Ask the Therapist
13 Year Old with Hypomania
My 13 year old son was recently (yesterday) diagnosed with Hypomania. His testing also revealed some OCD issues as well as ADD/HD. As we are between the testing result consult and the med consult, I have been trying to do some research on my own. One of the questions I am having is that hypomania is generally characterized by episodic spells of 4 days. With this diagnosis, does this mean that Ben, my son, stays in the hypomanic state, or will he cycle through it? He never has any problems with depression, hence the hypomanic diagnosis. Also, at his age, how can I keep a complete check on the increased sexual drive that accompanies this disorder?
I am beginning to formulate questions for our next visit with the doctor, but just need some clarification on a few things. Is there a website that has clear, concise information for the grandparents?
I'm confused. Hypomania is episodic. While it's occurrence may support a support a broader diagnosis, like Bi-polar II, in and of itself it is generally not a diagnostic label. In my experience it is more of a symptomatic descriptor. I would be inclined to look at the ADHD and compulsive features as a diagnostic foundation, with the Hypomania being a feature -- but that's me.
To answer your question directly, every kid is different. Strict Hypomania describes a distinct manic state which does not subside. In addition, the duration is of _at least_ 4 days...which means he could potentially stay elevated for weeks...or until either his brain chemistry or his body quits. Generally, the adrenals crash, which effects the immune system and the kid just plain gets sick -- a cold, flu, ear infection, poison ivy (an immunological response, not an allergic reaction), whatever.
As for the sexual aspect of mania, this refers more to an opportunistic symptom. If he's not sexually active, it's likely that this aspect of the episode will not manifest markedly. Looking at pornography on the Internet is not "active" enough for a manic. As for auto-erotic issues, it's likely he will be given a medication that reduces sex drive (most of the SSRIs and MAOs do so), so there's that. Otherwise, he's a curious 13-year-old and, disordered or not, he's going to be interested.
Finally, the best source of information for the grandparents is the family.
