Bipolar Disorder In Children And Trauma
While genetics may play a role in bipolar disorder development, early environment may also be a cause. Multiple reports cite, There are consistent indications that childhood traumatic events are associated with various severe clinical characteristics of BD, including an earlier onset of the illness, a rapid cycling course, psychotic features, a higher number of lifetime mood episodes, and suicide ideation.
While children may inherit genetics links predisposing them to bipolar disorder, living in a home with a parent who has the disorder is also a factor. Children of bipolar parents grow up in a chaotic environment with various types of unexpected stressors and disruptions. For a child, it can be incredibly harmful to live with a parent with intense mood swings, especially if they escalate into physical outbursts.
If bipolar disorder in the parent has not been treated or diagnosed, the resulting chaos will be confusing for all parties. In fact, bipolar disorder in children may even develop due to traumatic experiences and living environments.
In addition to bipolar disorder, the parent may also suffer from substance abuse and may become additionally harmful during phases of the disorder. Children may experience trauma due to repeated abusive episodes of a parent with unpredictable behaviors and actions. Others may experience irrational verbal or emotional abuse if the parents disorder has not been treated or diagnosed.
What Causes Bipolar Disorder Aside From Genes These Are The Things Most Likely To Increase Your Risk
The thought of developing bipolar disorder seemingly out of nowhere can be scary. Also known as manic-depressive illness, the disease can be severe and life-changing. Drastic changes in mood, including lows that leave you unable to function and highs that remove you from reality, can make it nearly impossible to make it through a daily job or routine.
Scientists have known for some time that certain genes are likely to cause bipolar disorder, and some of these genes are also linked to an increased risk of schizophrenia and alcoholism. But the things behind the development of bipolar disorder are likely a mix of different factors, ranging from gene mutations to a persons upbringing, as well as that persons penchant for anxiety and other mental health issues.
A Case Of Bipolar Disorder Premorbid Traumatic Brain Injury And Comorbid Migraine Headaches
The Compass Clinic, Orlando, Florida
CITATION:Shanley A. A case of bipolar disorder, premorbid traumatic brain injury, and comorbid migraine headaches. Consultant. 2020 60:22-23. doi:10.25270/con.2020.04.00006
Received December 12, 2019. Accepted March 22, 2020.
DISCLOSURES:The author reports no relevant financial relationships.
CORRESPONDENCE:Anamaria Shanley, MSN, APRN-C, The Compass Clinic, 100 W Gore St, Ste 406, Orlando, FL 32806
Psychiatric and neurological disorders have been linked to head trauma such as traumatic brain injury .1 Approximately 10% of persons with bipolar disorder have experienced a premorbid TBI.2 Individuals with BD have a 2 to 3 times higher incidence of migraines than the general population.3 The etiology of migraine and BD is unknown, but some studies have suggested that the conditions may share a common pathway.3
A 36-year-old man was referred to a psychiatry practice for a years-long history of migraines that had been unresponsive to treatment with numerous medications. The patient had sustained a significant TBI at age 20 as a result of a motor vehicle accident that had required admission to an intensive care unit and intubation.
Mental status examination findings at various follow-up visits were not consistent with his initial presentation. He appeared well-dressed and agitated with hyperactive behavior. His speech pattern was pressured with euphoric mood and affect. Insight and judgment were limited.
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Treatment For Bipolar Disorder And Drug Abuse
If you or someone dear to you is battling drug addiction and bipolar disorder, youre not alone. An estimated 70% of people with manic depression have also faced addiction at some point in their lives. Though common, co-occurring bipolar disorder and drug abuse are very serious and potentially dangerous.
Seeking treatment for both conditions is critical. However, its important for co-occurring disorders to be not only addressed but also treated simultaneously. Otherwise, the path to recovery can be hindered by the symptoms and behaviors of the other condition. Not only that, but going to rehab without getting treatment for bipolar disorder can increase a persons risk of relapse. And being treated for manic depression without addressing drug abuse can result in severe dependence and addiction. For these reasons, the most effective treatment for co-occurring disorders is an integrated dual diagnosis rehab program.
What Is The Link Between Childhood Trauma And Bipolar Disorder
There are many theories about the association between these two disorders. Most theories center on the developing brain of a child and how trauma can permanently alter some of its processes and functions.
More specifically, there is a theory that deals with the increased activation of the hypothalamic-pituitary-adrenal axis. Another theory asserts that severe stress, like that seen in childhood trauma, affects the structure and function of important regions of the brain.
These regions, known as the hippocampus, amygdala and the prefrontal lobe affect cognition and emotional processes. Certainly more research must be done to fully prove how childhood trauma causes bipolar disorder.
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Can You Have Both Ptsd And Bipolar Disorder
Its possible to have both conditions and many people do.
As noted above, evidence suggests that PTSD can increase your chances of developing bipolar disorder, while bipolar disorder could indirectly increase your chances of facing a traumatic experience.
Additional research supports the idea that either condition can contribute to the other.
One explored the rates of PTSD in 212 people diagnosed with bipolar disorder who were receiving inpatient care. Just over 72 percent of the participants had experienced some kind of trauma, while over 35 percent had a diagnosis of PTSD.
According to a
- Between 4 and 40 percent of people living with bipolar disorder also met criteria for PTSD.
- PTSD appeared more common in women and people living with bipolar I.
- Between 6 and 55 percent of people living with PTSD also met criteria for bipolar disorder.
- People living with both conditions tended to report worse symptoms and lower quality of life.
Older research notes that PTSD occurs, on average, in about 16 percent of people with bipolar disorder, compared to just under 8 percent of the general population.
If you do have both conditions, getting treatment for one might ease some of your symptoms but it generally wont improve them all.
Keep in mind that some treatments could worsen your symptoms. Antidepressants, which can help treat depression symptoms in PTSD, may sometimes trigger mania when used without a mood stabilizer, for example.
Seven Classes And The Key Findings That Shaped Them
The seven phenoclasses, as the U-M team has dubbed them, include standard measures doctors already use to diagnose and track the progress of bipolar disorder.
Changes in cognition, which includes thinking, reasoning and emotion processing
Psychological dimensions such as personality and temperament
Measures of behaviors related to substance use or abuse called motivated behaviors
Aspects of the persons life involving family, intimate relationships and traumas
Patterns of sleep and circadian rhythms
Measures of how patients symptoms change over time and respond to treatment
Some of the key findings the U-M team made in the Prechter cohort include:
Although bipolar disorder tends to run in families, the long-term study revealed no one gene explains it, says McInnis, who is the Woodworth Professor of Bipolar Disorder and Depression in the U-M Medical Schools Department of Psychiatry.
If there was a gene with a strong effect like what we see in breast cancer, for instance, we would have found it, he explains. We hope this new framework will provide a new approach to understand this disorder, and other complex diseases, by developing models that can guide a management strategy for clinicians and patients and give researchers consistent variables to measure and assess.
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The Effect Of Ptsd On People With Bipolar Disorder
Within the U.S., approximately 4% of adults will have a diagnosis of bipolar disorder at some point in their lives. What is bipolar disorder? Bipolar disorder is considered a mood disorder. There are two types of bipolar disorders, described as bipolar I and bipolar II.
In bipolar I disorder, a person has experienced one or more manic episodes. In most cases of bipolar I, episodes of major depression are a central aspect of the overall course of the illness.
In bipolar II disorder, hypomanic episodes have been experienced but not manic episodes. In addition, to be diagnosed with bipolar II disorder, a person needs to have also experienced a major depressive episode
Bipolar disorder can have a major impact on your life and it can also increase the risk that you develop other disorders.
In fact, people with bipolar disorder have been found to be at high risk for developing a number of other mental health disorders. One such disorder that co-occurs with bipolar disorder at high rates is post-traumatic stress disorder .
What Causes Dissociative Amnesia
Dissociative amnesia has been linked to overwhelming stress, which might be the result of traumatic events — such as war, abuse, accidents, or disasters — that the person has experienced or witnessed. There also might be a genetic link to the development of dissociative disorders, including dissociative amnesia, because people with these disorders sometimes have close relatives who have had similar conditions.
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Childhood Trauma Psychological Dimensions Cognition And Brain Imaging Abnormalities In Bd
One might postulate that childhood trauma is driving clinical outcomes through non-specific dimensions of psychopathology .
Affective lability is suggested as a core feature of BD that manifests itself as frequent and intense fluctuations in affect in response to both pleasant and unpleasant events. In BD, studies have found heightened affective lability in both manic and mixed episodes , as well as traits during euthymic periods . A previous study has linked childhood trauma to later affective lability in personality disorders and in BD . Also in BD, one large study and a smaller study have demonstrated that exposure to childhood trauma is associated with higher scores on affective lability, with the strongest association being that for emotional abuse . Furthermore, in an Emotion Recognition Task, patients with BD and childhood emotional neglect have a reduced performance in recognizing anger, compared to subjects without any trauma . Interestingly, childhood trauma is associated with increased amygdala activation , a brain region important for regulating fear and emotions , thus reinforcing potential links between childhood trauma, changes in emotional or affect regulation and brain imaging abnormalities .
Were You A Victim Of Childhood Trauma
If you suspect you were a victim of childhood trauma, share this with your treatment team, especially your therapist. The goal is to incorporate treatment for the childhood trauma into your existing regimen. The following therapies are used for victims of childhood trauma:
Cognitive Behavioral Therapy
This is a form or psychotherapy that focuses on the relationships among a person’s thoughts, feelings and behaviors. The overarching goal of CBT is to challenge automatic thoughts and behaviors and replace them with more constructive thoughts that will lead to healthier behaviors.
The CBT therapist carefully works with a client to reveal unhealthy thought patterns. The therapist then ties these thought patterns to self-destructive behaviors and beliefs. This mode of therapy requires a commitment from the client that goes beyond the therapy session.
The goal is for the client to continually practice living with the new thoughts until they become instinctive. CBT is an evidenced-based treatment for those who have experienced childhood trauma.
Accelerated Resolution Therapy
ART is a form of psychotherapy gaining recognition as a way to successfully treat patients with post-traumatic stress disorder and other forms of trauma. Unlike most other forms of therapy, ART has been shown to achieve benefits rapidly within one to five sessions.
Inner Child Therapy
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Psychotherapy And Bipolar Disorder
Psychotherapy, alongside medication, is an essential part of treating bipolar disorder.
Cognitive behavior therapy can be used to treat many mental illnesses, but it may be particularly helpful in treating bipolar disorder.
It can be beneficial in addressing past trauma, alongside other mental health illnesses. Through the approach, the patient addresses negative thoughts and works to erase them and replace them with positive ones.
Through this examination, CBT can help understand what triggers depressive episodes. Tools and methods can be used to manage the onset of those thoughts, which is helpful for independent living.
What Is The Connection Between Bipolar And Childhood Trauma
Childhood trauma refers to traumatic experiences occurring during formative years. Some specific events that are considered as childhood trauma include:
- Being the victim of an act that directly violates their person. Such acts include physical abuse, molestation or sexual abuse, verbal abuse or neglect.
- Witnessing domestic violence or the abuse of other family members.
- Experiencing acute trauma as the result of a serious accident, injury or natural disaster. This includes situations like school shootings or the loss of a loved one.
- Experiencing chronic trauma caused by ongoing stressful situations. This includes a mentally ill parent or a parent caught in the throes of addiction.
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What Are The Signs And Symptoms Of This Disorder
One of the challenges of diagnosing bipolar disorder is that the signs and symptoms are going to vary depending on whether someone is having a manic episode or a depressive episode. It is important to know the symptoms of both. Some of the signs of a manic episode include:
- Feeling like someone is on top of the world.
- Having the ability to go several days in a row without sleeping due to extreme energy
- Talking much more quickly than unusual
- Engaging in extremely risky activities such as spending large amounts of money in a short time, driving at excessive speeds, or doing large amounts of recreational drugs
When someones mood cycles in the opposite direction, they will experience a depressive episode. Some of the signs of a depressive episode include:
- Feeling down or hopeless
- Lacking energy to the point that it is hard to get out of bed in the morning
- Problems with a typical sleep cycle such as sleeping too much or having trouble sleeping at night
- The inability to enjoy activities that used to bring joy
- Difficulty concentrating on simple tasks
- Extreme changes in appetite
The hallmark of bipolar disorder is that people fluctuate between these two extreme mood states. Some people will fluctuate between these two states more quickly than others.
Does Trauma Cause Bipolar Disorder
The thing is, no matter how devastating a trauma might be, some people undergo the trauma and do not develop bipolar disorder while others do. This tells us that trauma alone does not cause bipolar disorder.
However, that does not mean that trauma does not play a role in the development of bipolar disorder. A bio-psycho-social model of bipolar tells us that while trauma may be part of the equation, it’s not the entire equation. In my opinion, it’s the biological part that people possess that makes a difference between whether trauma helps to cause bipolar disorder or not. Keep in mind that “biological” doesn’t just mean that it runs in the family . It might also mean that a person has a spontaneous mutation or a physical difference in the brain.
After Searching 12 Years For Bipolar Disorders Cause A Team Concludes It Has Many
A long-term study in more than 1,100 people yields a new seven-factor framework that could help patients, clinicians and researchers.
Nearly 6 million Americans have bipolar disorder, and most have probably wondered why. After more than a decade of studying over 1,100 of them in-depth, a University of Michigan team has an answer or rather, seven answers.
In fact, the team says, no one genetic change, chemical imbalance or life event lies at the heart of every case of the mental health condition once known as manic depression.
Rather, every patients experience with bipolar disorder varies from that of others with the condition. But all of their experiences include features that fall into seven classes of phenotypes, or characteristics that can be observed, the team reports in a new paper in the International Journal of Epidemiology.
The team, from U-Ms Heinz C. Prechter Bipolar Research Program, collected and analyzed tens of thousands of data points over years about the genetics, emotions, life experiences, medical histories, motivations, diets, temperaments and sleep and thought patterns of research volunteers. More than 730 had bipolar disorder, and 277 didnt. Three-quarters were active research participants in the Longitudinal Study of Bipolar Disorder.
The Prechter program is named for a Detroit automotive pioneer who fought bipolar disorder even as he built a successful business.
What You Should Do
What do you do if you believe you have been misdiagnosed by a mental health professional? The first thing to do is not to panic. Although we look up to doctors, they are the only people with diplomas. They are fallible and sometimes make mistakes such as giving the wrong diagnosis. If you feel your doctor has made a mistake, ask for a second opinion outside of that doctors clinic. Most insurance companies allow this maneuver and even if yours does not it is worth the peace of mind.
Second, make sure to be totally upfront and honest with your clinician. A mental health professionals diagnosis is only as good as the information you give them. If you hold back facts from your childhood or other information you are hurting yourself and become more likely to be misdiagnosed.
Last, if you do not feel your mental health professional is a good fit and that your diagnosis is wrong, seek out someone else for help. Take advantage of websites that help you find specialists who deal with complex post-traumatic stress disorder to find a good match.
Misdiagnosing CPTSD as bipolar disorder is dangerous and will not help the person experiencing symptoms to heal. Definitely, reach out to a mental health professional when you need help but keep in mind that misdiagnosis can and does occur.
Believe in yourself. You are braver than you think, more talented than you know, and capable of more than you imagine. ~ Roy T. Bennett
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