"Bipolar disorder is a mood disorder that's characterized by different episodes. So, manic
episodes, which involve elated or an irritable mood, where people
have exaggerated reactions in terms of their lifestyle
with respect to making risky decisions, losing their need for sleep, talking fast and
making decisions that are really uncharacteristic of them and sometimes unsafe.
In contrast to that they also have depressive episodes
during which they have a decrease in their motivation, a lower, sad mood,
and changes also in their appetite and sleep--usually usually towards loss of sleep or difficulty
sleeping. Also, negative thoughts about themselves even suicidal thoughts.
Some of the challenges that come up with youth are related to the fact that
oftentimes when bipolar disorder starts in teenagers
it's a more complex and difficult or severe form of the illness, which means that those
adolescent spend less of their time totally well for mood symptoms. So, even outside of
episodes where they're fully manic or fully depressed,
they suffer from what we call subthreshold symptoms
that still get in the way of teasing apart, what's the healthy adolescent and what's their symptom?
The other challenging aspect is that teenagers have a higher likelihood compared to adults
of what we call "mixed-manic" episodes, where there's an overlap almost simultaneously of
depressed and manic symptoms.
So when we look at a severe illness like bipolar disorder, what we want to try to do is try to
identify it as early as possible,
and by doing that we want to try to identify risk factors. And, by far, the most
replicated or consistent risk factor is having a biological parent with bipolar disorder.
And, among children who have a parent with bipolar disorder
their rates of themselves having the illness are increased five to ten fold, so we
know that's far and away the biggest risk. The problem is, even if you have a parent with
bipolar disorder, most children adolescents won't develop the illness themselves. So, the
question that we wanted to address is
which of these kids are the ones that do get the illness,
because they're the ones who we're particularly interested in,
in terms of identifying how we can prevent this in other adolescents, by
seeing the first signs of the first
factors that are connected with later getting bipolar disorder.
So, what we already knew was that the majority of children or adolescents have a parent with
bipolar disorder don't go on to get the illness themselves, and it's only about ten percent
of them, of these children and adolescents, that get bipolar disorder as well.
What we wanted to try to do is hone down
or identify what the risk factors were for these children adolescents having the illness,
and one of the things that we found was that having earlier forms of more common psychiatric
illnesses, so, for example, anxiety disorders and what we would call disruptive behaviour disorders--
so kids that have oppositional tenancies or aggressive behaviour--
kids that demonstrated those problems were the ones that were more likely to have bipolar disorder.
So, what this tells us is that when we're faced with the child and adolescent
who has a relatively common form of psychological problems,
those being anxiety or destructive behaviour,
if if they have a parent with bipolar disorder,
that may be a different story than it would be if they didn't.
Another one of the findings of the study indicated was that children that had had
exposure to antidepressant medicine,
or medicine the targets ADHD, or attention deficit symptoms, were also more likely to
develop bipolar disorder.
Unfortunately we weren't able to tease apart which came first,
but it does lead us to the question of what the risk versus benefit is
of those specific medications if somebody has a pair with bipolar disorder.
I think with the study brings us to is the suggestion that if a parent
has bipolar disorder and is being treated and diagnosed with that illness,
and they have any problems in terms of their child's behaviour or mood,
it's important that they let the treating physician of their child know that they have bipolar
disorder, because it could inform
the treatment decisions and the assessment.
What we're concerned about is that
potentially common problems in the general population, when they occur among
children of pairs of bipolar disorder,
might potentially be the first forms of what will eventually be bipolar disorder."