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Recognizing the signs of bipolar disorder Recognizing the signs of bipolar disorder
Bipolar disorder is a psychiatric disorder that in the past was known as 'manic depressive disorder.' It is a mood disorder characterized by... Recognizing the signs of bipolar disorder

by Kimberly Allen R.N.

Bipolar disorder is a psychiatric disorder that in the past was known as ‘manic depressive disorder.’  It is a mood disorder characterized by episodes of abnormally high energy levels with or without one or more depressive episodes.  There are several different types of bipolar disorder, however, there is no exact number listed.  Four specific sub-types have been listed by the DSM-IV-TR.

Bipolar I disorder is characterized by one or more manic episodes.  Though a hypomanic or depressive episode is not required it does frequently occur.

Bipolar II disorder has one or more hypomanic episode and one or more major depressive episode, however there are no manic episodes.  Bipolar II can be more difficult to diagnose as the hypomanic episodes are not as extreme as mania and are without psychosis.

Bipolar disorder NOS (not otherwise specified) is for all those that do not fall within one of the other specific subtypes.

Cyclothymia is characterized by hypomanic episodes along with episodes of depression that do not meet the criteria for “major depressive” episodes.

The diagnosis of bipolar disorder is usually made based on reports of abnormal behavior by  the individual, family members, friends or co-workers.  If the individual is a child or teen the doctor will also perform a medical exam to detect other problems that sometimes co-exist with bipolar disorder that also require treatment.  The doctor will also test for learning disorders like ADHD.

Children and teens with bipolar disorder experience extremely intense emotional states.  These emotional states occur in distinct periods known as “mood episodes.” An extremely happy or overexcited state is known as a manic episode and a depressive episode is a state of extreme sadness  or hopelessness.  A “mood episode” can include symptoms of both mania and depression and the child can be very irritable and explosive during an episode. Along with the changes in mood there are extreme changes in energy, activity and sleep.  Remember it’s normal for most children and especially teens to experience  changes in mood and energy, sometimes.  Do not confuse passing changes with bipolar disorder.  The symptoms of bipolar disorder are extreme and have a tendency to last most of the day, everyday for a week or more.

Bipolar disorder that is diagnosed during childhood or teens is known as early onset bipolar disorder and is usually more severe than the types of bipolar disorder seen in adults.  Children and young teens have more frequent mood changes with more mixed episodes and are sick more often.  They are also at greater risk for suicide and suicide attempts than those who develop bipolar disorder in adulthood.

Currently there is no cure fo bipolar disorder.  Current treatment for all forms of bipolar disorder includes psychotherapy and medications.  There are no specific guidelines for treating children and teens,  Drs usually depend on information related to treating adults.  As children can respond differently to any medication including psychiatric medications than adults it’s important to monitor them closely.

Kimberly Allen is a registered nurse with an AND in nursing. She has worked in ACF, LCF and psychiatric facilities, although she spent most of her career as a home health expert. She is now a regular contributor to, dispensing advice and knowledge about medical issues and questions. You can reach her with any comments or questions at