Bipolar Disorder

You've just reviewed some symptoms that may be indicators of depression. Many people find themselves depressed at various points in their lives; it is a fairly natural thing. Depression is a mental health problem that can “stand alone.” This means it can occur without association with another mental health problem.

When someone has a bipolar mental health experience, there are two components to it. Depression is one of those two components. The other is called mania. While depression can occur without mania, mania never stands alone without depression at some point.

Fact

The characters from the classic Winnie the Pooh stories make a good bipolar analogy. Think about Tigger the tiger and Eeyore the donkey. Tigger demonstrates the intense, “wired” energy and grandiose selfesteem associated with mania. Eeyore is typically self-loathing, lethargic, and full of hopelessness for the future. If they were both one and the same, that character would be the epitome of bipolar disorder.

When you've heard people disrespectfully described using the label “manic-depressive,” it refers to someone who experiences bipolar disorder. (Bipolar means two opposite ends of the poles, or two extremes — mania and depression). Bipolar may also be referred to as severe “mood swings.” When someone has bipolar disorder, there may be periods when he is level or even. The person may experience the onset of a manic experience that may develop gradually or skyrocket rapidly — it all depends on the individual. At some point, the person de-escalates from mania and either returns to feeling level or begins a descent into depression. Many people feel similar highs and dips, but they usually do not impair their daily lives. The difference here is that being bipolar can seriously affect one's life if not properly treated. In fact, a 2008 study by researchers in the Department of Neuropsychiatry at Kanazawa University Hospital, Kanazawa, Japan, concluded that of the forty-four adolescents and young adults with Asperger's examined, the major co-occurring mental health issue identified was bipolar disorder. The study also suggested that Asperger's and bipolar may share common genes. If accurate, this is all the more reason to be diligent in ascertaining your child's mental wellness.

You are now familiar with the primary symptoms of depression as they may appear in your child. Now review the symptoms of mania for any child, augmented with details specific to a different way of being.

Mood Swings

The first major symptom is a euphoric or irritable mood. Your child may seem delirious or giddy, with an increased intensity of laughing and grinning. At times she may have a fixed grin and speech that appears forced or unnatural. Her speech may be pressured, meaning it is bursting forth hard and fast as though her thoughts are speeding. You may notice your child forcing laughter at inappropriate times, like during serious discussions. If your child has always been a “kidder,” you may notice her taking things too far, unable to cease the joke-telling or pushing physical slapstick that gets out of hand or causes others harm. Your child's tolerance threshold for autistic-like sensory sensitivities may also be vastly diminished, heightening irritability.

Inflated Self-Esteem

The next manic symptom is a sense of inflated self-esteem, known as grandiosity. A child with Asperger's may project a sense of omnipotence and control over those in authority such as Mom, Dad, teachers, doctors, or caregivers. He may “hire” or “fire” you, threaten to withhold your salary, or physically direct you and others where to go in a given environment. In one instance, a young boy insisted, “God's not the boss, I am!”

Fact

One boy with Asperger's Syndrome and undiagnosed bipolar disorder clearly demonstrated the manic symptom of grandiosity when interacting with his counselor. He told the man that he intended to (creatively) kill his family, marry the counselor, and then kill him to assume his identity. Others might label this psychotic, but this fits within the bipolar framework in consideration with other symptoms.

The child may believe himself to be a childhood “celebrity” such as a popular TV, movie, or cartoon character, or even Santa Claus. The child may try to assume all or part of an authority fig-ure's name. Similarly, the child may believe he possesses superhuman “superhero” strength. He may climb on top of furniture, windowsills, and countertops, out onto rooftops, or into the street. There, he may hurl himself into space with the belief that he will fly, or that no harm will come to him. Grandiosity may also manifest in your child damaging property, like trashing his bedroom or attempting to lift and throw heavy objects such as a television or pieces of furniture.

In extreme instances, your child may smear or throw feces, or urinate in places other than the bathroom. You may notice your child hoarding food or taking someone else's food, even if your child has the same portions in front of him. Finally, and most significantly, your child may physically attack and harm people very dear to him — people he would otherwise never dream of hurting. This may include hitting, punching, pulling hair, biting, scratching, head butting, pinching, or using weapons like knives. Once the manic “high” has blown over, it is very common for many children with Asperger's to be extremely remorseful for their actions during the times they were not in control. They may sob bitterly, want to be held, or plead for forgiveness.

Obsessions

Another primary symptom of mania is an increased intensity in pleasurable activities. This is when the child's special areas of interest, or passions, may seem like an obsession. The child's focus may be so absorbed that she cannot be dissuaded away from the activity. If you insist, he may lash out verbally or physically. For some children, especially teens, this symptom may come through with a sexual intensity, called hypersexuality. He may make wildly inappropriate remarks to others (including adults), touch others without permission, or masturbate openly or with greater frequency.

Other Symptoms of Mania

Instead of jumping to conclusions about “delinquent behavior,” see if other symptoms support a case for mania. Additional symptoms of mania may include:

  • Increased agitation, as though your child has a “short fuse”

  • Being able to describe your child as “wired” with energy (Perhaps he doesn't sleep, sometimes for days in a row, or naps sporadically.)

  • Changes in appetite (Is your child gorging himself or hoarding food, such as in dresser drawers or under his bed?)

  • “Racing” thoughts or ideas (Does your child rapidly shift topics without any apparent connection between them? Or does he seem physically indecisive, moving from one activity to another without any rationale? Do your child's racing thoughts spill forth in his speech? He may talk at a very fast pace, tripping over words or spitting while talking.)

  • If your child is bipolar and he experiences periods of mania and depression, it will be important to stay focused on the child, not the behaviors. This will be your single greatest challenge as a parent. Remember, it is not your child's fault. It is no one's fault, but it is serious, and you must be aggressive in seeking relief for your child through proper treatment.

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