Adolescents suffer from bipolar disorder at the same rate as adults. Diagnosis in teens and children has increased 40 fold over the last 10 years, bringing the diagnosis rate for bipolar to 2.5%-3% of people under 18 years-old. Despite this, adolescents with bipolar disorder are particularly vulnerable both socially and psychologically.
Teenagers have a harder time being taken seriously about mental illness. They’re labeled as drama queens or “just acting out for attention.” While that may be the case for some, more than 2 million minors have bipolar disorder, and many others suffer from other mental illnesses. They should be given help and support, not written off.
More than 70% of adolescents in the U.S. don’t receive proper mental health care. Part of the problem is the stigma associated with even needing mental health care. In a time when younger people are developing their own sense of self, it can be detrimental to think they are in some way broken or weak. Middle school and high school students, especially black students, also perceive stigma more than their child or adult counterparts.
This sentiment keeps many from seeking out professional help on their own. For those that do, a significant number of them report being dismissed or ignored by mental health professionals. When they do receive treatment, less than 60% fully comply with all aspects of their treatment plans, including medication and therapy. Professionals can write off these patients as “non-compliant” or “hostile,” resulting in further stigma from the professionals who are supposed to be helping them.
The problem with simply labeling missing medication as “non-compliant” is that it overlooks the reasons adolescents are skipping doses. Being derided for circumstances beyond their control is hurtful to their mental health and may negatively affect the course of the disorder into adulthood.
A recent study published in the Journal of Child and Adolescent Psychopharmacology tracked the medication adherence of a group of patients aged 12-22. The researchers found six major reasons why the adolescents and young adults were skipping medication.
1 More daily doses
Some medications used to treat bipolar disorder require patients to take pills two, three or four times a day. It’s very easy to forget to take them. Having a routine and setting an alarm is the best way to remember.
2 Timing of taking medication
Afternoons and weekends are the most often skipped doses. It’s understandable that being busy can make any person forget. Again, it’s best to set an alarm and keep medication on hand.
3 Weight gain
Weight gain is a side effect of many medications. Students are already having to cope with the idea of a mental illness singling them out, adding physical appearance to that only amplifies problems with self-esteem. Changing medication to one less likely to cause weight gain can improve medication compliance.
4 Too much time between meds management appointments
These appointments can provide motivation for adolescents to stick to treatment as doing so minimizes any guilt or shame that comes with being “non-compliant.” After a period of time this urgency fades. Keeping regular appointments can provide extra motivation as well as make sure the medications and dosages are right for their symptoms.
5 Cognitive difficulties
Poor cognitive function (attention, memory, critical thinking and social functioning) is a major factor when dealing with bipolar disorder. Some patients may not be able to keep track of whether or not they’ve been compliant with treatment. They may need extra help keeping track.
6 Illness severity
Basically, the more severe the symptoms, the less likely patients are to take their meds. Bipolar disorder itself lends to poor judgement and lack of insight, especially in manic phases. At these times patients may not realize they have an illness or refute being told they have an illness in the first place. If this is the case, their original regimen may not have been effective and a meds management meeting may be required.
It’s important to take these factors into consideration when working with adolescents with bipolar disorder. Being a teenager is hard even when you don’t have a mental illness. They need extra support and may need help to comply with treatment plans. Patients and their families and friends should educate themselves on what it means to have bipolar disorder. Empathy from others is one of the most important aids in treatment a person can receive.
Image credit: Tammy McGary