Bipolar disorder at an early age
Bipolar or previously called depressive maniac disorder until 1980. (f.) It is a chronic mental illness with a greater incidence in women, it is characterized by the presence of a changing mood between 2 opposite poles, which are mania, which is the exaltation phase, euphoria and grandiosity and the phase ofdepression, characterized by the presence of sadness and ideas of death. The duration of these states may vary considerably and depression is usually more predominant.
According to the criteria established by the Manuel of Diagnosis and Statistical of Mental Disorders, this disease can be classified as bipolar and characterized by the presence of a manic episode and at least one depressive episode;Bipolar II that requires the minimum presence of a hypomaniac episode and a story of at least one prior major depressive episode;The cyclolylytic disorder characterized by numerous depressive and hypomaniac disorders, and the un specified bipolar disorder that does not meet any of the requirements of those mentioned above. This disorder affects about 2% of the world population. The age of appearance of this disorder can vary from an early age that goes from 17 to 24 years and the late that starts around 48 years.
Generally patients with bipolar disorder die 20 years before the rest of the population, this due to the cardiovascular problems generated by poor physical health. The poor state of health is due in large part to sedentary lifestyle and poor diet, which contains a large amount of calories, in the same way smoking and consumption of toxic substances increase cardiovascular risk and obesity.
Clinical factors have also been considered, since patients tend to consume substances, especially in the mania phase due to the relationship with the pleasure search for these patients. Due to the impulsivity present in these patients with this disorder, they have been linked to these with substance consumption. Even so, the existence of specific drugs has not been identified, or if there is a pattern in the consumption of these substances and agreement with the mood of these patients.
Bipolar (BP) or manic-depressive disease is a severe, chronic and recurring personality disorder, of genetic origin. According to Soutullo, Figueroa and Chang (2014) "its prevalence ranges between 1% if we include only BP and 7% if we include the" soft "forms of the spectrum". Bipolar disorder comprises seriously mania and depression episodes. It differs from severe depression since it does not have the presence of mania symptoms, while in bipolar disorder depressive episodes alternate or coexist with mania symptoms.
Since the 2000s, there was an increase in the prevalence of this pathology at an early age and it was proposed that there were several reasons for this, the first is because, although the frequency in the adult is approximately 1-2 %, it is a relatively uncommon disorder in childhood and adolescence and, most of the time which was thought to be lately diagnosed. In the end it was concluded that every day the frequency in children and adolescents increases that the only reason was the greatest capacity of professionals for their diagnosis new disorders that occur at the personality level which was a new field of development.
According to the Psychiatric Association of Latin America, approximately one third of children and adolescents who have been diagnosed with depression could suffer the incipient symptoms of a future bipolar disorder, this means that a precedent to suspect about this disorder could start from this indication.
According to what experts from the Mayo Clinic argue, diagnoses tend to be confused since emotional shock and rebel behavior are normal during childhood and adolescence, and in most cases they are not a sign of a problem of a problem ofmental health that requires treatment. In themselves, all children have difficult periods;It is normal to feel sad, irritable, angry, hyperactive or rebel at times at times. However, if your child has serious, persistent symptoms or serious humor changes, different from the usual humor changes, hyperactive, impulsive, aggressive or socially inappropriate behavior.
Bipolarity disorder consists of two episodes mainly:
- The first refers to two or more weeks of decreased energy, depressive mood, lack of interest in almost all activities, cognitive performance decreases, as well as language, feelings and thoughts of disability, hopelessness, disability, guilt, ruin in addition toThe ideation of death, which can reach suicidal attempt. This is known as episode of depression.
- The second is based on a period of more than a week, in which abnormal and persistently high, expansive, euphoric, irritable mood is presented, in the company of high self – esteem, escape of ideas, distraction, decrease in the need for the need forsleep. In children, rather than the presentation of a classical euphoric mania, pictures characterized by short and frequent periods of emotional lability and irritability are found.
In clinical practice some of the symptoms of bipolar disorder are usually confused with the symptoms of attention deficit disorder and hyperactivity according to what refers. This can lead to a erroneous treatment and overshadow the patient’s prognosis. The treatment of this pathology is based pharmacologically on antipsychotics and stabilizers of humor in monotherapy or combined and antidepressants associated with antipsychotics and/or stabilizers of humor for depressive episodes. As is reasonable, it should also focus on imparting a psychoeducation, family intervention and behavioral cognitive therapy.
In studies carried out in the USA. UU. in which the prescription patterns of psychotropic medications have been examined in patients with bipolar disorder. Most of these studies suggest that lithium or valproate are more frequently prescribed medications, so that more than 50% of patients with bipolar disorder receive one of these drugs. These studies have also indicated that at least half of the patients were prescribed sometimes antidepressants without a mood stabilizer. In these studies, monotherapy was the exception and not the rule, so that more than 80% of patients received more than one psychotropic drug. There is even a study conducted in elderly adults with bipolar disorder that showed results similar to those of the youngest population.
Maniaque episodes in children with bipolar disorder have a relationship with sleep disorders in which insomnia is included. Although it has been considered that it is considered one of the most underestimated symptoms, it is actually one of the most frequent symptoms. According to the results, density in the REM phase (by Rapid Eye Movement) could become a new method to analyze the presence of bipolar disorder.
Consumption psychoactive substances is a worldwide problem, especially among adolescents, in addition to this, there are addictions that are not related to substance consumption, as is the case with the excessive use of the Internet, which due to the technological advance this is every timemore frequent especially in adolescents, from this addiction other derived disorders can be generated such as Internet game disorder. In both cases these can generate hyperactivity, depressive and anxiety disorders, and even the tendency to suicidal ideas which is common in the bipolar disorder depression phase.
Evidence has been shown that family therapy in adolescents as well as family PSI co -education are very useful therapies in the treatment of bipolarity disorder. The results obtained through these therapies have shown an improvement in the mood of patients as well as an improvement in psychosocial functionality. It has also shown that psychosocial interventions are more effective in patients who are at an early stage of the disease, being able to have an effect of up to five years, but depending on the patient, this could need reinforcement sessions.
The use of antipsychotics is common in the treatment of bipolar disorder, in addition to these, the use of mood stabilizers have been generalized. Because there is no full evidence about the effectiveness of other medications apart from antipsychotics, the use of these is the most recommended. Recently the use of clinical statification began to take importance in the field of psychiatry as an help tool to diagnose forecast.
Bipolar disorder is a mental illness characterized by maniac episodes accompanied by episodes of depression, it is characteristic of older people, so studies in children and adolescents are not very frequent. The studies carried out that in this population the most frequent cause for the consumption of toxic substances and addictions related to technology, which first gives rise to anxiety and depression disorders, which are symptoms of bipolar disorder. A direct relationship between sleep disorders such as insomnia has also been demonstrated, which also generates depression disorders.
For the treatment of this disorder, antipsychotics and mood stabilizers have been used, but it has also been shown that therapies have great efficacy especially in the early stages of the disease.
Knowledge about Diagnosis and Treatment of TBPNA has been evolving in recent decades due to the progress in scientific psychology studies. Clinical manifestations require adapting to the life cycle stage for children and adolescents. There are variable response rates for different psychotropic drugs in acute mania episodes. There is limited information regarding the depressive and maintenance phase. The impact of comorbidity with other disorders during treatment has not been systematically evaluated. It should be noted that although the pharmacological treatment studies presented are mostly orie, which guides that although a treatment is preferably opt for monotherapy, other psychotropic drugs will eventually be required during acute episodes and due to the recurrence rate. The combination of psychopharmaceuticals is a viable alternative in a large proportion of patients.
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