Morning is an exciting time for many. It’s the start of a new day—a chance for a new beginning. It’s an opportunity to leave behind the disappointments and mistakes of yesterday and to look forward to the future.

But for some children and adolescents living with bipolar disorder, morning is the most difficult time of day. The thought of facing another 24-hour period filled with unknown demons is daunting. And while most children their age are getting dressed for school, children with bipolar disorder are dressing for battle instead.

Ryan’s Story
Ryan Licht Sang was all too familiar with this battle. His war began when he was only five years old.

A creative, young man who loved music, drawing, and writing stories, Ryan “was such a fun little boy who made friends easily,” Ryan’s mother, Joyce Sang, recalls. But there was something that Sang noticed about her son, “Something that was so subtle at first that no one else saw what I saw,” she said.

While Ryan was creative, he was also a good student. Things began to change, however, in middle school. Suddenly, as bipolar disorder began to influence his life, schoolwork became a challenge for Ryan.

“His ability to concentrate changed,” said Sang. “And we now know, looking back, that he was fighting the beginnings of a serious illness of the brain, something that he could not control.”

Since Ryan’s symptoms began in the early 1990’s, and it wasn’t determined until 1995 that children could meet the diagnostic criteria for bipolar disorder, doctors did not seem to know what was wrong with Ryan. “It was a very hard time for our family,” Sang said.

At age 13, Ryan’s psychologist thought he might have bipolar disorder. But it was not until Ryan was 16 that he was finally diagnosed with the illness. Ryan was battling to keep the demons at bay. And at age 24, Ryan appeared to be in remission from his illness. He was working in the family business, completing his first novel, composing experimental music, and producing artwork.

Like many who suffer from mood disorders or mental illness, though, Ryan did not like the side effects of his medications and stopped taking them.

He believed he could control his own illness. But when Ryan suddenly entered a manic episode, he had nothing to stabilize his brain chemistry. He had not slept in several days. In order to sleep, Ryan self-medicated and tragically passed away in his sleep.

The Ryan Licht Sang Bipolar Foundation

While Ryan’s battle with his illness ended that day, his memory lives on daily through the Ryan Licht Sang Bipolar Foundation and the efforts of his mother and father, Joyce and Dusty Sang. The Sangs founded the organization in order to foster awareness, understanding, and research for early-onset bipolar disorder.

With bipolar disorder affecting 5.7 million adult Americans and potentially affecting more than three percent of children and adolescents in the United States, the Sangs hope to find an empirical, biomarker test so that early detection and early intervention become a reality.

“It’s a purely clinical diagnosis at this point,” says Dr. Karen L. Swartz, a psychiatrist and Director of clinical and educational programs at Johns Hopkins Mood Disorders Center. “We don’t have a blood test,” Swartz continues. “And we don’t have a brain scan.”

According to Swartz, it is also difficult to diagnose early-onset bipolar disorder because part of the exam involves having someone describe what they are going through.“ Very young children have a hard time articulating their feelings,” says Swartz. Currently, it can take up to ten years to make a diagnosis.

Does my child have bipolar disorder?
“Parents should not jump to conclusions, but should seek the proper help if they are concerned about their child,” says Sang, “starting with their pediatrician and, if needed, getting a referral to a pediatric psychiatrist.”

Dr. Swartz agrees that concerned parents should speak with a pediatrician. But parents should also speak with the child’s school counselor.

Swartz suggests asking the counselor how the child is interacting with friends and how he or she is doing in school.

A concerned parent should also take note of the following bipolar disorder symptoms:

When manic, children and adolescents are more likely to be irritable and prone to destructive outbursts than to be elated or euphoric.

When depressed, physical complaints such as headaches, and stomachaches or tiredness; poor performance in school, irritability, social isolation, and extreme sensitivity to rejection or failure.

May require very little sleep.

May be thrill-seeking without worry about consequences.

Manic episodes are cyclical. Don’t assume child is being a “typical teenager.”

Teens with bipolar disorder may block out negative feeling with the use of alcohol or drugs.

May have difficulty functioning in school, with peers, and at home.

Bipolar disorder is more likely to affect the children of parents who have the disorder. When one parent has bipolar disorder, the risk to each child is 15 to 30 percent. When both parents have bipolar disorder, the risk is

50 to 75 percent. (National Institute of Mental Health)

There is hope

The Foundation is proud of the progress it has made in spreading awareness and education. Bipolar medical briefing luncheons bring doctors in the field of bipolar disorder to local communities for panel discussions. The Foundation also awards scientific research grants to outstanding scientists at major universities to pursue cutting-edge research in the “Quest for the Test.”

The RLSBF also supports an educational program for high school students from Johns Hopkins called Adolescent Depression Awareness Program (ADAP). “ADAP teaches the students, their parents and teachers how to
recognize depression and bipolar disorder and touches upon suicide and bullying in the schools,” says Sang.

Dr. Karen Swartz, who is also the founder and director of ADAP’s 15 year old program, leads educational parent night programs for parents and students. She also leads one day education programs about mood disorders for schools.

Swartz invites teachers from all grade levels to join the training, but the curriculum is specifically structured to take place in a high school health class over the course of three days. “We designed it to generate discussions,” says Dr. Swartz, “and crafted it to be appropriate for non-clinicians to teach.”

Annual Young Friends’ events in Palm Beach County and Chicago help to raise funds for the underwriting of ADAP costs, lesson plans, and materials needed for participating schools.
Through education and awareness, the Sangs and all those involved in the Foundation hope to erase the stigma of bipolar disorder.

“When Ryan was diagnosed, we could not say the words,” says Sang. “It was much too scary and we did not have the knowledge to understand what having bipolar disorder really meant.” But since then, more and more people, including celebrities, are stepping out and sharing their stories.

“I am honored,” Sang concludes, “to watch that what began with two grieving parents who had lost their only child to bipolar disorder has now grown into a cause that other people all over the country are beginning to own in order to make a difference for the next generation.”

For more information on early-onset bipolar disorder, visit the Depression and Bipolar Support Alliance (dbsalliance.org), the National Institute of Mental Health (nimh.nih.gov), Johns Hopkins ADAP page at hopkinsmedicine.org, or the Foundation’s website: ryanlichtsangbipolarfoundation.org. Email the Foundation at: [email protected] with any questions.

Join the Young Friends of the Ryan Licht Sang Bipolar Foundation for their seventh annual Gone Country Dinner Dance on Saturday, March 29th at 7 p.m. at the Bonnette Hunt Club at 5309 Hood Road in Palm Beach Gardens. Visit the Foundation’s Facebook page to purchase tickets.

Chrissie Ferguson is a freelance writer and has been a Young Friends’ of the Ryan Licht Sang Bipolar Foundation committee member for the past seven years. She is also the director of children’s ministries at the Royal Poinciana Chapel in Palm Beach and is the mother of three young boys. Read her mom blog at soundoflittlefeet.blogspot.com