Eastman 1 Megan Eastman Dr.

Karin Mendoza Intermediate English Composition (ENGL 2089) 9 April 2014

Abstract This research argumentative paper talks about Bipolar Disorder and what the effects are from diagnosing this illness at a young age. The goal for this paper is to get the audience to look at both sides of the positives and negatives of diagnosing at a young age. The argumentative paper includes insight from parents with children who are diagnosed with the disease as well as my own experiences with a child who I believe had this disorder. I have also looked at research from medical practitioners and their insight on this issue. The purpose of this paper is to educate the readers on why I think it is important to diagnose at a young age. I also hope to help the audience understand how bipolar disorder affects the lives of not just the child, but the family as well.

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Diagnosing a Child with Bipolar Disorder: Detrimental or Necessary Bipolar Disorder (BD) is a mental disorder marked by alternating periods of elation and depression. How would you feel as a child having this mental illness at a young age and not know what is going on? Or, how would you feel as a parent, watching your child go through the periods of happiness and then depression in a matter of minutes? These questions come to mind when I think about BD and the consequences of not diagnosing the illness as soon as the symptoms arrive. I believe diagnosing a child with bipolar disorder at an early age is necessary for a fulfilled life. There are pros and cons to what I believe in and research studies proving both sides to this controversy. BD is more likely to affect children of parents who already have the disorder and are diagnosed. If one parent has the disorder, the child has a 15-30% chance of developing BD as well. If both parents have the disorder then the risk increases to 50-75% chance. Bipolar Disorder is common in people with depression as well. Symptoms of depression are severe despondency and dejection, typically felt over a period of time and accompanied by feelings of hopelessness and inadequacy. Up to 1/3 of the 3.4 million children and adolescents with depression in the United States may actually experience the early onset of BD. Like I explained earlier, Bipolar Disorder is a condition in which a person has periods of depression and periods of being extremely happy or being cross or irritable. Typically, when a child develops bipolar disorder, it is considered early onset bipolar disorder because this is when the symptoms have just started and could turn into full-blown bipolar disorder. BD is either caused by genes, abnormal brain structure or brain function, or anxiety disorders. Genes is a common explanation for having BD because the illness runs in the family. Children with a

Eastman 3 parent or a sibling who is suffering with BD are more likely to get the mental disorder as well, over a child with no history in the family of this disorder. Kids with an anxiety disorder, which is a disorder with a feeling of worriedness and nervousness, can also cause early onset depression. If a child has BD, they will have multiple symptoms that are referred to as episodes. The episodes are every day and they can last a week or two or even longer. They may be extremely happy or extremely sad, have a short temper, talk rapidly about a lot of things, have trouble sleeping but do not feel tired, have trouble staying focused, talk and think about sex more often and do risky things. If a child is having three or more of the following symptoms according to the diagnostic and statistical manual of mental disorders (DSM), then the child has bipolar disorder. You can also test BD with a blood test and a brain scan and this can also determine if someone has the mental disorder. Unfortunately, there is no cure for bipolar disorder but there is treatment, which includes medication and therapy. Medication depends on how severe the symptoms are because if the symptoms are extremely severe, the child may need more than one medication prescribed to them to calm down the symptoms. There is also therapy, which is just psychotherapy where the child can express their anger in a healthy way. As the years go on, I hope there will be a cure but for right now, treatment is as good as medicine can get. Mental Disorders have always been fascinating to me because it amazes me what some people go through on a day-to-day basis when suffering with a disorder. I am fortunate enough to not have a mental disorder but an estimated 26.2 % of America does (NIMH), and if I could help even a fraction of those people, then I would be satisfied with myself. I am a psychology major and helping people is what I want to do for a living. I want to be a mental health

Eastman 4 counselor to children who are suffering with mental disorders. I want to be the person who the child goes to, to talk about their problems and what they feel on a daily basis. I recently was a nanny to a family with a five year old girl who seemed to be suffering with a mental disorder but was not diagnosed. I thought it was bipolar disorder but her parents would not listen to me when I tried to tell them to take her to see a doctor. My experience with her was unlike any experience I have ever had with a child. On one particular day, I asked her to take a bath and she did not want to, so she colored on the carpet and then flooded the bathroom. After about 10 minutes of her screaming, she finally shouted, I cannot help how I act, something is wrong. For a 5 year old to say that, it really struck me that she must have a mental disorder. I noticed other things she would do, like be happy one second and then extremely upset the next, so this made me consider that she had BD. While researching why children should be diagnosed at an early age, I wanted to get that point of view from a parent. Sometimes we only think about the struggles for the child and we do not think about what the parent has to go through, so I went online and found a good clip on YouTube about a woman with her 3-year-old daughter suffering from BD. Sadie, a 3-year-old was suffering from BD and the symptoms started in Pre-school. Her mother, Dorothy ODonnell said she would be extremely happy one minute and screaming the next. Her pre-school decided that Sadie needed to undergo a psych evaluation. During the YouTube clip, Richard Goldwasser, M.D, a child psychiatrist said, the children with bipolar disorder know there is something wrong. They know that something is not right and they feel sad and know it is not normal (ODonnell). For Sadies psychological test, she had to circle how she felt when certain situations would come about. For example, Sadie would have to circle how she felt when she was alone or how she felt when she was with her family. The results showed a high level of

Eastman 5 depression at the young age of three. Dorothy then explained how relieved she was that they had an answer to her issue. In this circumstance, diagnosing the child at an early age was successful because now she has medicine that calms her down. Without her medicine, Sadie would not be able to be calm in situations and that would ruin her. In the situation I just explained earlier, Sadie being diagnosed was a blessing. She was young and acted out and the kids at school labeled her as the bad kid. With her diagnosis, she can now gain control of her life with the medicine she is taking. This gives me a good argument on why diagnosing a child with bipolar disorder is necessary to their future. Without the medicine, who knows where Sadie would be and who knows how severe her symptoms would have gotten. On the other hand, after I did some research on diagnosing at a young age, I noticed some research that explained how it was unnecessary to diagnose at such a young age and it could lead to an even worse outcome. According to Prevention of Pediatric Bipolar Disorder, a total of 25-50% of individuals with BD attempt suicide at least once and 8.6-18.9% die by suicide (Chang 236). Suicidal risk appears highest in childhood-onset BD, with nearly 1/3 of children and adolescents with BD already having an attempt suicide (Chang 236). This statistic alone can scare any parent into not wanting their child to be tested for BD. This is one of the negative sides of diagnosing at a young age. Although having your child being treated with medicine and making the manic episodes stop, the fear of the child becoming suicidal is a big risk factor. Children diagnosed with BD tend to become suicidal due to the medicine they are taking. When a child takes medicine for so long, depression can start and lead into worse, suicide. Besides suicide, there are other risk factors that can happen if diagnosed with BD. According to the National Institute of Mental Health, substance abuse is another risk factor of

Eastman 6 diagnosing a child or teen with BD along with attention deficit hyperactivity disorder (ADHD). All of these other negative effects play into having bipolar disorder and this may be another reason why a parent would not want to get their child diagnosed. Other than the side effects of diagnosing BD, like the ones I shared earlier, there is also controversy about diagnosing the wrong mental illness. In the scholarly article, Bipolar Disorder in Children by Nancy Ferguson-Noyes, she explains, no test can diagnose pediatric bipolar disorder and that the usual course in children is the development of attention deficithyperactivity disorder (ADHD) (Noyes 35). Many symptoms of ADHD and BD overlap, including distractibility, physical hyperactivity, and talkativeness (Noyes 35). She did a study of 677 children with bipolar disorder and found that 88% also met the requirement for ADHD. To be diagnosed with ADHD the child or adolescents must have multiple symptoms including being in constant motion, squirm and fidget, make careless mistakes, do not seem to listen or finish tasks and many more. If the child has these symptoms and examined by a physician, then it is most likely that the child is suffering from ADHD. The problem with being bipolar disorder instead of ADHD is the medication. The child may be taking the wrong medication if being diagnosed wrong and if the child is being diagnosed with both, then doubling the medications can take a toll on the child. This is another controversy that is being taken into consideration when talking about diagnosing at such a young age. Waiting for the child to get older, may be helpful because then they can explain their symptoms better and learn to handle the mental illness on their own if possible. Overall, I still stand firmly in my belief that diagnosing a child with bipolar disorder is necessary to their life. After watching that YouTube of Sadie, and hearing her mother talk about how thankful she is for having a name to the illness that has been causing havoc on her

Eastman 7 daughters life, it makes you happy knowing the diagnosis helped. Would you want your child to have an answer to a question that has been causing them pain? I am not a parent, but I assume every parents answer would be a yes. I know there are many different opinions on this issue and you wonder why it is so important. For psychology majors like myself and other people out there in the medical field or not, helping someone is the greatest joy that can come to you. Figuring out a childs illness and having an answer can really be rewarding, which is why I feel strongly about this topic and other people should too. There may be opposing opinions on whether not it is healthy to diagnose early, but after all the research I have done; I still strongly believe that it is the smartest thing to do.

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Work Cited

"Bipolar Disorder Statistics." Depression and Bipolar Support Analysis n.pag. DBS Alliance. Web. 10 Apr 2014. <http://www.dbsalliance.org/site/PageServer?pagename=education_statistics_bipolar_dis order>. Chang, Kiki, Megan Howe, Kim Gallelli, and David Miklowitz. "Prevention of Pediatric Bipolar Disorder." Integration of Neurobiological and Psychosocial Processes. (2006): n. page. Web. 10 Apr. 2014. "Does your child go through intensive mood changes?." Bipolar Disorder in Children and Teens n.pag. National Institute of Mental Health. Web. 10 Apr 2014. <http://www.nimh.nih.gov/health/publications/bipolar-disorder-in-children-and-teenseasy-to-read/index.shtml>. Egger, Helen Link, and Adrian Angold. "Common Emotional and Behavioral Disorders in Preschool Children: Presentation, Nosology, and Epidemiology." Journal of Child Psychology and Psychiatry 47.3-4 (2006): 313-37. Print Ferguson-Noyes, Nancy. "Bipolar Disorder in Children." Advance Healthcare Network 13.3 (2005): 35. Nurse- Practitioners and Physician- Assistants. Web. 10 Apr 2014. Hamrin, Vanya, RN, and Maryellen Pachler, RN. "Pediatric Bipolar Disorder: EvidenceBased Psychopharmacological Treatments." Journal of Child and Adolescent Psychiatric Nursing 20.1 (2007): 40-58. Web. Hirshfeld-Becker, Dina R., Joseph Biederman, Sara Calltharp, Eliza D. Rosenbaum,

Eastman 9 Stephen V. Faraone, and Jerrold F. Rosenbaum. "Behavioral Inhibition and Disinhibition as Hypothesized Precursors to Psychopathology." Biological Psychiatry 53.11 (2003): 985-99. Print. O'Donnell, Dorothy. Raising Sadie: My Bipolar Child. 2013. video. YouTube.comWeb. 10 Apr 2014. Post, Robert M., Gabriele S. Leverich, Guoqiang Xing, and Susan R. B. Weiss. "Developmental Vulnerabilities to the Onset and Course of Bipolar Disorder." Development and Psychopathology 13.3 (2001): 581-98. Print. WebMD, . "Attention Deficit Hyperactivity Disorder: Diagnosing ADHD." ADHD in Children Health Center (2014): n.pag. WebMD. Web. 10 Apr 2014.