A Remarkable Calamity

I have recently been forced by my physical state of being, to examine my life. It would seem that a lifetime of being intimately acquainted with calamity has damaged my nervous system. There was 

Calamity Jess (Photo credit: Jessie Romaneix ©)

my own calamity, the calamity of my Mother, and for years now, the calamity of others.

When I think about why my nervous system might be on the fritz, I have to really examine the effect that stress has had on me. In those terms the cost has been pretty big. It is pretty clear that I have exceeded the manufacturer’s specification for the proper care and maintenance of a nervous system. No wonder it is shot. Life can be hard on us. Infact, life will get us all in the end. Perhaps this is why Plato said that we should be kind because we are all fighting a hard battle.

Cover of Plato

I had to consider whether or not to go back to the very work that wore me down. I had  to ask myself if I could continue? There was a still, quiet, but undeniable voice inside that wouldn't let me forget something. Life is not easy, but  we can adapt and overcome. We don't have to continue to suffer. I had adapted to having a mental illness and had learned to excel. I decided that I would have to take on this challenge head on too. I am grateful because it helped me to  understand my core mission again. I am not sure how I could have lost it, but when we grow weary it can be hard to see such things in the world. For me it is simple,  I just want people who are suffering to know that they are not alone and I just want them to know there is hope.

In the face of some new challenges in my life I think I can say that I am not alone. In the face of so much calamity, I have hope. I think my life has been remarkable. It has been more of an adventure than I could have ever imagined. Along the way I have learned to accept, love, forgive, and in that way, it has been a remarkable calamity.

Presidential Mental Illness

(This is an excerpt of a larger piece submitted to the Journal of Psychology & Psychotherapy for scholarly review and publication it remains intact minus some of the demographic and epidemology factors that are not important to this blog)

Abstract: Recent events in the United States have spurned national debates on mental health and crime. Much of the discussion is comprised of gun controls and vague references to treatment. The discussions do not address specifics about the people who are committing these crimes and what makes for meaningful treatment. The more we can learn from the people out in our communities who have mental illnesses, the more we can reduce the costs to our communities. Most of these crimes are perpetrated by a small portion of the estimated 5% 7 of  the adult population with severe mental illnesses. 

The discussions rarely focus on what it means to have a mental illness. Mental illness does not preclude a successful and fulfilling life. This article uses the example of mental illness in some of the people that we expect to be the most highly functioning, our Presidents. One specific example is reviewed. This past President was at times suicidal and would have to be considered at times to have a severe mental illness. While he was significantly impacted by depression, he became one of the most respected leaders in history.  

Keywords:

Mental Health, Presidents, Crime, Treatment, Social Stigma, National Debate

Introduction:  

With the rash of recent school shootings and other major traumatic events that have been perpetuated by those with mental illness, we may be forgetting that mental illness is no respecter of persons. It affects those from all walks of life.  It has become easy to react to these people with doubt and mistrust. What would you think if the President announced that he too had a mental illness? Would you call for his immediate resignation? If you knew that a candidate had such an illness, would you vote for him?

According to the Substance Abuse and Mental Health Administration or SAMHSA; mental disorders are common in the United States and internationally. An estimated 26.2% of Americans ages 18 and older — about one in four adults — suffer from a diagnosable mental disorder in a given year 1. This demographic is not limited to the poor, under educated, and disaffected. Mental illness can be seen in people from all walks of life. Doctors, judges, artists, neurosurgeons and CEOs all are as likely as anyone else to be impacted at least sometime in their lives.

Body & Discussion

Surely our Presidents are free from this worrisome problem, right? According to an article by Dr. Jonathan Davidson, professor of psychiatry and several of his colleagues at Duke University 2, these mental illnesses have affected Presidents since the formation of our great nation.  This study used diagnostic criteria from the DSM-IV and found that 48% of the Presidents from 1776 to 1974 had a diagnosable mental illness. The most prevalent diagnosis was depression. Of the 18 Presidents with mental illness, 24% of them suffered from depression.  Surely when we look at these men we would find that those with mental illness are worthy of the least regard. But then, perhaps not.

For a moment, let us consider one particular past President. This man was born into a poor family from the South. He was like many poor rural people of his time, he had limited access to formal education. If we look back into his history we discover that he had only about a year and a half of dedicated instruction. His principal teachers  were clergymen and as a result he learned to read by reciting the Bible 3. He would stand for hours reading it aloud and committed much of it to memory. This had a significant impact on the young man. It habituated him to read all of his written works out loud. This method worked so well for him that he may have been one of the most profound of the Presidential speakers and writers. While he was never a well regarded poet there are two poems that are notable. Both of these poems have some literary credibility but their content was an indication of a somewhat morose and insidious suffering that impacted his entire life.

One of his poems, Suicide Soliloquy, was published in the Sangamo Journal on August 25, 1838 4:  

Here, where the lonely hooting owl

Sends forth his midnight moans,

Fierce wolves shall o’er my carcase growl,

Or buzzards pick my bones.

No fellow-man shall learn my fate,

Or where my ashes lie;

Unless by beasts drawn round their bait,

Or by the ravens’ cry.

Yes! I’ve resolved the deed to do,

And this the place to do it:

This heart I’ll rush a dagger through,

Though I in hell should rue it!

Hell! What is hell to one like me

Who pleasures never knew;

By friends consigned to misery,

By hope deserted too?

To ease me of this power to think,

That through my bosom raves,

I’ll headlong leap from hell’s high brink,

And wallow in its waves.

Though devils yell, and burning chains

May waken long regret;

Their frightful screams, and piercing pains,

Will help me to forget.

Yes! I’m prepared, through endless night,

To take that fiery berth!

Think not with tales of hell to fright

Me, who am damn’d on earth!

Sweet steel! come forth from your sheath,

And glist’ning, speak your powers;

Rip up the organs of my breath,

And draw my blood in showers!

I strike! It quivers in that heart

Which drives me to this end;

I draw and kiss the bloody dart,

My last—my only friend!

This moment of despair was not an isolated event. He was a tall and lanky man. This suffering President could not be considered to be handsome. He was at times a loner. He recognized and commented to friends that he was probably a less than eligible bachelor. In his life he had few romantic entanglements. After one relationship was severed, at least temporarily, his friends were forced to search his rooms to make sure that there was nothing that could be used to hurt himself 5. If this were the case today he would likely have been detained and checked into a locked down hospital ward.

Yet he was an entirely remarkable man. Although he had a limited education he was a business owner, the holder of a patent, an appellate level attorney and eventually became one of the most admired people in history. Doris Kearns Goodwin 6, a noted presidential historian, gave a TED Talk about learning from past Presidents. The TED Talks are a series of speeches that are available on ted.com. Their motto is, “Ideas worth spreading. This speech is certainly one of these ideas. During her speech she said:

I was so thrilled to find an interview with the great Russian writer, Leo Tolstoy, in a New York newspaper in the early 1900s. And in it, Tolstoy told of a trip that he'd recently made to a very remote area of the Caucasus, where there were only wild barbarians, who had never left this part of Russia. Knowing that Tolstoy was in their midst, they asked him to tell stories of the great men of history. So he said, "I told them about Napoleon and Alexander the Great and Frederick the Great and Julius Caesar, and they loved it. But before I finished, the chief of the barbarians stood up and said, 'But wait, you haven't told us about the greatest ruler of them all. We want to hear about that man who spoke with a voice of thunder, who laughed like the sunrise, who came from that place called America, which is so far from here, that if a young man should travel there, he would be an old man when he arrived. Tell us of that man. Tell us of Abraham Lincoln.'" He was stunned. He told them everything he could about Lincoln. And then in the interview he said, "What made Lincoln so great? Not as great a general as Napoleon, not as great a statesman as Frederick the Great." But his greatness consisted, and historians would roundly agree, in the integrity of his character and the moral fiber of his being.

Yes, the man who was thus afflicted; who freed the slaves, who won the civil war, and who held a worn and weary nation together was Abraham Lincoln. Lincoln’s greatness as a human being and as President came from his practical understanding of one of Plato’s profound utterances. Plato said, “Be kind, for everyone you meet is fighting a hard battle”.

The Front of the SAMHSA building at 1 Choke Cherry Road in Rockville, Maryland. (Photo credit: Wikipedia)

We have begun a national dialog on violence and mental illness. We must consider those with mental illness in a broad manner. Not all people with mental illness are dangerous or incompetent. Not all who commit violent acts have a mental illness. For all of those with mental illness there is hope. There is a reasonable potential for wellness and achievement. People who have mental illnesses are not a threat on that basis alone. Further, statistics show that severe mental illness affects approximately 5% 7 of the adult population. Although these people can have significant challenges, most are not dangerous. During this time of national discourse please consider people like Abraham Lincoln. Please also consider the 1 out of 4 people who have some form of mental illness. Try to see in them possibility and not disability. I encourage you to learn more about mental illness. It is not a character deficiency nor a reason to throw out the human behind the disease. After many years of research, SAMHSA tells us that recovery from mental illness is possible.

Part of my work with others occurs when people have been arrested. These crimes span the spectrum of offenses. Mental illness can and does have an impact on why people commit these egregious acts.  Most of the time it does not excuse their actions. It should however impact the dispositions of their cases. People with mental illnesses need to get treatment that is appropriate to their needs. Each person has their own path to recovery. For the most part they can go on to lead happy and productive lives and contribute back to their communities. For the small margin that remains we can only hope that the suffering of the community, their families and their own suffering will not spill over into tragedy.

Conclusion

English: Picture of the Abraham Lincoln statue in the Lincoln Memorial. Italiano: La statua di Lincoln al Lincoln Memorial. (Photo credit: Wikipedia)

I believe that if we can look at people like President Lincoln we can develop a balanced approach to evaluating mental illness. It is easy to be influenced into believing that all people who have a mental illness are not able to be responsible with their lives. This is true whether or not they are gun owners. Fear should not dictate our perspective in the debate about mental illness. In Lincoln we have a clear example that for some, mental illness can lead to inspired lives.

It seems that his suffering helped him to understand that all people suffer. It was in this way that he learned so clearly about the human condition and our inherent value as a human beings. It is how he seemed to understand the principles of freedom within the words of the founding fathers: We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty, and the Pursuit of Happiness. When we begin to see all people from within this perspective, we will have the greatest impact on reducing both the tragedies and horrors of mental illness in our communities.

References

1.) The Substance Abuse & Mental Health Administration web site, http://www.samhsa.gov/data/NSDUH.aspx

2.) Haley Hoffman, The Chronicle (Duke), 23/02/2006

3.) A. Lincoln A Biography, Ronald C. White Jr., Random House, First chapter - Undistinguished Families

4.) Neal Conan and Joshua Wolf Shenk, author of The Melancholy of Lincoln. National Public Radio Broadcast, Talk of The Nation air date 04/09/2004. From the book, The Melancholy of Lincoln

5.) A. Lincoln A Biography, Ronald C. White Jr., Random House, page 112

6.) Doris Kearns Goodwin, ted.com. Posted October 2008

7.) A discussion of the methodology used to generate SMI and any mental illness estimates can be found in Appendix B. For information on mental illness see chapter 2 in Office of Applied Studies. (2010). Results from the 2009 National Survey on Drug Use and Health: Mental health findings (HHS Publication No. SMA 10-4609, NSDUH Series H-39). Rockville, MD: Substance Abuse and Mental Health Administration. Retrieved from http://store.samhsa.gov/product/Mental-Health-Findings-Results-from-the-2009-National-Survey-on-Drug-Use-and-Health-NSDUH-/SMA10-4609

With A Little Help From Your Friends - Peer Supported Respite

Institute of Mental Health 6, Nov 06 (Photo credit: Wikipedia)

 Introduction

"What is clear from the results is that these patients could do as well or better in a less restrictive environment," said Tom Greenfield

There is an increasing mental health crisis around the entire world. With worldwide financial resources quickly eroding many countries are running out of the ability to care for those with a mental illness. Due to this, we need to re-evaluate our practices and systems of treatment. Hospitalization, medications, and cognitive therapy may not be enough to promote psychological growth.

Logo of the National Institute of Mental Health. (Photo credit: Wikipedia)

From research done by the State Of Massachusetts, the National Institute of Mental Health, the Substance Abuse and Mental Health Services Administration shows that there is hope for increasing mental health and reduce many of the higher costs of services and treatment. Further there are articles in the American Journal of Community Psychology that cover this research extensively.

The goal is to provide a more prophylactic treatment protocol through the use of services such as peer supported respite centers. Peer supported respite centers are residential, pre-crisis and crisis facilities that are staffed by certified professional peer support specialists. According to one study from Massachusetts peer supported respite is not only cost effective but is more likely to lead to psychological growth.

Institute of Mental Health 4, Nov 06 (Photo credit: Wikipedia)

A different and less threatening environment

Respite care is different from traditional inpatient hospitalization. Most respite centers are not locked down wards. The average stay at a peer supported respite center may be longer in duration than hospitalization. This is largely possible due to lower total cost of care that consumers receive.  

The longer duration of inpatient care offers opportunities to build skills in self-advocacy, establishing good support networks, and how to deal with crisis in a safe and effective manner. These centers also allow for more time to adjust to changes in medication. This significantly helps with the side effects and allows for emotional support until therapeutic benefits are realized.

Experienced staffing

These facilities are generally staffed by professionals who have been diagnosed with mental illnesses. These people have very practical experience dealing with mental illness and recovery. They have what is referred to as, “lived experience” and have reached a meaningful level of recovery themselves. This enables them to provide very individualized care and treatment plans. Often these practitioners work closely with human service organizations and other peer supported services in the community. These relationships help to establish long term stability and to overcome problems like housing which can be a significant problem.

Respite care and the criminal justice system
Peer supported care is being looked at more often as a resource for alternative sentencing agreements for those who are involved in the criminal court process. The desired outcomes of this would be to reduce re-entry into the system, increase compliance, and reduce the cost of administering these cases. According to the federal government 61% of inmates have a significant mental illness. Often these people are not receiving adequate care even within traditional systems of mental health. It would seem that financial resources are a major contributing factor. One department of corrections director told me that to get any real change in caring for those with mental illness is to sue them. They have repeatedly asked for money to deal with the increased populations that they are mandated to treat. This problem is extended when inmates are released under community supervision.

If you consider the benefits and outcomes from peer supported respite, it is easy to come to the conclusion that a community based respite center can bring both financial and emotional relief. I encourage the leaders of our communities, counties, and states to take a serious look at this option. If we build stronger Americans, we build a stronger America. Respite centers may offer a significant resource in accomplishing that goal.

Mental Health "Injustice System" - Failures Criminal Rights & Just Dispositions

Introduction

If we are to temper justice with mercy,  we have to consider the individual and societal needs of forgiveness in order to soften (temper) our need for justice. This helps us assure that the punishment, if warranted, fits the crime. Today, we have systems where those with mental illnesses are charged for crimes or wrongdoings and are met with such incredibly harsh and seemingly disproportionate punishments. We do immense harm to a person's spirit and ability to overcome, repent, develop and grow from mistakes and recover. Further, we do specific harm to the basic civil and human rights of all. - paraphrased, author unknown.

As a part of the advocacy work that I do, the mentoring, and peer support, I run into a lot of people who have criminal issues. So far my experience in dealing with the criminal court systems have brought up both challenges and opportunities. One thing I can say with certainty is that it has at times been a huge disappointment.

I live in a County where there are five full-time attorneys in the District Attorney’s Office. Between them they deal with 2,500 cases a year. They’re good people who work hard for our community. Unfortunately this is one of the areas where I found some disappointment. In a meeting with the district attorney, he laid out all the things that he would not consider as being partially or wholly mitigating circumstances. The case I was involved with was abstracted and given to him so we could discuss some of the very real problems with cases like this. I’m not sure he actually read it. He is after all a very busy guy. So we never really got to the heart of the conversation.

Are we seeing these cases clearly and early?

One of the first factors that I saw in this case is that early identification and careful evaluation of the arresting officers reports should have raised a flag that this was not a criminal matter. Apparently the attorney presenting the charges to the court did not read the full statement of the arresting officer. I think in any reasonable level the probable cause that a crime had been committed was seriously in question. In fact, it may have been more appropriate to refer the matter to the adult protective service agency and/or medical professionals.

The second factor that I saw in this case is based on my experience in dealing with people who have mental illnesses. I have practical day-to-day experience with people on all levels of the spectrum and have seen major improvement in the quality of their lives and their ability to reach meaningful recovery. Facilitating this recovery is a large part of what I do. I know many the mechanics from practical experience. I feel qualified enough to say; that based on this lady’s diagnoses and my observations of her leads me to believe that her low day-to-day functioning puts her at risk. I did however feel that with the support of halfway house services, medical stabilization, helping her to build healthy support networks, she would be very likely able to stop having interactions with law enforcement. Actually, with this individual, I know I had a significant impact on the outcome of the case. I appeared in the case as a friend to the court to facilitate communications between the court and the defendant because of her significant mental illness. The significant portion of this mental illness was demonstrated by her largely disorganized thinking and varying functionality from day-to-day.

It was pretty clear to me

It didn’t take a lot of investigation to figure this out. In the arresting officer’s report, he noted some issues that clearly illustrate that mental illness may have been a mitigating factor in the crime. The arresting officer says several things specifically; that she was unable to and not unwilling to follow simple commands, that she was incoherent, and that there were large amounts of psychotropic medications visible to him. He does not mention specifically but I assume all of the medications were properly labeled and prescribed to her.

The judge asked me about my general opinion about the case. I pointed out to him that on the face of the arresting officer’s report that it was a lot more likely to be a psychological crisis than it was a crime. Apparently he agreed with me. Once back in session, the judge asked both attorneys to appear in chambers. I know basically what was said in that meeting. The judge simply asked why we were not thinking of a civil solution in this case. It would seem that both the defense counsel and the prosecuting attorney agreed immediately. The terms for a deferred prosecution agreement were discussed and settled upon.

How can someone consent to an agreement with the court if they clearly do not understand it?

English: Justice and Law Suomi: Oikeutta ja lakia (Photo credit: Wikipedia)

In the presence of the defense counsel I participated in the discussion about the deferred prosecution agreement and what it meant to her. I started to grow concerned after about 45 minutes of conversation with her. In that time she was never once able to clearly articulate and/or paraphrase what a deferred prosecution meant to her and what would be expected of her. I am not sure she understood that the prosecution of the crime would only happen if she did not follow along with the civil requirements. As a recall, she was still asking about how much jail time she was going to receive. It didn’t seem to sink in that jail time was not an issue. I think it was at this moment that her civil liberties started to erode. If she could not understand what the agreement meant she could have never consented to it. I did mention this to several parties. I also advised various parties that to reduce the likelihood of seeing her before the court again she would need more comprehensive services than were being discussed.

This is where my conversation with the judge may have had in negative impact. Since it was so easy to put a deal on the table, she was not evaluated for competency. For various reasons she was ordered to comply with state law that did not suit her needs. Because the civil solution came up so fast, any real understanding of her competency was not investigated. Due to this, I felt that the civil solution on the table was a failed solution. She perhaps did not get the care she needed to avoid re-entry into the system. Approximately one year after the first case I got a phone call from her. She had been arrested again and the circumstances were almost the same as the previous case.

If you want changes in our department sue us

There are people who complain about costs in our system. In talking with agencies like the Department of Corrections they realize this is a problem also. They are the ones having to deal with inmates with mental illness in high numbers. I had a director of one such department that flat out told me the only way to affect changes in our organization is to sue us. This is because they lacked funds and resources for treatment.

There are evidence-based solutions that are highly effective. The use of peer support can contribute as part of the answer. Peer support specialists are much more cost-effective and have better percentages of reimbursement rates for their services. Along with this more intermediary respite care facilities are required. Current admission standards for mental illness generally requires that a person say that they have a plan and intention to kill themselves. I think more investigation and research by the criminal justice system needs to be done in this area as viable methods to reduce re-entry are available and these programs are financially prudent.

Training is an important issue also. The need for more training for officers in crisis intervention may help to resolve issues without arrest. It might help identify mental health crisis as compared to criminal intent. I believe that lawyers need better education about evaluating competency. Traditionally, not guilty by reason of mental defect or insanity is almost impossible to make a case for. Competency to assist in defence should be clear if the person can’t understand what they are agreeing to. Lawyers could have a better understanding of what a successful disposition looks like given the balance between justice and civil liberties. Hopefully  this will broaden the defenses that are available.

Change is needed and can be done

An American judge talking to a lawyer. (Photo credit: Wikipedia)

It would seem that the civil and criminal liberties that we all enjoy as citizens are desaturated for those with significant mental illnesses. Insight on this factor comes not only from this case, it also comes to us right from the jails and prisons themselves. The Bureau of Justice statistics reports that says 61% of state prisoners have a mental illness, jails have a rate of 41% of inmates with mental illness. In general our population has about 5% of people who have diagnosable severe mental illnesses in any given year. As an example, our County has around 80,000 people. This suggests that 4000 people in our community have major psychological problems. Considering the high numbers of people with mental illness in the justice system, how many of these cases are being misidentified? How many cases are we missing? Also, what can we do with these people anyway? For many states and counties the resources are very restricted. There are cost-effective and effective recovery methods and resources that can be developed and tend to reduce re-entry into the system. With some willingness, people with mental illnesses can receive the benefit of justice tempered by mercy.

Alternative Medicine In America

Journal of Alternative and Complementary Medicine (Photo credit: Wikipedia)

Americans Use Less Alternative Medicine Than Other Countries

World-wide the amount of people who use some form of complementary and alternative medicine, or CAM, is estimated to be 65% to 80%. This translates roughly into 3 billion individuals who use systems of medicine other than the model we are most familiar with here in the United States. In our country the use of alternative medicine is estimated to be about 36%.  The typical American person will use these therapies in addition to our westernized system of medicine.


To change the balance of how much CAM and regular medicine we have to change certain aspects of both our culture and system of care. In the past our doctors were trained around treating symptoms and disease in a reactionary model. Certain conditions indicated specific intervention. Then our doctors started to focus more preventative care. This was reinforced by research that showed that perhaps we could take a slightly longer view on medical care. At this point there was still a large reliance on intervention with medicines or procedures. 

Western Medicine vs. Alternative Medicine

Logo of the United States National Center for Complementary and Alternative Medicine , part of the National Institutes of Health. (Photo credit: Wikipedia)

This system of medicine has made some wonderful strides. During the process it evolved into an 

institution where often the most humble and human qualities were ignored. This is in contrast to many alternative systems of medicine. Much of the philosophy behind these systems strive to seek a balance in all of life. Physical, mental, and spiritual factors must be addressed to have complete wellness in life. 

Alternative Medicine Acceptance Grows

Our growth as a society has begun to really change both individual acceptance of alternative 

medicine and that of the medical community. Approximately one-third of all American schools of medicine offer classes in alternative medicine.  Some of the schools that are included in this list are Harvard, Yale, John’s Hopkins, and Georgetown University. This new found acceptance has spread to encourage some alternative medicine coverage by insurance companies. A recent comment from insurance carrier Mutual of Omaha said that it saves about $6.50 in covering alternative medicine. 

Image by Sprengben  via Flickr

While alternative medicine in our society is less prolific than in other parts of the world it is growing. Support for this has come from a new trend being considered by our institutions that are charged with overseeing and paying for medical care. This consideration is called “Evidence Based Medicine”. Simply if the research shows that something works, use it. This is true even if it may not come from your tool chest. With continued research into the efficacy of alternative medicine the percent of Americans that use it will grow quickly.

Bipolar Disorder In Children

What Is Bipolar Disorder?

According to the National Institute Of Mental Health (NIMH) Bipolar Disorder is a serious mental illness that can affect the brain. While less diagnosed, Bipolar Disorder in children can have as much impact as adults with Bipolar Disorder. In the past Bipolar Disorder was known as manic-depression. The term manic-depression is less used today. In basic terms a Bipolar person experiences cycles of unusually intense emotional states. These emotional states are typically seen as periods of either intense high or low emotions. These states of mind and emotion are distinctive.

From time to time we all may feel depression. For individuals with Bipolar Disorder, the depressive phase tends to be extreme. This depression if often incapacitating. This may lead to prolonged or frequent absences from work, school, or other important responsibilities. Bipolar depression may impact personal hygiene and physical wellness. Bipolar Disorder in children has been linked to poor school attendance, behavioral problems, and academic failure. 

As we can see the depressive phase can have significant impact. Bipolar mania may be just as troublesome. Bipolar mania is characterized by periods of extreme energy, excessive and fragmented speech, and often wild or intense beliefs. For example a person in a state of intense Bipolar mania may think that they are somehow superhuman in aspects of their lives. For some this manifests as a completely delusional state of mind. At this level Bipolar Disorder can have a significant impact on both the Bipolar person and those around them. Other symptoms of Bipolar mania can include; Extreme happiness or silliness, rapid speech, trouble falling asleep, loss of focus, risky behaviors, sexual extremes. 

Bipolar Disorder should be diagnosed by an experienced physician. Bipolar Disorder in children can often be a complicated diagnosis. Both children and teenagers can show signs of Bipolar Disorder that are actually symptoms of ADHD or other serious medical conditions. This makes it hard to diagnose children with this disease. 

There are generally three types of Bipolar Disorder that are diagnosed. These are; Bipolar type I, type II, and Bipolar effective. Bipolar I & II are generally determined by the speed that the cycles of the depression and mania. 

Bipolar Disorder Associated With Other Medical Conditions

Percent of Youth 4-17 ever diagnosed with Attention-Deficit/Hyperactivity Disorder: National Survey of Children's Health, 2007 (Photo credit: Wikipedia)

It is likely that persons with Bipolar Disorder may experience other related medical conditions. Doctors refer to these other conditions as being, "co-morbid". These co-morbid aspects may show up as; substance abuse, Attention Deficit/Hyperactivity Disorder (ADHD), Anxiety disorders, Separation Disorder and others. Sometimes the Bipolar Disorder co-morbidity may be due to side effects of the medications that are given to treat the disease. It is quite common to find a Bipolar patient is over-weight, has elevated blood sugars which may lead to diabetes, or in the case of medicines like Lithium it may be toxic in high doses.  In addition to these conditions bipolar medications my cause a condition known as, "Tardive Dyskinesia". Tardive Dyskinesia is a condition that may be permanent. People with Tardive Dyskinesia have problems with repeated movements of the tongue, face, or other

movement issues.

How Does Bipolar Disorder In Children Different From Bipolar Adults?

Currently the treatment of Bipolar Disorder in children may be less effective then treatment of adults. Often children experience more severe behavior problems and symptoms. Children are more likely to suffer from continual symptoms. This can significantly impact the ability for a Bipolar child to see meaningful recovery. It is important to look at a wide range of support for your child. Since Bipolar Disorder is a life-long disease it is important that you work with your child's teachers, doctors and therapists in order to help your child break the cycles of suffering. Good management of Bipolar Disorder must help to mitigate the impact of this illness in every aspect of their lives. While it is important to teach your child good life skills, Bipolar Disorder in children requires that we work with the child to build long lasting and meaningful support systems. For example a child may have a difficult time performing various tasks in life. This may lead to a breakdown in the ability of a child to deal with the basic life responsibilities. 

Although it may be hard for a child to do certain things on their own, it is possible to get everything they need taken care of in a responsible manner. Responsible behavior may be less about what a person can do as compare with what a person can get done. It is important to get an inventory of the life skills that a child possesses. From there a plan must be developed to either improve the life skills that a child has or to develop solutions for getting these needs taken care of. 

Bipolar Disease in children has been shown to impact their ability to participate in education. It is reasonable to understand that children with Bipolar Disorder may not have sufficient attention to successfully complete assignments or retain the information that they receive. It is very important to build a relationship with the educators that work with your child. 

Over time it is possible for children to realize meaningful recovery. When you work with doctors, therapists, and other professionals you will find medications and techniques that work for your child's specific needs. It is important to find a path for your child that directly effects your child's illness. Each person has different experiencess with Bipolar Disorder. Every path to recovery is specific to the person with disease. It is important to treat the person behind the disease. When you develop the person you have a good chance at mitigating the impact of their mental illness. 

How can I help My Bipolar Child?

It can be very hard to deal with the ramifications of Bipolar children. It is important to educate your self and to find support for yourself. The stress that is induced in you must be accounted for. You can find support for yourself from organizations like the National Alliance on Mental Illness (NAMI). NAMI offers education about mental illness, support for families and peer support. The United States government has several organizations that deal with mental health. These organizations like the fore mentioned National Institute Of Mental Health (NIMH) and the Substance Abuse & Mental Health Services Administration (SAMHSA) offer great information and resources on Bipolar Disorder. Another good resource for dealing with Bipolar Disorder is the Depression & Bipolar Support Alliance.

It is important that you be patient with your child. Please encourage your child to talk about their problems. Be open and listen. Often a Bipolar person will feel isolated and alone. Open support for your child will help them to feel that they are not alone and understood. Help your child to educate themselves about their disease. Hold on to the belief that Bipolar Disorder in children is something that they can recover from. Your children can lead happy and productive lives. Work together closely and you will see lasting change for the better. 

The link between sleep and Bipolar Disorder is becoming more and more clear. A regular and consistent sleep schedule will help your child to deal better with their illness and can have a big impact on the cycles of Bipolar Disorder. 

Threats Of Suicide

It is important that your child receive immediate medical support if they talk about or demonstrate intentions to commit suicide. Every threat or indication must be taken seriously. Do not write off these indications as a need for attention. This could easily lead to the loss of your child. Sometimes these conditions exist because of reactions with medications. This is why it is important to address these issues with a competent medical professional. Another good resource is the toll-free suicide helpline 800-273-Talk (8255) this is run by the National Suicide Prevention Lifeline.

With your help and encouragement the Bipolar Disorder in children is treatable and manageable. With the right tools and resources you can succeed in helping to child with this often troublesome disease.