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States-of-Mind

Bi-polar disorder in youth

Lithium use in youth with bipolar disorder

In the past few years there has been a growing recognition that bipolar disorder does not always present for the first time in adulthood. 

More than half of all cases of bipolar disorder begin before age 25 and for many with this condition, symptoms begin much earlier in childhood or adolescence.

Bipolar disorder is a serious psychiatric condition characterized by extreme shifts in mood between mania and depression.

When it begins in childhood, the condition is called early-onset bipolar disorder and it seems to be more severe than forms that first appear in older teens and adults.

Often, youth with bipolar disorder have more frequent mood shifts and have more mixed episodes (when they exhibit simultaneous symptoms of mania and depression). People with early onset bipolar disorder also seem to be at greater risk of suicide than those whose symptoms begin in adulthood.

Treatment for bipolar disorder differs from treating unipolar depression. Using antidepressant medications for a bipolar patient is risky and can cause the person to shift from depression to mania.

Mood stabilizing medication such as lithium is typically used to help bring a bipolar individual to a normal mood state.

Lithium is considered a gold standard in treating bipolar disorder in adults, but research is lacking when it comes to its use in youth with the condition. 

One study examined the use of lithium on children aged 7-17 with bipolar disorder. It found those taking lithium experienced a greater reduction in manic symptoms than those on placebo.

The medication was also generally well tolerated and not associated with negative side effects such as weight gain.

Sometimes, people balk at the idea of using any medication at all in children exhibiting mental health conditions. However, growing evidence suggests it is best to begin treatment as soon as possible for best results.

As with many psychiatric conditions, bipolar disorder is chronic and progressive in nature. The earlier effective treatment can begin, the less lasting damage is done and the sooner the individual can get back to enjoying life.

More research is needed to monitor the long-term effects of lithium use beginning in youth as well as to compare it with other medications used in treatment of this condition, but these early results are promising.

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About the Author

Paul Latimer has over 25 years experience in clinical practice, research, and administration.

After obtaining his medical degree from Queen's University in Kingston, Ontario, he did psychiatric training at Queen's, Oxford and Temple Universities. After his residency he did a doctorate in medical science at McMaster University where he was also a Medical Research Council of Canada Scholar.

Since 1983 he has been practicing psychiatry in Kelowna, BC, where he has held many administrative positions and conducted numerous clinical trials.

He has published many scientific papers and one book on the psychophysiology of the functional bowel disorders.

He is an avid photographer, skier and outdoorsman.

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The views expressed are strictly those of the author and not necessarily those of Castanet. Castanet does not warrant the contents.

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