Bipolar disorder in children

Bipolar disorder is a chronic mental illness that causes dramatic shifts in a person’s mood, energy and ability to think clearly. People with bipolar have high and low moods, known as mania and depression, which differ from the typical ups and downs most people experience. If left untreated, the symptoms usually get worse. However, with a strong lifestyle that includes self-management and a good treatment plan, many people live well with the condition.

Symptoms

A person with bipolar disorder may have distinct manic or depressed states. A person with mixed episodes experiences both extremes simultaneously or in rapid sequence. Severe bipolar episodes of mania or depression may also include psychotic symptoms such as hallucinations or delusions. Usually, these psychotic symptoms mirror a person’s extreme mood. Someone who is manic might believe he has special powers and may display risky behavior. Someone who is depressed might feel hopeless, helpless and be unable to perform normal tasks. People with bipolar disorder who have psychotic symptoms may be wrongly diagnosed as having schizophrenia.

Signs of Bipolar Disorder In Children and Teens

Children may experience severe temper tantrums when told “no.” Tantrums can last for hours while the child continues to become more violent. They may also show odd displays of happy or silly moods and behaviors.

Causes

Scientists have not discovered a single cause of bipolar disorder. They believe several factors may contribute:

• Genetics. The chances of developing bipolar disorder are increased if a child’s parents or siblings have the disorder. But the role of genetics is not absolute. A child from a family with a history of bipolar disorder may never develop the disorder. And studies of identical twins have found that even if one twin develops the disorder the other may not.


• Stress. A stressful event such as a death in the family, an illness, a difficult relationship or financial problems can trigger the first bipolar episode. Thus, an individual’s style of handling stress may also play a role in the development of the illness. In some cases, drug abuse can trigger bipolar disorder.


• Brain structure. Brain scans cannot diagnose bipolar disorder in an individual. Yet, researchers have identified subtle differences in the average size or activation of some brain structures in people with bipolar disorder. While brain structure alone may not cause it, there are some conditions in which damaged brain tissue can predispose a person. In some cases, concussions and traumatic head injuries can increase the risk of developing bipolar disorder.

Diagnosis

The Diagnostic and Statistical Manual of Mental Disorders (DSM) defines four types of bipolar illness:

• Bipolar I Disorder is an illness in which people have experienced one or more episodes of mania. Most people diagnosed with bipolar I will have episodes of both mania and depression, though an episode of depression is not necessary for a diagnosis. To be diagnosed with bipolar I, a person’s manic or mixed episodes must last at least seven days or be so severe that he requires hospitalization.


• Bipolar II Disorder is a subset of bipolar disorder in which people experience depressive episodes shifting back and forth with hypomanic episodes, but never a full manic episode.


• Cyclothymic Disorder or Cyclothymia, is a chronically unstable mood state in which people experience hypomania and mild depression for at least two years. People with cyclothymia may have brief periods of normal mood, but these periods last less than eight weeks.


• Bipolar Disorder "other specified" and "unspecified" is diagnosed when a person does not meet the criteria for bipolar I, II or cyclothymia but has had periods of clinically significant abnormal mood elevation. The symptoms may either not last long enough or not meet the full criteria for episodes required to diagnose bipolar I or II.

Treatment

Bipolar disorder is treated and managed in several ways:

• Medications, such as mood stabilizers, antipsychotic medications and antidepressants


• Psychotherapy, such as cognitive behavioral therapy and family-focused therapy


• Electroconvulsive therapy (ECT)


• Self-management strategies and education


• Complementary health approaches such as meditation, faith and prayer.

Conditions

Common conditions that people with bipolar disorder also experience include:

• Anxiety disorders, including posttraumatic stress disorder (PTSD)


• Attention-deficit hyperactivity disorder (ADHD)


• Posttraumatic Stress Disorder (PTSD)


• Substance abuse. Many people use alcohol or drugs to try to control their moods or treat their symptoms. Using drugs makes the illness worse and can lead to more frequent relapses and increased suicide attempts.

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