“For” Pediatric Bipolar Depression Disorder 

Childhood bipolar disorder is real and is a serious illness that should be recognized and treated as early as possible. Although bipolar disorder is mostly diagnosed in older children and teenagers, it can occur at any age (Nationwide Children’s Hospital, 2020). Emotional upheaval, feeling down, irritability, anger, hyperactive or rebellious behavior are a normal part of life in younger children and teens, but when the behavior interferes with daily living or activities it becomes a major problem (Hurley, 2021). The PMHNP must be knowledgeable to identify and separate bipolar symptoms from other psychiatric symptoms or disorders. Bipolar disorder is estimated to occur in 1-3% of youth, and early diagnosis and treatment is the key to helping kids learn how to manage symptoms and succeed in life. To receive a diagnosis of Bipolar I, a child must meet the criteria for a manic episode and may also experience depressive episodes. To receive a diagnosis of Bipolar II, a child has experienced both hypomania (a milder form of mania) along with a major depressive episode (American Psychiatric Association (APA), 2013)

Bipolar disorder involves episodes of both major depression and mania. The manifestation includes severe mood swings, hyperactivity, impulsive, aggressive, or socially inappropriate behavior, risky and reckless behaviors, insomnia, grandiosity, and suicidal thoughts or ideations (APA, 2013). Decrease in interest in pleasure, increase agitation, irritability, difficulty sleeping or problem falling asleep, significant changes in appetite, lack of concentration, frequent sadness or crying all the time, feeling of hopeless, helpless, and worthless, hypersexual, drugs and alcohol abuse and even thought of suicide (Sadock et al., 2014). The combination of episodes of mania and major depressive episodes is what constitutes a classic bipolar disorder. However, more than one type of bipolar disorder exists.

As a PMHNP, careful evaluation, comprehensive assessment, family history of bipolar and depression is crucial before a diagnosis should be made to children as it is somehow difficult to differentiate from other psychiatric disorders or symptoms. During this practicum experience, I have witnessed a child that was presented with the classic symptoms of bipolar and depression. The child was referred to my preceptor by her PCP, and after careful evaluation, she was diagnosed with bipolar, depression disorder, and treatment was started immediately. Treatment options must also be carefully chosen to improve the overall wellbeing and safety of the child. The treatment option for bipolar depression involves a combination of medication, psychotherapy, psychoeducation, school support, friends, and family support (Sadock et al., 2014). Evidence has shown that early detection and treatment of bipolar disorder in children and adolescents helps them live better and succeed in life. So, for this reason, I stand to support that pediatric bipolar depression disorder be diagnosed as early as possible and treatment commences to help the children suffering from this disorder succeed. Safety monitoring is important as children with bipolar depression may have increase risk for suicide.

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