COBPD (Childhood Onset Bipolar Disorder)

"All those with bipolar disorder experience mood swings that alternate from periods of sever highs (mania) to severe lows (depression). However, while these abnormally intense moods usually last for weeks or months in adults with the illness, children with bipolar disorder can experience such rapid mood swings that they commonly cycle many times within a day. The most typical pattern of cycling among those with COBPD, called ultra-ultra rapid or ultradian, is most often associated with low arousal states in the mornings followed by increases in energy towards late afternoon or evening.

COBPD is usually inherited." I do have a family member with bipolar disorder.

"Many parents report that their children have seemed different since early infancy. They describe difficulty settling their babies, and they note that their children are easily over-responsive to sensory stimulation. Sleep disturbances and night terrors are also commonly reported.

Later in a child's development, hyperactivity, fidgetiness, difficulties making changes and high levels of anxiety (particularly in response to separation from the child's mother) are commonly seen. Additionally, being easily frustrated, having difficulty controlling anger, and impulsiveness (difficulty waiting one's turn, interrupting others) often result in prolonged and violent temper tantrums.*

Rarely does bipolar disorder in children occur by itself. Rather, it is often accompanied by clusters of symptoms that, when observed at certain points of the child's life, suggest other psychiatric disorders such as ADHD, OCD, ODD, and conduct disorder.**

An estimated 50% to 80% of those with COBPD have ADHD as a co-occurring diagnosis. Since stimulant medications often prescribed for ADHD have been known to escalate the mood and behavior fluctuations in those with COBPD, it is important to address the bipolar disorder before the ADHD in such cases.

Several studies have reported that more than 80% of children who go on to develop COBPD have five or more of the primary symptoms of ADHD - distractibility, lack of attention to details, difficulty following through on tasks or instructions, motor restlessness, difficulty waiting one's turn and interrupting or intruding upon others."

I included information that only pertains to Damien. If you would like more information on COBPD click here.

Researched via D.F. and J.D. Papolos

If you feel that you may have a loved one that is bipolar (manic depressive), here are some signs to look for.

"Symptoms of a depressive episode:

1. depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful). Note: In children and adolescents, can be irritable mood.
2. markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others)
3. significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. Note: In children, consider failure to make expected weight gains.
4. insomnia or hypersomnia nearly every day
5. psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down)
6. fatigue or loss of energy nearly every day
7. feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick)
8. diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others)
9. recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide***

Symptoms of a Manic Episode:

1. inflated self-esteem or grandiosity
2. decreased need for sleep (e.g., feels rested after only 3 hours of sleep)
3. more talkative than usual or pressure to keep talking
4. flight of ideas or subjective experience that thoughts are racing
5. distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli)
6. increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation
7. excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)

Symptoms for a Hypomanic Episode

1. inflated self-esteem or grandiosity
2. decreased need for sleep (e.g., feels rested after only 3 hours of sleep)
3. more talkative than usual or pressure to keep talking
4. flight of ideas or subjective experience that thoughts are racing
5. distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli)
6. increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation
7. excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., the person engages in unrestrained buying sprees, sexual indiscretions, or foolish business investments)"

*Damien has been witnessed doing all of these things.

**Damien has been diagnosed with all of these disorders.

***Damien was, at one time,  considered suicidal. His counselors, psychologists, and doctors all feel he is a threat to himself . Damien has often stressed to us that everyone would be happier if he were dead. He has tried to overdose on medication, walk out into traffic, and threatened to burn the house down. I made the mistake, before any diagnoses, of telling him when he drank some mouth wash, "If you drink anything like that, medicine, cleaners, whatever; you could die." I didn't know that I was giving him ideas and feel guilt for this.

With that being said, Damien is much more in control of his moods and behaviors than what he was when he was young. Though he often has suicidal thoughts, he has learned to go for a walk to cool down. He understands that getting away from the problem and thinking about his options does help. He also understands that we would be hurt and sad if he is gone, and he has said that he doesn't want to hurt us. This diagnosis has been since removed by Damien's psychiatrist, as she believes the behaviors were not due to Bipolar disorder but more related to the difficulty in effectively expressing himself.