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However, Charlie Brown is still a child making medication controversial. In this case medication should be considered as a last resort if he does not respond to therapy within a reasonable period.

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The most effective way to treat mood disorders is through medication. In the cause of a bipolar disorder a mood stabilizer such as lithium carbonate, which has been shown to be effective in 50% of patients, is typically prescribed to reduce mood spikes and prevent suicidal tendencies. (Barlow & Durand p250)

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"The relationship of stressful events to the onset of episodes in bipolar disorder is also strong" (Barlow & Durand p240)

The main stressor that affects Charlie Brown is bullying from his peers, which can be difficult to address directly. The best option would for him to to attend therapy to address the causes of his being bullied and how he copes with it.

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Bipolar I Disorder is strongly correlated to both biological and environmental influences, as such treatment should take both into account.

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Relation to the 4 D's of abnormality (2/2)

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Relation to the 4 D's of abnormality (2/2)

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Intensity - More severe cases of bipolar I Disorder can lead to:
-more risk taking, possibly endangering the patient or those around them
-impaired judgment, leading to significant distress and long term dysfunction
-deviates further from the average person's baseline, making them more "abnormal"

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Birmaher also states, "when one parent has BP, the risk of the child having BP is between 10% and 25% with higher rates when both parents have BP" (Birmaher p145). While Charlie Browns parents are not pictured in "Peanuts" (Shultz) it is not unlikely that he has a family history of Bipolar Disorder.

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Most people who do not understand Bipolar disorders believe that it results in sudden and uncontrollable bouts of anger, rather than often long-lasting swings between Mania and Depression. This can often lead to active avoidance of Bipolar individuals, causing social isolation or in worse cases, such as Charlie Brown's, bullying.

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In his study Boris Birmaher states, "BP spectrum disorder is a familial disorder that occurs in 1%–3% of children and adolescents, with increased rates of onset during the adolescent years." (p145). This may likely explain why Charlie Brown is 'Different' from his small group of peers.

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A study into "children with FHR-BP (Family History of Bipolar Disorder) did not report significantly lower QoL or self-esteem, except from on the 'Social Acceptance (Bullying)' scale...reported significantly more bullying" (Ellersgaard, et al. p857)

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American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text revision). https://doi.org/10.1176/appi.books.9780890425787

Barlow, D., Durand, V. (2012). Abnormal Psychology an Integrative Approach (7th ed.). Cengage Learning

Birmaher, B. (2013). Bipolar disorder in children and adolescents. Child & Adolescent Mental Health, 18(3), 140–148. https://doi.org/10.1111/camh.12021

Ellersgaard, D., Gregersen, M., Ranning, A., Haspang, T. M., Christiani, C., Hemager, N., Burton, B. K., Spang, K. S., Søndergaard, A., Greve, A., Gantriis, D., Jepsen, J. R. M., Mors, O., Plessen, K. J., Nordentoft, M., & Thorup, A. A. E. (2020). Quality of life and self-esteem in 7-year-old children with familial high risk of schizophrenia or bipolar disorder: the Danish High Risk and Resilience Study-VIA 7—a population-based cohort study. European Child & Adolescent Psychiatry, 29(6), 849–860. https://doi.org/10.1007/s00787-019-01397-3

Mendelson, L. (1963). A boy named Charlie Brown.

Melendez, B. (1965). A Charlie Brown Christmas.

Melendez, B. (1972). Snoopy Come Home.

Shultz, C. M. (1950-2022). Peanuts.

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Charlie Brown is frequently portrayed externalizing feelings of depression & low self-efficacy indicative of significant distress

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Charlie Brown is not overtly "odd" in the perspective of the average audience member. However further thought can establish that he is the only person within his sphere of influence (Age/Area) portrayed as mentally unwell. Furthermore, his glum behavior making him "different" may be the cause of his being bullying

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Charlie Brown has displayed signs of depression to the point of dysfunction. However without knowing the duration of the symptoms it can not be said for sure that they consistently impair his life.

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Charlie Brown has never shown any behavior that indicate a present danger to himself or others

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- Most severe indicator is in "A Boy Named Charlie Brown" (Mendelson 1963). After Charlie Brown loses the spelling bee that had been his goal & motivation, he enters a depressive state where he completely loses motivation for a full day.
- Duration of episodes can be seen in "A Charlie Brown Christmas" (Melendez 1965) where he becomes mildly depressed for most of the season
(Possibly Seasonal Affective Disorder)
- Occasional displays of Anhedonia seen in "Snoopy Come Home" (Melendez 1972)

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B: 1,3,4,6 & C
- Charlie Brown is depicted as more confident when playing baseball
- In contrast to his usual slow dialogue when talking about baseball Charlie Brown sometimes rambles about various signs  much to the confusion of his friends
B: 6 & C
- In "A Boy Named Charlie Brown" (Mendelson 1963) Charlie Brown is shown to be intensely motivated toward his goal to win a spelling bee
D
- Charlie Brown has never been depicted taking mood altering substances

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From the comic-strip & cartoon "Peanuts" (Shultz 1950)

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From the comic-strip & cartoon "Peanuts" (Shultz 1950)

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[X] A. Five or more of the following symptoms over a 2 week period representing a change in behavior
[X] 1. Depressed mood most of the day
[X] 2. Marked decreased interest in most activities
[  ] 3. Significant change in weight
[  ] 4. Insomnia or hypersomnia
[  ] 5. Psychomotor agitation
[X] 6. Fatigue or loss of energy
[X] 7. Prolonged feelings of worthlessness
[X] 8. Diminished ability to think or concentrate
[  ] 9. Recurrent thoughts of death or suicide
[X] B. Symptoms cause significant distress or impairment
[X] C. episode is not attributable to a physiological altering substance
(American Psychiatric Association, 2013)

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[?] A. Period of increased activity and or energy lasting at least one week
[X] B. During the period of disturbance 3 of the following symptoms are exhibited
[X] 1. Increase to self esteem
[   ] 2. Decreased need for sleep
[X] 3. More talkative
[X] 4. Flight of ideas / ideas are racing
[   ] 5. More Distractible
[X] 6. Increase in goal-directed activity
[   ] 7. Excessive involvement activities that may lead to personal harm
[X] C. The disturbance is severe enough to cause marked social impairment
[X] D. Episode is not in response to physiological altering substance
(American Psychiatric Association, 2013)

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According to the DSM-5, it is unlikely that Charlie Brown has avoidant personality disorder as he only meet three out of the required 4 criterion.

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The DSM-5 requires the presence of at least one Manic episode for a diagnosis; and while indicative of the disorder Major Depressive episodes are not required for a Bipolar I Diagnosis

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The DSM-5 requires four out of seven of the following symptoms for a Avoidant Personality Disorder diagnosis:
[   ] 1. occupational avoidance out of fear of criticism or disapproval
[   ] 2. Unwilling to be involved without the certainty of being accepted
[X] 3. Restraint within intimate relationships for fear of shame
[X] 4. Preoccupied with criticism or rejection in social situations
[X] 5. Inhibited in interpersonal situations because of feelings of inadequacy
[   ] 6. Views self as socially inept, unappealing or inferior
[   ] 7. is reluctant to take personal risks or to engage in any activities that may prove embarrassing
(American Psychiatric Association, 2013)

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Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (American Psychiatric Association, 2013)

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Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (American Psychiatric Association, 2013)

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- Bipolar I Disorder -

- Avoidant Personality Disorder -

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- Frequent externalized feelings of inadequacy
- Occasional severe depressive episodes often following periods of intense goal oriented confidence
- Occasional Anhedonia

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Overall he is considered to be "a good man"

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Overall he is considered to be "a good man"

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Charlie Brown is commonly characterized as a "lovable loser". He is naïve, frequently bullied, fails at most endeavors, but despite all of it he maintains loyalty and kindness to his friends.

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A measure of how often symptoms occur

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Intensity is used to: "evaluate in a global sense important symptoms that are often present across disorders in almost all patients...", can also referred to as severity.
(Barlow & Durand p90)

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A measure of how long symptoms persist

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Common of Bipolar I Disorder according to the DSM-5 (American Psychiatric Association, 2013)

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Common of Bipolar I Disorder according to the DSM-5 (American Psychiatric Association, 2013)

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Duration -
- Manic episodes typically last at least a week
- Hypomanic episodes last at least four days
- Major depressive episodes last at least two weeks

Frequency -
- During an episode symptoms occur at least once per day or throughout the whole day

Intensity -
- Ranges from mild to severe depending on degree of impairment

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Relation to the 4 D's of abnormality (1/2)

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Relation to the 4 D's of abnormality (1/2)

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Duration - The long duration of bipolar I disorder can lead to significant distress and dysfunction as it can impair a person significantly both in the present and in their long-term plans

Frequency - Can be a factor in distress and dysfunction, (if someone only has one or two episodes it may not have long term consequences)

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Due to the typical format of Peanuts, (loosely connected short sketches) it can be difficult to determine how long Charlie Brown's symptoms may last:

Depressive - In "A Charlie Brown Christmas" (Melendez 1965) he is depicted as depressed throughout the majority of the winter season. This shows that his depressive episodes may last at around a month.

Manic - In "A boy named Charlie Brown" (Mendelson 1963) his goal oriented activity is shown to last at least 4-5 days, however as there is no clear timeline it likely could have lasted the required week

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Charlie Brown's case of bipolar I is relatively mild, as it does not stop him from attending school or lead to complete isolation from his peers

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It can be implied from Charlie Brown's frequent self-deprecation and anhedonia, that both his episodes and and the symptoms therein are constant