Managing a Young Adolescent with Bipolar Disorder: An Experience from Nepal
- 1. Department of psychiatry, National Medical College and Teaching Hospital (Trivuwan University), Nepal
Abstract
Bipolar disorder (BD) is a common psychiatric problem in youths and can pose
a challenge in diagnosis in children and adolescents. The diagnosis of Youth Bipolar
Disorders is complicated due to the various overlapping symptoms shared by other
psychiatric disorders like attention deficit hyperactivity disorder (ADHD). Varying
presentation, having ill defined diagnostic criteria and increased comorbidity are the
major challenges faced for the assessment of the BD in early teens. We report a
case of a 13 year old boy, who presented with decreased sleep, over talkativeness,
distractibility, hyperactivity in the form of increased dancing and singing, irritable mood
and inflated self-esteem in the absence of positive family history. He was diagnosed
as BD by using DSM-5 criteria and after repeated mental state examinations, rating
scale, exploring history from parents, family members and teachers. Though diagnosis
might not be difficult in an American setup, it is difficult here because of the educational
and cultural background. There was significant improvement in his illness following
two weeks of treatment with olanzapine, lithium and behavioural techniques but the
maintenance of remission is quiet challenging in the socio-economic scenario of Nepal.