Severe mental disorders, such as bipolar disorder, have become more prevalent in children and adolescents over the last few decades, leading scientists, doctors, and parents to question whether medicating developing minds in adolescents is an effective and safe way to treat these disorders (Gaviria, Sayers, Hentoff, Wright, & Lyman, 2008). This topic has remained controversial for years because there is no definitive way to diagnose bipolar disorder in adolescents, and it can be confusing to differentiate symptoms of hyperactivity, inability to focus, depression, aggression, and other symptoms as factors for mental illness or normal hormone development in youth. As more medications are developed to specifically treat bipolar disorder, there is a growing concern that children will suffer from cognitive decline, suicidal ideations, and overdose (Gaviria, Sayers, Hentoff, Wright, & Lyman, 2008). However, some adolescents present with severe symptoms, indicating a need for medication to live as close to a normal life as possible.
Thousands of studies have been conducted over the last ten years to evaluate different methods used to diagnose and treat bipolar disorder in adolescents. One of the main concerns is misdiagnosing pediatric patients, as many present symptoms with comorbid disorders, making it difficult to differentiate symptoms to effectively treat individuals (Birmaher, 2013). If a child presents with ADHD, bipolar disorder, and anxiety, the treatment becomes more complex as some symptoms are prevalent in each disorder. Another problem with diagnosing children with mental health disorders is how they are diagnosed. As the Frontline documentary stated, many children are evaluated by primary doctors and pediatricians instead of psychiatrists, which is of great concern because these professionals are not properly trained to diagnose more severe cases (Gaviria, Sayers, Hentoff, Wright, & Lyman, 2008). This often results in overmedicating, which can lead to overdose, tics and twitches, depression, and suicidal thoughts/ attempts.
The current Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is a tool used by mental health professionals to reference symptoms and properly diagnose adolescents with bipolar disorder. Although it’s not a definitive way to diagnose bipolar disorder, especially in children with less pervasive symptoms, the DSM-5 is more reliable than an evaluation with a pediatrician or general practitioner. Furthermore, the DSM-5 helps psychiatrists decide which medications will work best according to the symptomology of individuals. It’s not a one-size-fits-all, and that becomes a problem when prescribing SSRIs, antipsychotics, atypical drugs, psychotropic drugs, and other medications (Romanelli, et al., 2009). The side effects from these medications have a wide range anywhere from general fatigue to suicidal ideations, and the results are grave for many children who are very young.
Medicating children who present with varying degrees of bipolar disorder may be controversial, but evidence supports the efficacy of certain drugs like lurasidone and olanzapine (Dineen Wagner, 2018). Medication alone may be sufficient in extreme cases, but current research points to additional methods in the treatment of pediatric bipolar disorder. An evaluation of family history, substance abuse, trauma, comprehensive assessments, domestic violence, socioeconomic status, and parenting skills should all be evaluated when considering a bipolar disorder diagnosis (Romanelli, et al., 2009). Additionally, different types of behavioral therapy in conjunction with alternative treatments (yoga, meditation, breathing exercises, etc.) may help reduce the symptoms of bipolar disorder in adolescents. Further empirical research should be conducted to test certain drugs against placebos, in order to ensure efficacy and reliability. From a pharmacologic perspective, developing new drugs with less severe side effects would be greatly beneficial for young developing minds.
Birmaher, B. (2013, September 1). Bipolar disorder in children and adolescents. Child and adolescent mental health, 18(3). Retrieved November 15, 2018, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3835470/
Dineen Wagner, K. (2018, August). Treatment of Bipolar Depression in Children and Adolescents. Psychiatric Times, 35(8), 8. Retrieved November 15, 2018, from https://eds.b.ebscohost.com.ezproxy.lib.usf.edu/eds/pdfviewer/pdfviewer?vid=4&sid=812af262-0742-44e2-8600-8068f507d2ba%40pdc-v-sessmgr02
Gaviria, M., Sayers, J., Hentoff, M., Wright, D., Lyman, W. (Producers), & Sayers, J. (Director). (2008). Frontline. The Medicated Child [Motion Picture]. Retrieved November 15, 2018, from https://www.dailymotion.com/video/x17awuw
Romanelli, L. H., Landsverk, J., Levitt, J. M., Hurley, M. M., Bellonci, C., Gries, L. T., . . . Child Welfare-Mental Health Best Practices Group. (2009, January). Best Practices for Mental Health in Child Welfare: Screening, Assessment, and Treatment Guidlines. Child Welfare, 88(S1), 163. Retrieved November 15, 2018, from https://eds.b.ebscohost.com.ezproxy.lib.usf.edu/eds/pdfviewer/pdfviewer?vid=3&sid=5060ca70-ef2b-4170-9e68-fcc1ff11688b%40pdc-v-sessmgr01
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