New Research in Juvenile Bipolar

I’m reading about new research regarding childhood bipolar, which includes changing the way they categorize the disorder into a dimensional approach, because of the frequent overlap (comorbidity) of other disorders.

Other symptoms of juvenile bipolar disorder (all of which are true for The Captain except the nightmares):

  • deflects blame
  • suffers horrendous nightmares
  • antagonizes siblings
  • excessively craves sweets and carbohydrates
  • functions in mission mode
  • wets the bed
  • sleeps hot
  • takes excessive risks
  • hoards food
  • has many ideas at once
  • interrupts or intrudes on others
  • experiences periods of self-doubt and poor self-esteem

One of the phenotypes they’ve identified is the “Fear of Harm” phenotype (The Captain’s matches in bold and red).

Territorial Aggression

  • is willful or refuses to be subordinated by others
  • argues with adults
  • defies or refuses to comply with rules
  • is easily angered in response to limit setting
  • is bossy towards others
  • relentlessly pursues own needs and is demanding of others
  • blames others for his/her mistakes
  • has protracted, explosive temper tantrums
  • displays aggressive behavior towards others
  • has irritable mood states
  • lies to avoid consequences of his/her actions
  • is intolerant of delays
  • has difficulty maintaining friendships

Attention / Executive Function

  • has difficulty organizing tasks
  • demonstrates inability to concentrate at school
  • is easily distracted during repetitive chores and tasks
  • attempts to avoid homework assignments
  • has poor handwriting
  • is easily distracted by external stimuli
  • has difficulty estimating time
  • able to focus intensely on subjects of interest and yet at times is easily distractible
  • has auditory processing or short-term memory deficit
  • has difficulty making transitions

Mania

  • has periods of high, frenetic energy and motor activation
  • has period of excessive and rapid speech
  • has many ideas at once
  • has elated or giddy, goofy, silly mood states
  • is easily excitable
  • interrupts or intrudes on others
  • is hyperactive or easily excited in the PM
  • displays abrupt, rapid mood swings
  • fidgets with hands or feet
  • is very intuitive and/or creative
  • tells tall tales; embellishes or exaggerates
  • has exaggerated ideas about self or abilities

Harm To Self Or Others

  • Makes clear threats of violence to others or self
  • Makes moderate threats of violence to others or self
  • Has made clear threats of suicide
  • Curses violently, uses foul language in anger
  • Has destroyed property intentionally
  • Is fascinated with gore, blood, or violent imagery

Self-Esteem

  • feels easily criticized and/or rejected
  • feels easily humiliated or shamed
  • experiences periods of self doubt and poor self-esteem
  • complains of being bored
  • has periods of low energy and/or withdrawals or isolates self
  • has decreased initiative

Sleep/Arousal

  • has difficulty getting to sleep
  • has difficulty settling at night
  • sleeps fitfully or wakes in the middle of the night
  • has difficulty rising in the AM

Sensory

  • is extremely sensitive to the textures of clothes, labels, and tightness of fit or socks and shores
  • exhibits extreme sensitivity to sound and noise
  • complains of body temperature extremes or feeling hot despite neutral ambient temperature

Hypersexuality

  • displays precocious sexual curiosity
  • exhibits inappropriate sexual behaviors (openly touches self or others’ private parts)

PPSO

  • wets bed
  • has night terrors and/or nightmares
  • hoards or avidly seeks to collect objects or foods
  • has acknowledged experiencing auditory and/or visual hallucinations
  • craves sweet tasting food
  • has concerns with dirt, germs, or contamination

Anxiety

  • displays excessive distress when separated from family
  • exhibits excessive anxiety or worry

…  and what does that all mean?

The expectation is that, when we identify the causative genes for bipolar disorder, we will be able to point to a network of signaling pathways in the brain that regulate specific behaviors associated with the condition. Once researchers are able to isolate the genes involved and understand their functions, the development of more targeted treatments becomes a real possibility.

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