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El trastorno bipolar en los jóvenes: avances y retos

He said, “I didn’t know what was going on or if it could be treated.” He added that for parents of teenagers who have a hard time identifying abnormal behavior in teenagers, “it is sometimes difficult to distinguish what is an illness and what is normal grandiosity or normal sadness caused by breaking up with a girlfriend could have been caused “. “.

Burmaher stressed that although young people with bipolar disorder often experience repeated major depressive episodes, “episodes of depression are not necessary to make a diagnosis”. In some cases, mania is the main symptom.

When depression is the symptom that prompts people to seek professional help, making a proper diagnosis can be especially difficult. As Ketter explained, sometimes people with depression cannot remember previous episodes of mania that occurred when they were not depressed.

Miklowitz mentioned that one of the first signs of bipolar disorder is “mood dysregulation, which means the child feels angry or depressed at a certain moment and feels excited, happy, and full of ideas soon after.”

He made a list of characteristics that can help parents distinguish these extremes from the normal ups and downs of adolescence. Some of these symptoms, many of which should be obvious to those around them, are “megalomania, decreased need for sleep, rushed or rushed speaking and / or ideation, delusional ideas, distraction, excessive goal-oriented activity, and risky and impulsive behavior,” said Miklowitz.

As for the symptoms of depression, he suggests observing whether “there is some deterioration in normal activities; for example, if the child is suddenly absent from school or is late, does not finish homework, falls asleep in class, drops the grades, does not want to eat with others, talks about suicide or injures himself ”.

Depending on the severity of the respective deterioration, if non-life-threatening symptoms are found in adolescence, it is possible to initiate psychotherapy and avoid drugs with side effects, said Miklowitz.

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The Challenges of Bipolar Dysfunction in Younger Individuals

Dr. Birmaher noted that young people with bipolar disorder usually have recurring episodes of major depression, but that “depressive episodes are not necessary for making the diagnosis.” For some, mania is the primary symptom.

When depression is the symptom that brings patients to professional attention, the correct diagnosis can be especially tricky. As Dr. Ketter explained, depressed individuals may be unable to recall previous episodes of mania that occurred when they were not depressed.

Dr. Miklowitz said one of the first signs of bipolar disorder is “mood dysregulation — the child is angry or depressed one moment, then is excited and happy and full of ideas moments later.”

He listed characteristics of mania that can help parents distinguish them from normal teenage highs and lows. The symptoms, several of which should be noticeable to other people, can include “grandiose thinking, decreased need for sleep, rapid or pressured speech and/or flight of ideas, racing thoughts, distractibility, excessive goal-driven activity, and impulsive or reckless behavior,” Dr. Miklowitz said.

With depressive symptoms, he suggests looking for “an impairment in functioning — suddenly not going to school or going late, not finishing homework, sleeping through classes, a drop in grades, not wanting to eat with anyone else, talking about suicide, self-cutting.”

Depending on the severity of a child’s impairment, if nonlife-threatening symptoms are caught in the early teens, Dr. Miklowitz said it may be possible to start with psychotherapy and avoid medication, which has side effects. “But if the child’s life is at risk, if he can’t function at home or at school, medication may be the answer,” he said. “There are risks to not medicating.”

When medication is necessary, he said, the dosage should be just high enough to control symptoms and not be overly sedating.