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Many children and especially adolescents experience mood swings as a
normal part of growing up, but when these feelings persist and begin
to interfere with a child’s ability to function in daily life,
bipolar disorder could be the cause. Bipolar disorder, also known as
manic-depression, is a type of mood disorder marked by extreme changes
in mood, energy levels and behavior. Symptoms can begin in early childhood
but more typically emerge in adolescence or adulthood. Until recently,
young people were rarely diagnosed with this disorder. Yet up to one-third
of the 3.4 million children and adolescents with depression in the United
States may actually be experiencing the early onset of bipolar disorder
according to the American Academy of Child and Adolescent Psychiatry.
Doctors now recognize and treat the disorder in both children and adolescents,
but it is still an under-recognized illness.
Children with bipolar disorder usually alternate rapidly between extremely
high moods (mania) and low moods (depression). These rapid mood shifts
can produce irritability with periods of wellness between episodes, or
the young person may feel both extremes at the same time. Parents who
have children with the disorder often describe them as unpredictable,
alternating between aggressive or silly and withdrawn. Children with
bipolar disorder are at a greater risk for anxiety disorders and Attention-Deficit
Hyperactivity Disorder (ADHD). These “co-occurring” disorders
complicate diagnosis of bipolar disorder and contribute to the lack of
recognition of the illness in children.
What are the Signs and Symptoms?
Bipolar disorder begins with either manic or depressive symptoms. The
lists below provide possible signs and symptoms. Not all children with
bipolar disorder have all symptoms. Like children with depression,
children with bipolar disorder are likely to have a family history
of the illness. If a child you know is struggling with any combination
of these symptoms for more than two weeks, talk with a doctor or mental
health professional.
Manic Symptoms
-
Severe changes in mood—from unusually happy or silly to irritable,
angry or aggressive.
- Unrealistic highs in self-esteem. May feel indestructible or believe
he or she can fly, for example.
- Great increase in energy level. Sleeps little without being tired.
- Excessive involvement in multiple projects and activities. May move from
one thing to the next and become easily distracted.
- Increase in talking. Talks too much, too fast, changes topics too quickly,
and cannot be interrupted. This may be accompanied by racing thoughts
or feeling pressure to keep talking.
- Risk-taking behavior such as abusing drugs and alcohol, attempting daredevil
stunts, or being sexually active or having unprotected sex.
Depressive Symptoms
- Frequent sadness or crying.
- Withdrawal from friends and activities.
- Decreased energy level, lack of enthusiasm or motivation.
- Feelings of worthlessness or excessive guilt.
- Extreme sensitivity to rejection or failure.
- Major changes in habits such as over-sleeping or over-eating.
- Frequent physical complaints such as headaches and stomachaches.
- Recurring thoughts of death, suicide, or self-destructive behavior.
Many teens with bipolar disorder abuse alcohol and drugs as a way to
feel better and escape. Any child or adolescent who abuses substances
should be evaluated for a mental health disorder. If an addiction develops,
it is essential to treat both the mental health disorder and the substance
abuse problem at the same time.
What Should Parents and Caregivers Do?
Early identification, diagnosis, and treatment help children reach their
full potential. Bipolar disorder is treatable. Children who exhibit
signs of bipolar disorder should be referred to and evaluated by a
mental health professional who specializes in treating children. The
evaluation may include consultation with a child psychiatrist, psychological
testing, and medical tests to rule out an underlying physical condition
that might explain the child’s symptoms. A comprehensive treatment
plan should include psychotherapy and, in most cases, medication. This
plan should be developed with the family, and, whenever possible, the
child should be involved in making treatment decisions.
To learn more or talk to a doctor or mental health
professional, contact
your local mental health association or the National
Mental Health Association or the resources below:
National Mental Health Association, 800-969-NMHA, www.nmha.org
American Academy of Child and Adolescent Psychiatry, www.aacap.org
American Psychiatric Association, 888-357-7924, www.psych.org
American Psychological Association, 800-964-2000, www.apa.org
Children and Adults with Attention Deficit/Hyperactivity Disorder, 800-233-4050,
www.chadd.org
Child and Adolescent Bipolar Foundation, 847-256-8525, www.bpkids.org
Federation of Families for Children’s Mental Health, 703-684-7710,
www.ffcmh.org
Knowledge Exchange Network, 800-789-2647, www.mentalhealth.org
National Association of School Psychologists, 301-657-0270, www.nasponline.org
Depression and Bipolar Support Alliance, 800-826-3632, www.ndmda.org
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