For over 50 years, May has officially been Mental Health Month. The goal is to increase awareness about the importance of emotional "wellness" and to get help for the estimated one in 17 Americans who suffer from a serious mental illness. According to the World Health Organization, mental disorders are the leading cause of disability in the U.S. for persons ages 15-44.
That number is disturbing, but even more troubling is the number of kids who are struggling with mental illness. It's been estimated that one in ten children and adolescents suffer from a serious emotional problem. Sadly, only one in five receives the mental health intervention they need. Recognition and early intervention in a child with an emotional disorder enhances the likelihood of him or her developing into a healthy and productive adult, which will ultimately benefit us all.
One of the most incapacitating mental illnesses in adults is bipolar disorder. Previously known as manic depression, it is a serious mental illness that is characterized by recurrent episodes of mania, often alternating with depression or a combination of the two moods simultaneously. Sufferers experience unusual and extreme shifts in mood, energy and behavior that interfere with their ability to function in the everyday world. A much more dangerous and destructive illness than most people realize, adult sufferers are at a heightened risk for financial and social disability as well as suicide.
Though previously thought to be rare in children, recent studies indicate this is far from true. Sadly, estimates indicate that half a million to one million children and adolescents are victims of this form of mental illness. Bipolar disorder in children looks somewhat different than in adults, contributing to the diagnostic confusion. Bipolar children's moods and behaviors are often easily and unpredictably changeable. Different combinations of sad, silly, goofy, angry, guilty, agitated, oppositional, overactive, and impulsive states are not uncommon. These episodes can be brief, lasting mere minutes, or hours, or days. Not infrequently, these children exhibit violent, dangerous, irrational behavior with threats and acts that can pose a serious danger to themselves or others. I have even witnessed children under five express serious suicidal thoughts. More than one young child has told me "I wish I was dead" or "not alive" or that they wished they could join their deceased relative (for example, a grandmother) in heaven.
These kids experience internal pain and torment that no one, especially a child, should ever endure. Raising such a difficult, hard to sooth, unpredictably sad, giddy, intermittently self-loathing and aggressive youngster, is a monumental task that tests the metal of even the most experienced and well-meaning parents. The outside world - be it relatives, medical and mental health professionals, educators, neighbors, people in the grocery store and otherwise well-intentioned adults - blame the parents for the youngster's incorrigible behavior. The demoralized, isolated, and guilt-ridden parents suffer intense feelings of guilt and helplessness as they feel unable to ease their child's pain or to control their family's daily functioning, all of which is compounded when there is more than one child in the family.
Confounding the whole process of diagnosis and treatment is the fact that bipolar children often have more than one mental disorder. When problems occur simultaneously the stress on the child and his family is heightened even more. Add to this highly tense situation, a bipolar parent whose mood is also unstable (bipolar disorder often runs in families) and the situation can go from bad to worse.
There is no greater sadness for parents, as well as other adults, than witnessing the suffering of a child, especially a very young child. Acknowledgment and recognition of the existence of mental illness in childhood is the first step towards understanding the disorder. Help in these situations requires a team approach. Educating the parents and enlisting their full cooperation as responsible partners in the therapeutic process is critical. As a society, the more we learn about this potentially devastating disorder, the more likely we will be able discover the most effective treatment options.
Remember treatment is not necessarily synonymous with medication. Treating mental illness is not so different from treating a physical disorder, but proper treatment is essential. Just as a primary care physician wouldn't prescribe an antibiotic for a virus, there are other forms of intervention such as the various talk therapies, behavior modification and adjustments to the educational environment which can be very effective in the treatment of some children with mental illness.
Given the staggering number of young people who are thought to suffer from bipolar disorder, the seriousness of this condition, and its potential long term social and economic consequences, there is an increasingly urgent need for more intensive studies into this form of mental illness. This is our task. These are our children.