Mood disordered by brain chemicals

Who says that childhood must be filled with days of innocence? The fact is that 13% of children and teenagers in the US have encountered mood disorder in any 6-month period.

Who says that childhood must be filled with days of innocence? The fact is that, according to the U.S. National Institute of Mental Health, 13% of children and teenagers in the US have encountered mood disorder in any 6-month period. Half of them suffer from depressive disorder, and attention-deficit, hyperactivity and anxiety are not uncommon. What can you do if you are the family member of one of these children and adolescents? The stories of Annie and Beatrice may give you some inspiration.

The emotional pair

Annie, aged seven years, was the little devil of her parents. They noted that since late infancy, the tomboyish girl tended to be overactive, and often had accidents and unexpected mood swings. Annie's attention spans on classes were short, and her score in examination remained within the lowest quintile. She was also complained by teachers in school for disturbing other children.

Beatrice, a 17-year-old young teenager, had passed the HKCEE and started her school life as a Form 6 student two months ago. Instead of feeling relieved from the pressure of examination, she looked stressed and worrisome all the time. She also claimed herself with fatigue and poor sleep. Starting every morning she felt tight with her stomach and limb-muscles, and the symptoms became "unbearable" after lunch. She lost her temper quite often, and her school performance plummeted due to poor concentration.

Emotion driven by serotonin

Both Annie and Beatrice were taken to the physicians by their parents respectively. Annie was given electro-encephalogram (meaning: a diagnostic test which measures the electrical activity of the brain using high sensitive recording equipment attached to the scalp by fine electrodes) and other tests. After exclusion of other illnesses, she was diagnosed to have attention-deficit/hyperactivity disorder (ADHD). Her inappropriate behaviour that had caused social difficulties, in spite of her near-normal intelligence, was indeed symptoms of disease.

On the other hand, specialist told Beatrice's family that her symptoms matched the definition of anxiety disorder, which a typical patient shows signs of feeling stressed-out with fears out of proportion to the actual degree of danger-exposure, thus causing subjective distress or objective disability in social or job functioning. Beatrice's parents were told that one or more of the following features had helped carer suspect that anxiety disorder was indeed the likely cause of Beatrice's sufferings, and Beatrice had all of them: restlessness or feeling keyed up or on edge, being easily fatigued, difficulty concentrating, irritability, muscle tension and sleep disturbance.

Such mood disorders in childhood and adolescence are, in many cases, driven by biological disorders. The symptoms of Annie and Beatrice could be merely gene-controlled brain chemical imbalance showing up years after birth. Gene and medication studies have shown that there is a possible relation between ADHD and of isolated regional developmental dysfunction of the brain. Similarly, it is shown that the imbalance in the brain chemicals, such as underactivity of serotonin and overactivity of norepinephrine, is a possible cause of anxiety disorders, as well as suicide-risk in some serious cases.

Care, the professional one

Both Annie and Beatrice were offered medication and help from trained helpers. Substantial improvement was noticed by their parents and carers shortly since treatment. Annie turned back from devil to her parents' lovely angel within a short period. Similar to 80% of the ADHD patients who mature to near normal by late teens, she was quite well by the age of 14 years. Beatrice's symptoms faded within two months of cognitive-behavioural treatment and a short period of drug medication, as well as unconditional support from her parents. She was followed up for another six months.

To ready children and adolescents for possible burdens and mood swings, parents may encourage them follow an ABCDE "empowerment checklist", a list inspired from 10 Positive Steps for Mental Health published by the UK Health Education Authority:

• Advancing sports-plan
• Basking in relaxation
• Calling friends to keep in touch with them
• Diverting enjoyment into a weekly "hobby group-hour" or "learning-hour"
• Extending contacts through social groups

Another list is suggested to manage such mood swing when it inevitably happen:

• Advancing sports-plan
• Basking in relaxation
• Calling trusted "regular contacts" e.g. cousin and peer
• Diverting enjoyment into healthy drinks, instead of alcohol or the caffeinated
• Extending and using your "emergency contacts" to ask for help when necessary

Just like the parents of Annie and Beatrice, you can become your family's early-warning sensor in triggering early recruitment of trained caregivers in the whole process of minimizing suffering from mood disorder. With proper care and follow up, the misery of these children and teenagers symptoms can be minimized, so as the possibility of tragedy caused by such disorders.