Cyclo Bipolar in Children

Cyclo is short for cyclothymic bipolar disorder. A non-clinical description of this would be "mild" bipolar disorder because the mood swings are not as severe. In spite of the moderate episodes, it can still interfere with daily functioning. Cyclothymic bipolar disorder is especially difficult to diagnose in children as the symptoms must be discerned from typical shifts in energy and mood.

Definition

• Cyclothymic bipolar disorder is a persistent unstable mood state characterized by episodes of mild depression and hypomania (less intense mania). For children to be diagnosed with cyclothymic disorder the symptoms must be present for at least one year and they can't be accounted for by any other psychiatric diagnosis. Some children diagnosed with this disorder will eventually experience a full-blown manic episode or major depression and the diagnosis will be changed to bipolar I or II.

Children's Mood Episodes

• Children's mood swings, especially when they are mild, can be difficult to diagnosis. They must be separated from typical developmental behavior, such as the tantrums of the terrible 2's or the normal emotional upheavals of adolescence. In children's bipolar disorder, it is common for the mood swings to be rapid-cycling. Unlike the distinct and longer lasting adult episodes of depression and mania, children with bipolar disorder can fluctuate between episodes rapidly and many times during one day. The cycling can be so rapid that they experience mixed episodes, meaning they have depression and mania at the same time. This picture is the same in cyclothymic disorder, except the episodes are mild, making them even harder to differentiate.

Behavior Symptoms

• Children with mood instability often exhibit specific behavioral symptoms. They are likely to be irritable, easily upset, impulsive, prone to temper tantrums, hyperactive and rebellious. All kids can sometimes get hyper and rowdy, but this is usually in response to an activity and with correction they realize their behavior was inappropriate. Children with cyclothymic disorder are more likely to have feelings and responses that are disproportionate to the occasion, they aren't able to stop, and they fail to see what they did that was wrong. The key to discerning typical from problematic behavior is to consider the severity, persistence of behavior and their ability to control themselves. This is not simply a child who is spoiled or undisciplined and it is important to see the difference.

Mood Symptoms

• Symptoms of depression in cyclothymic bipolar disorder are feeling sad, lazy and slightly irritable. These children are likely to decline invitations from friends because they don't feel like socializing. They will also often have a low frustration level, becoming upset over "little things" that don't normally bother them. Hypomania in children manifests as increased energy, hyperactivity and usually a need for less sleep. They may have an inflated self-esteem that is both unusual and inappropriate. Ironically, this type of mild mania in children is usually a time when they are more productive and do better at school.

Charting

• Since diagnosis of cyclothymic bipolar disorder depends on an account of the child's behavior over a long period of time, parents should keep a daily diary of behavior, moods and any events that may have contributed to a mood change. Other relevant and helpful pieces of information to include in the diary would be the child's performance at school, changes in social activities, illnesses, medications taken, any repetitive behaviors and temper tantrums. This tool will become invaluable if the child's moods and behaviors start to impact daily functioning.