Bipolar disorder is a mental illness that causes severe mood swings. The symptoms are often difficult to spot among children and teens because others mistake it for the normal ups and downs that every kid goes through. It is estimated that about 3.4 million American kids and teens experience the early onset of bipolar disorder, according to the American Academy of Child and Adolescent Psychiatry.

Current treatments for bipolar disorder include lithium and psychotherapy. However, lithium medication is often prescribed to adults only as mood stabilizers. While there are many studies on lithium use in adults, only a few tested its effectiveness and safety on children.

The participants were given a standard dose for the first four weeks before gradually increasing it to a maximum dose for the remaining weeks. The researchers assessed the participants’ moods using the standard tools used for bipolar disorder. They also listed the side effects of the drug on the participants.

The analysis showed that those who took lithium showed a significant improvement compared to those who were under the placebo. Almost half of them scored either “very much improved” or “much improved” compared to only 21 percent of those who were under the placebo. Some of the side effects include weight gain and reduced kidney and thyroid function, the authors wrote in a press release.

“Until this study, there was no data to support the use of lithium in the treatment of youth with bipolar disorder,” said Dr. Victor Fornari, director of child and adolescent psychiatry at Zucker Hillside Hospital in Glen Oaks, N.Y., to HealthDay News. “This study provides evidence to support the efficacy and benefit of lithium in the treatment of children with bipolar disorder in a manic state.”

The researchers plan to continue their study to determine whether lithium can be used on children long term.

This article first appeared on ‘HNGN’ on 12 October 2015.

The national survey of 5500 children aged 9 to 13 highlighted the significant gap in wellbeing between mainstream kids and those who have a disability, are Indigenous, are young carers or from poor backgrounds.

Thirty per cent of children fall into one or more of these marginalised groups, and they rate their health worse, are less happy at school and have lower levels of family cohesion than their peers. Children with a disability are the worst off overall.

“There is a lot of diversity in wellbeing among young Australian children,” Flinders University associate professor Gerry Redmond, who led the study, said. “We need to focus on why some children are doing a lot less well than others.”

The gap between marginalised and mainstream kids is particularly pronounced by the time they reach year 8.

The Government-funded Australian Child Wellbeing Project surveyed children in years 4, 6 and 8 from 180 schools. Students were asked about their family, living arrangements, school, health, friendship, material wellbeing and bullying. It is the first national survey of children in the middle years, and the findings will be presented at the Australian Social Policy Conference on Monday.

Overall, most children report high life satisfaction and are optimistic about their future. More than 90 per cent of children are in good health. Children nominated family as the most important factor for having a good life, followed by health and friends. Those with a big support network were healthier, more engaged with school and less likely to be bullied.

However, some children are struggling more than their peers. One in five kids report being bullied once a week, with year 4 students experiencing the highest levels of bullying. Bullying included being ignored, being teased, having lies told about them, and people ganging up on them.

Children from marginalised groups were more likely to be bullied, and those with a disability the most bullied of all. The more often children are bullied, the more likely they are to miss school.

“I get the impression, talking to teachers, that this kind of non-physical bullying, like exclusion and telling tales, is extremely difficult to counter,” Professor Redmond said.

Sixty per cent of all children who were bullied reported two or more health issues, including frequent headaches, stomach aches, dizziness, feeling nervous, or having difficulty going to sleep. These complaints are often symptoms of stress.

A quarter of young people have a family member who has a disability, chronic illness, mental illness or drug or alcohol addiction. These young people experience significantly more health complaints than their peers.

“These health problems may be associated with worries about their family, and their direct caring responsibilities,” Professor Redmond said. “They’re worrying about these things that are normally seen as adult issues.”

Mainstream kids score an average life satisfaction of 85/100, while marginalised children score between 64 and 70. Similarly, mainstream children have a health score of 90/100, compared to marginalised kids, who score between 72 and 81.

Professor Redmond said his study provided the hard evidence policy-makers and schools need to act to better help these kids. “Young people in these groups are marginalised, but they actually comprise a large proportion of all young people,” he said.

“This should give policy-makers extra impetus to reduce the disadvantage they experience, and improve their lives.”

This article first appeared on ‘Brisbane Times’ on 25 September 2015.

Children of anxious parents are at an increased risk of developing anxiety, but that doesn’t have to be the case, according to new research by University of Connecticut Health psychiatrist Dr. Golda Ginsburg.

The study, published in The American Journal of Psychiatry, found family-based intervention works. Only nine percent of children who participated in a therapist-directed family intervention developed anxiety after one year, compared to 21 percent in a group that received written instruction, and 31 percent in the group that did not receive any therapy or written instruction.

“The finding underscores the vulnerability of offspring of anxious parents,” Ginsburg said. “If we can identify kids at risk, let’s try and prevent this.”

Anxiety tends to run in families, with up to 50 percent of children of anxious parents growing up to be anxious themselves, she noted.

“Anxiety and fear are protective and adaptive,” Ginsburg said. “But in anxious kids they may not be, because these children have thoughts about danger and threat when there really isn’t one.”

Both inborn temperament and life experiences play a role, she said. The more negative experiences a person has growing up, the greater the likelihood he or she will struggle with anxiety as an adult.

Most of the adults who participated in the study struggled in school and didn’t tell anyone. They didn’t raise their hands, or they got sick before exams. They might not have had any friends. As adults, their anxiety limits their activities and sometimes those of their family members.

During the study, some of the families participated in eight, hour-long sessions with a trained therapist over a period of two months. Others were just given a pamphlet that contained general information about anxiety disorders and treatments. Still others received nothing at all.

The families who participated in therapy were taught to identify the signs of anxiety and how to reduce it. They practiced problem-solving skills, and exercised safe exposures to whatever made their child anxious.

One of the ways to reduce anxiety is a reality check, according to Ginsburg, such as learning to recognize when a fear is healthy and worth paying attention to, like a growling dog, or unhealthy, like  a suspicion that the birthday cake is poisoned.

“We taught the kids how to identify scary thoughts, and how to change them,” Ginsburg said.

For example, if a child is afraid of cats and encounters one in the street, she can first identify the scary thought: “That cat is going to hurt me.” Then she can test that thought: “Is it likely that the cat will hurt me? No, the cat doesn’t look angry. It isn’t baring its teeth or hissing, it’s just sitting there. OK, I can walk past that cat and it won’t do anything.”

The researchers found that, in general, children who participated in the intervention had lower anxiety overall than children who did not participate in the intervention with their families.

The researchers now have received funding from the National Institutes of Health for a follow-up to see whether the effects are maintained over time.

Ginsburg said she wonders whether there would be value in providing regular mental health checkups for families. She added she is considering approaching insurers about offering this to families at risk, to see if it lowers their healthcare costs overall.

“I’d say we need to change our model of mental health to a checkup method — like going to the dentist every six months,” she said.

This article first appeared on ‘Psych Central’ on 28 September 2015.

The research by not-for-profit the Black Dog Institute aims to identify ways to prevent male suicides, which account for about 75 per cent of the total Australian figure.

Lead researcher and clinical psychologist Doctor Michael Player said the study showed many men wanted help, but were not getting it.

“Men actually do want help,” he said.

“Unfortunately we don’t have a really good dialogue or opportunity for men to talk about their mental health.

“This goes back to the way we have been brought up.

“We haven’t had really good role models that have shown adequate ways to deal with mental health issues.”

As part of the institute’s study, 35 males who had attempted to take their own life within the last six to 18 months, as well as 47 friends and family members of men in that situation, were interviewed face-to-face.

The interviewees were from a variety of urban and regional settings nationwide.

There was also an Australia-wide online survey undertaken as part of the qualitative research.

“We were looking at how to interrupt a suicide attempt, what helped and what kept men safe,” Dr Player said.

Non-judgemental, honest discussion works best

Dr Michael Player said they found the majority of men wanted intervention to prevent suicide, but they did not want to ask for help.

“There is clear evidence that comes from the paper – that men want to accept help” he said.

“But it has got to be from the right person, being that person that they trust and respect.”

Dr Player, who is a clinical psychologist in the Sydney public health system, said there was a fine balance between helping and being invasive.

“But if you notice something, you have to ask a question,” he said.

“We often found that the trigger for an attempt was something in isolation that was actually quite minor but it was just part of a train of stresses or unpleasant events over a period of time.

“You have to be looking at the chronicity of someone’s distressed mood, isolation and they’re coping strategies like avoidance and numbing behaviours.”

Compounding the problem, he said many friends and family members were reluctant or even scared to ask the men in their lives about thoughts of suicide.

“Not being judgmental, being honest and open and calling it what it is helps,” Dr Player said.

“Just being direct and often opening the space for a male to talk will be enough to illicit a positive response.”

Dr Player said the men surveyed reported feeling significantly better after talking about their suicidal thinking, as opposed to feeling at a greater risk of self harm.

“Ninety-two per cent of the people that were in the study actually had improved mood after actually taking part in the study,” he said.

“It wasn’t a downer that made people depressed, so that was a really positive finding that we hope is translated to other research.

“Everyone underlined that you just keep persisting, even if it seems the man doesn’t want you to.”

Hospital, GP screening for suicide recommended

The Black Dog Institute said the study highlighted how much work was needed to better target programs for men at risk of suicide.

Dr Player said men often displayed signs of unhelpful coping like drinking, violence, drug use and other self harm.

“Men tend to convert their emotional pain into physical pain which is something they feel more adept to deal with,” he said.

“Men often give subtle warning signs, and they tend to be self-destructive warning signs like externalising behaviours like isolation and more irritability.

“So we need to screen for self-inflicted injuries or injuries as a result of risk taking or self harm or things like that.”

Dr Player said the findings suggested men needed to be more proactively screened by hospitals and health authorities.

“We need to be more proactive about screening men for suicide when they present at a GP or Emergency Departments with these externalising sort of behaviours,” he said.

Suicide prevention not ‘popular’ cause

Dr Player expressed frustration about the lack of national discussion about suicide prevention, compared to other major social issues like domestic and family violence.

Unfortunately we get a few high-profile suicides and there is a bit of a spotlight shown on the area for a short period of time, but it doesn’t seem to hold people’s interest,” he said.

“The suicide rate is double what the road toll is, yet we don’t have ads on the television as we do have for road deaths.”

Beyond Blue’s Movember Foundation donations provided the $100,000 funding for the qualitative research.

He said the study was published in open-source journal PLOS1, as it offered a quick review and publishing timeline and was available to everyone.

This article first appeared on ‘ABC’ on 25 June 2015.