RESPONSE 1

Please respond to this post

Hi Group, 3:        

 Thanks for your comprehensive post. I want to contribute by answering your first two questions:1. How would you sensitively explain a possible bipolar diagnosis to Joe’s mother in “layman’s terms?2. How would you recommend screening and monitoring the symptoms of bipolar in a pediatric patient? How might Joe’s mom be able to help with this?1. How would you sensitively explain a possible bipolar diagnosis to Joe’s mother in “layman’s terms?”         Adults with bipolar disorder frequently experience distinct phases of significant depression followed by moments of mania. Rapid cycling (mood swings) and mixed states, which combine mania and depression, may be significantly more common in children. This can make a bipolar disorder diagnosis much more difficult in these age groups. ( Clark & Sahakian, . 2022).         Although long-term investigations have not supported these observations, many doctors have noticed that bipolar disorder symptoms vary as children develop. Younger children may exhibit chronic irritation and mood instability without typical mood swings. These signs and symptoms most closely resemble the disorder’s mixed condition. Euphoric, grandiose, and paranoid episodes may be more common in older kids and teenagers. Hyperactivity, distractibility, and hurried speech are common in all age groups. The more symptoms resemble those seen in adults, the older the person. (Brickman & Fristad, 2022).         Recurrent episodes of high mood are a defining feature of bipolar disorder (mania or hypomania)—depressive periods, which can be more frequent, alternate with manic episodes. Sleep is being reduced, self-esteem is being raised, and speech is being pressured and quick. Dramatic moods can occur in prepubertal youngsters, but they often persist much shorter than in adolescents (sometimes only a few moments).Children typically have a history of being extraordinarily temperamental and challenging to control, and onset is typically sneaky. (Strawbridge et al., 2022).2. How would you recommend screening and monitoring the symptoms of bipolar in a pediatric patient? How might Joe’s mom be able to help with this?        Most of us are accustomed to receiving specialist blood tests or other laboratory evaluations to assist our healthcare providers in making a precise diagnosis. However, most laboratory or imaging studies are ineffective in identifying bipolar illness. Being honest with our healthcare providers about our mood swings, behaviors, and lifestyle choices may be the most effective diagnostic tool. While a physical examination can reveal a patient’s general health, the best way for a healthcare provider to diagnose and treat bipolar disorder is to hear from the patient about the signs and symptoms of the condition. (Alaei et al., 2022).        Being her mom, it will be helpful to note the symptoms she observes that might indicate sadness, hypomania, or mania before consulting with a healthcare provider to confirm a diagnosis. Not only should variations in the mood be given special consideration, but also those in sleep, energy, thinking, speaking, and conduct. Obtaining a comprehensive family history from family members before seeing the doctor is also helpful. A family history can be highly supportive when diagnosing or recommending therapies. (Montes et al., 2021).References:Alaei, S., Jalali Nadoushan, A. H., Soraya, S., Maraghi, E., & Shabani, A. (2022). Identifying Recent Manic Symptoms by Newly Discharged Patients with Bipolar Disorder. Medical journal of the Islamic Republic of Iran, 36, 38. https://doi.org/10.47176/mjiri.36.38

Brickman, H. M., & Fristad, M. A. (2022). Psychosocial treatments for bipolar disorder in children and adolescents. Annual Review of Clinical Psychology, 18, 291-327.

Clark, L., & Sahakian, B. J. (2022). Cognitive neuroscience and brain imaging in bipolar disorder. Dialogues in clinical neuroscience.

Montes, J. M., Pascual, A., Molins Pascual, S., Loeck, C., Gutiérrez Bermejo, M. B., & Jenaro, C. (2021). Assessment Tool of Bipolar Disorder for Primary Health Care: The SAEBD. International journal of environmental research and public health, 18(16), 8318. https://doi.org/10.3390/ijerph18168318

Strawbridge, R., Kurana, S., Kerr‐Gaffney, J., Jauhar, S., Kaufman, K. R., Yalin, N., & Young, A. H. (2022). A systematic review and meta‐analysis of treatments for rapid cycling bipolar disorder. Acta Psychiatrica Scandinavica, 146(4), 290-311.

 

 

 

 

RESPONSE 2

 

Excellent job with your post this week! You provided some great resources. I also like how you set up your questions as a case scenario. For my post, I will focus on questions #1-2.It can be difficult for a parent to receive any mental health disorder diagnosis in their child. A bipolar diagnosis can be especially scary because there is a large stigma associated with this disorder. “Bipolar” is a term that often gets thrown around, causing discrepancy between facts and fabrication. As a provider, it’s essential we explain the diagnosis thoroughly to both the parents/care providers and the child. It’s also important to explain it in a way that everyone understands. Taking the time to educate can help alleviate a lot of anxiety for both the patient and family.Bipolar disorder (BD) is characterized by extreme mood swings– from emotional highs (mania) to extreme lows (depression) (Handrup, 2020). Mood swings are common in children, so it is crucial to understand the difference. Mood changes in bipolar are much more extreme. They are often unprovoked and accompanied by changes in sleep and energy level. Mania often presents as increased energy and activity in a child. The child may appear more happy or silly when manic. They can also appear more irritable and short-tempered. Depressive episodes can present as decreased energy and activity. A parent might notice a depressed child is less active than usual and easily fatigued. Joe’s mother reports some behaviors pertinent to bipolar disorder. Joe’s increased energy, without need for sleep, irritability, and pressured speech could suggest a bipolar diagnosis. As a provider, I would need more context of these episodes including how long they last.Bipolar spectrum disorders (bipolar I, bipolar II, cyclothymic disorder, bipolar related to another condition), occur in about 2% of youth with 55-60% of adults with bipolar reporting onset in childhood (Roley-Roberts & Fristad, 2021). Because there are no medical tests (scans, bloodwork, etc.) available to diagnose bipolar disorder, the child’s medical and behavioral history along with family history is key. According to Weintraub et al. (2022), years prior to the full development of full bipolar disorder, youth at risk display impairments in psychosocial functioning across multiple domains, including family, social-emotional and school functioning. Bipolar can often be misdiagnosed or mistaken for other mental illnesses including depression, anxiety and attention deficit hyperactivity disorder (ADHD). Joe’s mother can help identify the present behaviors and assist with an overview of any past behaviors. This can ensure the provider has all the correct information to make a formal diagnosis. Joe’s mother could journal his behaviors and emotions to help keep track.ReferencesHandrup, C. T. (2020). Understanding bipolar disorder: What is bipolar disorder and why is it so difficult to diagnose? American Nurse Journal, 15(11), 26.Roley-Roberts, M. E., & Fristad, M. A. (2021). Moderators of treatment for pediatric bipolar spectrum disorders. Journal of Clinical Child and Adolescent Psychology, 50(4), 464–477. https://doi.org/10.1080/15374416.2020.1772082Weintraub, M. J., Schneck, C. D., Posta, F., Merranko, J. A., Singh, M. K., Chang, K. D., & Miklowitz, D. J. (2022). Effects of family intervention on psychosocial functioning and mood symptoms of youth at high risk for bipolar disorder. Journal of Consulting and Clinical Psychology, 90(2), 161–171. https://doi.org/10.1037/ccp0000708

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