Bipolar disorder causes mood swings with extreme ups (mania) and downs (depression). When people with this problem are up, they have brief, intense outbursts or feel irritable or extremely happy (mania) several times almost every day. They have a lot of energy and a high activity level. When they are down, they feel depressed and sad.
What causes bipolar disorder?
Experts don’t fully understand what causes bipolar disorder.
It seems to run in families. Your child has a greater risk of having it if a close family member such as a parent, grandparent, brother, or sister has it. Parents may wonder what they did to cause their child to have bipolar disorder. But there is nothing a parent can do to cause or prevent it.
What are the symptoms?
In children and teens, moods quickly change from one extreme to another without a clear reason. But for a child to have bipolar disorder, these mood changes must be different from the child’s usual moods and must happen with other symptoms or changes in behavior. These distinct periods of time with changes in mood and behavior are called mood episodes. People with bipolar disorder have manic and depressive mood episodes.
Times of mania (ups) or depression (downs) may be less obvious in children and teens than in adults.
- A manic episode lasts at least a week. It is a period of extremely happy, aggressive, and/or angry mood that occurs with some of the following symptoms. The child or teen may:
- Have little need for sleep.
- Have high energy levels.
- Have extreme confidence in themselves.
- Talk very fast.
- Have many thoughts at once.
- Seem very distracted and unable to focus.
- Touch his or her genitals, use sexual language, and approach others in a sexual way.
- Act inappropriate or are intrusive in social settings.
- A depressive episode is a period of sad, low, or cranky mood that occurs with some of the following symptoms. The child or teen may:
- Not find pleasure in things they normally enjoy.
- Have low energy or feel “slowed down.”
- Have sleep and appetite changes.
- Have low self-esteem.
- Feel guilty or worthless.
- Withdraw from friends or family.
- Have difficulty focusing.
- Have thoughts about death or suicide.
How is bipolar disorder diagnosed in children and teens?
This disorder can be hard to diagnose in children and teens. The symptoms can look a lot like the symptoms of other problems, such as:
- Attention deficit hyperactivity disorder (ADHD).
- Alcohol and drug abuse problems.
- Conduct disorder.
Bipolar disorder can often occur along with these problems.
If your doctor thinks your child or teen may have bipolar disorder, he or she may ask questions about your child’s feelings and behavior. Your doctor may also give you and your child written tests to find out how severe the mania or depression is.
The doctor may do other tests (such as a blood test) to rule out other health problems. He or she may ask if your family has any history of mental illness or problems with drugs or alcohol. Any of these problems can be linked to bipolar disorder.
Why is early diagnosis of bipolar disorder important?
Children with this disorder are more likely to have other problems. These include alcohol and drug abuse, trouble in school, running away from home, fighting, and even suicide. Treating the disorder as early as possible may keep your child from having these problems.
Watch for the warning signs of suicide, which change with age. Warning signs of suicide in children and teens may include thinking too much about death or suicide. Watch also for things that can trigger a suicide attempt such as a recent breakup of a relationship or the loss of a parent or close family member through death or divorce.
How is it treated?
The mood changes that come with bipolar disorder can be a challenge. But with the right treatment, they can be managed well. Treatment usually includes both medicine (such as mood stabilizers) and counseling.
An important part of treatment is making sure your child takes his or her medicine. Children and teens with this disorder sometimes stop taking their medicines when they feel better. But without medicine, their symptoms usually come back.
Medicines for bipolar disorder in adults have been well studied. But more research is being done on how the medicines work and if they are safe for children and teens.
Keeping a consistent sleep-wake schedule is an important first step in managing bipolar disorder. Set a regular sleep-wake schedule for your child, to make sure they go to bed and wake up the same time every day, even on weekends.
Accepting that your child has bipolar disorder can be hard. The disorder can be a serious, lifelong problem. Your child will need long-term treatment and will need to be watched carefully. By working with your child’s doctor, you can find a treatment that works for your child.