Bipolar disorder (BPD) is a serious mental illness. Children with this disorder have extreme changes in mood and behavior. In the manic phase they are highly energized and very active. In the depressed phase they are sad and have low energy. These moods happen more often and are far more severe than typical for children of the same age. Bipolar disorder used to be called manic-depressive illness.
The causes of the disorder are unclear. BPD runs in families. If parents have bipolar disorder or depression, children are more likely to have it.
A first episode of mania or depression may be triggered by substance abuse, a death in the family, parents divorcing, breaking up with a boyfriend or girlfriend, or other traumatic events. However, often BPD begins with no specific event.
BPD is different in children and teens than in adults. In adults there are often clear episodes of mania or depression that last a week or longer. In the manic phase the person has very high energy and may do wild, reckless things. This phase is often followed by depression.
In children and teens, the phases are less distinct and the changes between them may be more rapid. Depressed children are more likely to be irritable, cranky, and withdrawn, and less likely to be sad or feel hopeless than depressed adults. Children may cycle between depressive and manic phases as often as once or twice a day. This is called "rapid cycling,"
Many experts believe that children as young as 5 or 6 years old may show signs of BPD. Other experts believe that BPD cannot be diagnosed until the late teenage years. Some children and young teens may show a "mixed state." In a mixed state, depression and mania happen at the same time.
A child in the manic phase may:
A child in the depressed phase may:
Teens, when depressed, may:
When manic, teens may:
Sometimes it is hard to tell bipolar disorder from other problems such as depression, substance abuse, anxiety, and PTSD. Many symptoms are also symptoms of other disorders. A mental health therapist who specializes in working with children and teens is best qualified to diagnose bipolar disorder.
The therapist will ask about your child's symptoms and behavior, medical and family history, and any medicines the child is taking. Your child may also need some lab tests to rule out medical problems.
Children and teens may also have other disorders in addition to BPD, such as:
Both medicines and therapy are usually used to treat BPD.
Your child may need to start taking medicines before therapy can be effective. Several types of medicines can help treat depression. Your healthcare provider will work with you to carefully select the best one for your child.
If your child also has attention deficit/hyperactivity disorder (ADHD), medicines for ADHD may be prescribed. However, in some cases the medicines for ADHD can trigger manic symptoms or mood swings in children with bipolar disorder. Antidepressant medicines can also bring on BPD symptoms in children.
It is important to have an experienced professional working with your child or teen. Your child's therapist will need to check your child's symptoms and medicines often.
Cognitive behavior therapy (CBT) helps children learn how to manage their physical symptoms, negative thoughts, and problem behaviors.
Family therapy is often very helpful. Family therapy treats the family as a whole rather than focusing on just the child. Children often feel very supported when parents and siblings attend therapy with them and work as a group.
Interpersonal therapy and psychoeducation (learning about the disorder and how to lessen symptoms) have also been found to be helpful.
About 10% of teenagers who have a major episode of depression lasting several weeks develop BPD as adults.
Bipolar disorder is a lifelong problem. Without treatment, it may get worse. With medicine and regular therapy, however, it is often well controlled. Many children function normally once a good treatment program is in place.
If your child is suicidal, get professional help immediately. Without treatment, nearly 1 in 5 people with bipolar disorder commit suicide.
If your child often has the BPD symptoms listed above, seek professional help. Do not try to treat these symptoms by yourself. Your child needs professional treatment.
Get emergency care if your child has thoughts of suicide or harming others, or if manic behavior puts you, others, or your child in danger.
For more information, contact:
Depression and Bipolar Support Alliance
Web site: http://www.dbsalliance.org
National Alliance for the Mentally Ill
Telephone: 800-950-NAMI (6264)
Web site: http://www.nami.org
National Institute of Mental Health
Telephone: 866-615-NIMH (6464)
Web site: http://www.nimh.nih.gov/
National Mental Health Alliance
Telephone: 800-969-NMHA (6642)
Web site: http://www.nmha.org