common in Bipolar Disorder. It is also similar to the symptoms of conduct disorder. For example, impulsivity, stealing behavior, substance abuse, disobeying rules and quick temper are common in both disorders."
Preventive treatment is important in Bipolar Disorder
Stating that the patient usually needs to be hospitalized in the treatment of manic attacks, Gökten emphasized the importance of preventive treatment and said the following:
"Before starting treatment, biochemical evaluation, i.e. analyzes such as blood count, liver function tests, thyroid hormone tests are performed. History of drug or substance use and possible medical diseases are questioned. With medication, the patient usually shows complete or near complete improvement within 2-4 weeks. The most important point in the treatment of Bipolar Disorder is preventive treatment. Because attacks are temporary but there is always a risk of recurrence. The drugs used in the preventive treatment of Bipolar Disorder are called "mood stabilizers". It may be difficult to diagnose BPS in the first episode, and since mood stabilizers are used for preventive purposes after the episode, in some cases, the second episode can be waited to start these medications. Some medications (especially antipsychotics and anxiolytics) can be used in the acute phase. If antidepressants are used, they are discontinued. Depending on the accompanying symptoms, such as sleep problems, aggression, significant attention and learning problems, additional medication may be administered. In the case of a mixed type of attack, the use of antidepressants is avoided despite the presence of symptoms of depression. In addition to medication, individual psychotherapy, family therapy, family education and cognitive behavioral therapies may be added to the treatment. One of the most important issues in the treatment of BPSD is the prevention of attacks. Recognizing the initial symptoms of attacks and going to psychiatry control without wasting time is essential in preventive treatment."
Beware of these seasons!
Stating that the main feature of Bipolar Affective Disorder is that it is characterized by occasional periods of deterioration, that is, attacks, Assist. Assoc. Prof. Dr. Emel Sarı Gökten said, "In many cases, these attacks become more frequent in various seasons. Especially the period between May and August is considered more risky."
Get information and be realistic
Asst. Assoc. Prof. Dr. Emel Sarı Gökten also gave important advice to the family and relatives of an adolescent diagnosed with Bipolar Affective Disorder. Gökten listed her suggestions as follows:
1. First of all, get as much information about BAD as possible. Consult your doctor about obtaining evidence-based and in-depth information resources.
2. Do not neglect to get help from experts and consult them when necessary.
3. Try to reduce the number of stressors in your life. Increased stressors not only negatively affect the course of BAB, but also make it more difficult to treat the disease.
Insomnia and substance abuse
4. Insomnia and substance use such as cannabis can trigger a manic episode. Take care to control such risks.
5. Have realistic expectations. BAB can be a chronic and very challenging illness with episodes, and despite all kinds of treatment, the symptoms may not disappear completely. Therefore, focus on getting better, not perfect.
6. Don't neglect yourself. If you are not in good mental and physical health, you may not be able to help your loved one who has been diagnosed with BAB. On the other hand, your distress may reflect negatively on him/her.
7. Make sure that treatment is continued without interruption.
8. Learn about the possible effects and side effects of medication and observe and note these effects.
9. Have an action plan for emergencies. Sometimes there may be unexpected symptoms or side effects of medication. There should be a clinic you can call or go to in this case. You can ask your doctor in advance what to do in these possible situations."