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Caregiver Role Strain due to Bipolar Disorder in Children

Jenna M. Cheese
Creighton University

Introduction

      Family dynamics are complex and roles are often complicated. This is especially true when a child has a behavioral disorder that challenges the primary caregivers or family members. Bipolar disorder is a behavioral disorder that is exemplified by extreme alternating mood swings (Apps, Winkler, & Jandrisevits, 2008). These episodes “involve both major depression and mania which cause dysfunction in multiple areas of a child’s or adolescent’s life including home, school, and with peers” (Apps et al. p.1). Due to a lack of information or knowledge of the disorder, family members may not know how to react to a child with bipolar disorder, thus causing stress and tension within the family. The purpose of this paper is to address the relationship that children with bipolar disorder have with their primary caregivers and to discuss effective nursing interventions to assist in the care of the child. 

      Bipolar disorder affects people of all ages. This paper will focus on children between the ages of 5 to 14 years old. Approximately 2% of children in the elementary to middle school age range are affected by bipolar disorder (Pavaluri, Birmaher, & Naylor, 2005, as cited in Wade, 2006). Specialists approximate that 1 million children suffer from bipolar disorder in the United States; however, the actual number of cases is unknown due to difficulties diagnosing this illness (Olson & Pacheco, 2005). Studies show that 70-100% of children with bipolar disorder will recover, but as many as 80% will undergo another reoccurrence within two to five years (Birmaher, Axelson, & Pavuluri; Pavuluri, Birmaher, & Naylor, 2005; Birmaher et al., 2006; Geller, Tillman, Craney, & Bolhofner, 2004, as cited in Birmaher, 2007).  Typically 10 years elapse before a correct diagnosis is made and with every year there is a 10% decrease in the probability of recovery (Pavuluri, Birmaher, & Naylor, 2005; Birmaher et al., 2006, as cited in Birmaher). Bipolar disorder can ultimately lead to suicide. When suicide does a occur it is either seen as either an accident or seen as a result of lack of attention (Olson & Pacheco). Bipolar disorder affects all socioeconomic and ethnic groups similarly (Wade). Regarding gender, bipolar disorder affects boys and girls equally; however, boys display more manic symptoms and girls more often exhibit symptoms of depression (Cummings & Fristad, 2008). Bipolar disorder most likely occurs in children who have a genetic link, experience recurrent emotional alterations, and have an overall decreased function level (Singh, et al., 2007; Hauser et al., 2007, as cited in Cummings & Fristad).

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