Your Child Does Not Have Bipolar Disorder

The bad science and misdiagnosis of childhood bipolar disorder.

Romantic Love and Hypomania in Adolescence

Normal Developmental Phase Mistaken for Hypomania?

Despite changing sexual mores and changing sexual behavior of adolescents, love continues to play a major role in the psychological development of many adolescents. In a study of romantic love in adolescents, Brand, et al., (1) developed the criteria below to characterize a state they call Early Stage Intense Romantic Love (ESIRL).  

*Intense focused attention on the loved one.

*Constant, intrusive, and persistent thinking about the love object.

*Extreme empathy, extreme altruism, and willingness to die for the love object.

*Sympathetic arousal, feeling energetic, and needing less sleep

*Elation, euphoria, and increases in self esteem.

*Sexual desire.

To study the sleep patterns of ESIRL and to compare ESIRL to hypomania, Brand, et al., recruited 113 adolescents, 72 female and 41 male, with a mean age of 17.9 years, who reported being in love currently or in the recent past.  The adolescents were individually interviewed about their romantic experiences. The adolescents who were in the early stages of their relationships (mean relationship length 5.5 months) reported significantly more intense romantic feelings than did those adolescents who were in later stages of their relationships (mean relationship length 13.0 months).  Adolescents who were currently not in a romantic relationship were also identified.

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All three groups completed nightly sleep logs.  The participants in current romantic relationships (early or late stage) were also administered a variation of a questionnaire for obsessive compulsive disorder, which asked questions such as, “How much time do you think of the other person?” and “How hard is it for you to resist thinking about your loved one?”  The adolescents who were in the early stage romantic love group scored significantly higher on the questionnaire than the adolescents in the later stage romantic love group. The adolescents who were in the early stage romantic love group reported significantly less sleep, but felt significantly more rested, than the adolescents in the later stage romantic love group  or the adolescents not currently in romantic relationships.  Further, there was a significant negative correlation between the love-obsessions questionnaire and sleep: those with higher obsession scores had lower sleep time.

All participants (early stage romantic love, late stage romantic love, and not currently in a romantic relationship) then completed a self-report inventory of hypomanic symptoms.  The investigators compared the scores of the adolescents in the three groups to the scores of adult psychiatric patients diagnosed as hypomanic on the same inventory.  There was no significant difference between the scores of the adolescents in the early stage romantic love group and the scores of the adult hypomanic psychiatric patients.  The scores of the early stage romantic love adolescents and the adult hypomanic psychiatric patients were significantly higher than those of the adolescents in late stage romantic love or no current romantic relationship.

Brand, et al., conclude: 1) early stage intense romantic love in adolescence is a normal phenomenon associated with psychological and physiological changes; 2) early stage intense romantic love in adolescence can easily be mistaken for hypomania; and, 3) unlike hypomania, early stage intense romantic love in adolescence is a normal developmental phenomenon.

1Brand, S, Luethi, M., von Planta, A., Hatzinger, M., Holsboer-Trachsler, E. J. of Adol Health 41 (2007) 69-76.

Copyright, 2013, Stuart L. Kaplan, M.D.

Stuart L Kaplan, M.D. is the author of Your Child Does Not Have Bipolar Disorder: How Bad Science and Good Public Relations Created the Diagnosis. http://notchildbipolardisorder.com/

Stuart L. Kaplan, M.D., is a clinical professor of psychiatry at the Penn State College of Medicine.

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