Neurofeedback And The Treatment Of The Bi-polar Child
Not too long ago, it was believed that Bi-polar Disorder developed over the course of many years, reaching its full “maturation” into the full-blown syndrome when a person reached their twenties or later. Over the past few years however, the psychological community has seen an intrusion of Bi-polar Disorder into a younger and younger population of children, some as young as eighteen months (Papolos). It is important to note here, that the recognized marker for this condition in children was the high variability in mood, specifically the rapid cycling commonly associated with Bi-polar Disorder, rather than the specific behaviors associated with adult Bi-polar Disorder, namely mania and major depression.
In children, the principal markers for early onset Bi-polar Disorder are rage and wildly explosive behavior, in addition to mindless and even violet defiance. These symptoms may alternate or cycle with periods of calmness, and the cycling between them may be rapid, with cycling at greater than daily rates. If the cycling is diurnal, the child may behave and perform relatively well in school but fall apart later in the day at home. Other symptoms identified with this condition in children are marked irritability, oppositionality, aggressive behavior, racing thoughts, and grandiosity, and in some instances over-sensitivity in general. Often Bi-polar Children display symptoms of Oppositional-Defiant Disorder and of conditions such as Tourette Syndrome, Obsessive-Compulsive Disorder, and temporal lobe or complex partial seizures and the sub-clinical variants of these conditions. In instances of co-occurrence with Tourette Syndrome, motor and vocal tics may be visible in addition to risk-seeking behavior and hyper-sexuality. The child may also be very difficult to reward or sanction, display hypersensitivity to humiliation or perceived slights. Co-occurrence of Obsessive-Compulsive Disorder may involve obsessions and compulsions and behaviors thereof that are often so unobtrusive the parent may not be aware of their existence. In the case of temporal lobe seizure vulnerability, even in the absence of overt seizures, one may see manifestations of night terrors, hallucinations, paranoia, suicidal ideation, and episodic bizarre behavior. Another signature is that these children have a history of being very active in utero; often possess a strong and insatiable craving for sweets, and may display irregular sleep and appetite patterns.
One reason as to why more children are being diagnosed with Bi-polar Disorder than ever before is due to the increase in stimulants and anti-depressants prescribed at a younger and younger age. Children who are Bi-polar may initially respond favorably to such medications, but in time their improved behavior deteriorates. There is a strong suspicion that the use of such medications on children with Bi-polar Disorder, as they are inappropriately prescribed, may actually worsen things for the child over time.
From our neurofeedback perspective, Bi-polar Disorder in children is due to insufficient regulation of these young brains as to be unstable, manifesting itself in a variety of classic forms. In this manner, we interpret the mood instabilities, the sleep and appetite disregulations, and the intense cravings for sweets as manifestations of brain disregulation. This instability can be so severe as to manifest night terrors or overt seizures; the uncontrollable rages may also be seen as disregulations that are paroxysmal, or seizure-like.
Neurofeedback then, can be viewed as a means of training the unstable brain toward steadiness and improved self-regulation, on the part of the child. The urgency of treating this vulnerable population with non-invasive modes of therapy like neurofeedback is great, given the possibility that strong medications employed to treat symptoms of Bi-polar Disorder may ultimately cause further brain disregulation. Neurofeedback provides parents with a further avenue of exploration when confronted with the possibility of dealing with a Bi-polar child, and interventions taking advantage of neurofeedback may reap life-long benefits without the risk of dependence on burly medications.