I am the president of the Bicycle association, which aims to help families of bipolar children and adolescents. As a society we like to pretend these children don't exist. However, every year, more than 200 families get in touch with us.
Bipolar disorder refers to the presence of violent mood swings, which alternate between manic highs and depressive lows.
People with bipolar disorder may put themselves in danger, and have a tendency to become irritable, angry, or spirited. They may also become withdrawn and experience suicidal thoughts.
We have a very difficult time trying to convince families, friends, doctors, psychologists, schools, and social workers that bipolar disorder is different from ordinary moodiness. Certainly, a child who handles their frustration poorly and throws a tantrum is normal! It is not normal though when this occurs on a regular basis, when no educational strategy works for longer than two weeks, and when this keeps happening beyond the age of 7. It is not normal when they hit their head against a wall, break your furniture, or cut themselves.
But it's not true that parents are to blame. What we see through our work at Bicycle is that many different families have the same problems.
In France, there is a reluctance to acknowledge this problem in children younger than 14 or 15. Many people tell us that acknowledging the problem would mean sentencing the child to an illness, and that it is dangerous to "stick them with a label."
But there is a threat of an onslaught of negative and misleading labels if they are not diagnosed. Society may describe them as being spoiled, losers, outcasts, manipulators, perverse narcissists, or even psychopaths. Doctors may decide that the child has an attention disorder along with a behavioral disorder, an attachment disorder, or other types of disorders.
So why not simply speak of bipolarity? In any case, a diagnosis is always revisable, and can be revisited when the child grows up.
A failure to diagnose children with bipolar disorder can lead to one of the following scenarios.
Parents may believe that they have done something wrong, and blame themselves for their child's problems. In this case, the family becomes fragmented; faced with a failure to understand the child's problems, guilt and suffering become pervasive.
But it's not true that parents are to blame. What we see through our work at Bicycle is that many different families have the same problems. In families with multiple children, only one child may be bipolar. Bipolar disorder can be traced to a hormonal imbalance that makes the child function poorly when faced with stress; it's not a factor of child-rearing. However, it is necessary that the families adapt their parenting to the particular needs of the child.
Secondly, and most importantly, is that without diagnosis, the proper care will not be given. This can be extremely dangerous.
When the diagnosis comes, it is a difficult moment. But it is the solid basis on which to act.
All families agree that psychoeducation is the most important treatment. Psychoeducation relates to learning how changes in moods and emotions takes place in the brain, and how to manage daily life through anticipating mood changes and improving quality of life. Such skills are indispensable.
Without a diagnosis, how would you explain to someone that the higher the highs, the more severe the subsequent lows will be? Without a diagnosis, how do you understand the hyperemotionality that halts the brain's reasoning capacity, and the impact that can have on daily life?
Doctors should be wary of prescribing certain medications, which could be as strong as they are ineffective, maybe even dangerous!
Yes, some of our children need a little medicated help. First of all, they need it to regulate their moods. But to prescribe an antidepressant or psychostimulant (mood-enhancing medications) may be risky; some children have had very severe crises as a result, at times requiring hospitalization. Very few psychologists prescribe small doses or change the dose regularly so that the child does not feel like they're under a chemical straitjacket. Some children are significantly overmedicated.
With time, the disorder may be regulated, and bipolarity fades into the background, superseded by their intelligence, their creativity, their empathy, and their courage.
Refusing to see bipolar syndrome often means misinterpreting behaviors associated with the disorder. For example, the child is suddenly seen as a slacker at school during his depressive phase. A day later, he might undergo a manic phase, acing his test but insulting the teacher.
I am not insinuating that it is necessary to diagnose every temperamental child as bipolar -- the disorder requires the presence of precise symptoms. When the diagnosis comes, it is a difficult moment. But it is the solid basis on which to act; we know what we're fighting against, and that allows us to better evaluate what mental state the child is in, and to act effectively to avert a crisis.
If we can successfully avert crises and the child's hospitalization, and if we can help the manage their disorder, that would be a very important change for society, and for their lives.
And since bipolar disorder is only one characteristic among many others for children, with time, the disorder may be regulated, and bipolarity fades into the background, superseded by their intelligence, their creativity, their empathy, and their courage.
Young Minds Matter is a new series meant to lead the conversation with children about mental and emotional health, so youngsters feel loved, valued and understood. Launched with Her Royal Highness, The Duchess of Cambridge, as guest editor, we will discuss problems, causes and most importantly solutions to the stigma surrounding the UK's mental health crisis among children. To blog on the site as part of Young Minds Matter email firstname.lastname@example.org
This post first appeared on HuffPost France. It has been translated into English and edited for clarity.