From the Guidelines
Bipolar disorder is characterized by distinct episodes of mania and depression, with symptoms including elevated or irritable mood, increased energy, decreased need for sleep, racing thoughts, and poor judgment, as well as persistent sadness, loss of interest in activities, and changes in appetite and sleep. The disorder is caused by a combination of genetic factors, brain chemistry imbalances, and environmental triggers. Some key points to consider when assessing and treating bipolar disorder include:
- The importance of using the DSM-IV-TR criteria, including duration criteria, when making a diagnosis of mania or hypomania in children and adolescents 1
- The need to carefully evaluate for other associated problems, including suicidality, comorbid disorders, psychosocial stressors, and medical problems 1
- The use of mood stabilizers, antipsychotics, and psychotherapy as treatment options, with most patients requiring lifelong medication to prevent recurrences 1
- The importance of psychoeducational therapy, relapse prevention, individual psychotherapy, and social and family functioning in the treatment of bipolar disorder 1 It is also important to note that the diagnosis and treatment of bipolar disorder in children and adolescents can be complex and may require a comprehensive and multimodal approach. Treatment typically includes mood stabilizers like lithium (600-1200mg daily), valproate, or lamotrigine; antipsychotics like quetiapine or olanzapine; and psychotherapy, with the goal of preventing recurrences and improving quality of life. Overall, the assessment and treatment of bipolar disorder require a thorough understanding of the disorder and its symptoms, as well as a comprehensive and individualized approach to treatment.
From the Research
Classic Symptoms of Bipolar Disorder
The classic symptoms of bipolar disorder include:
- Recurrent episodes of depression and mania or hypomania 2
- A distinct change in mood and behavior during discrete time periods 2
- Depressive episodes similar to major depressive episodes 2
- Manic and hypomanic episodes characterized by a distinct change in mood and behavior 2
Types of Episodes
Bipolar disorder can involve different types of episodes, including:
- Manic episodes: characterized by an abnormally elevated mood 3
- Depressive episodes: similar to major depressive episodes 2
- Mixed episodes: a combination of manic and depressive symptoms 4, 3
- Hypomanic episodes: a less severe form of mania 2, 3
Diagnosis and Treatment
Diagnosis and treatment of bipolar disorder can be complex, with:
- A high frequency of psychiatric and somatic comorbidities affecting the course of the illness 3
- Early diagnosis and treatment associated with a more favorable prognosis 2
- Long-term treatment consisting of mood stabilizers, such as lithium, valproate, and lamotrigine 2, 5, 6
- Antipsychotic agents, such as quetiapine, aripiprazole, asenapine, lurasidone, and cariprazine, recommended for treatment 2