Children and teens with bipolar disorder

Although bipolar disorder is more common in older teens and young adults, it can also appear in children as young as 6 years of age. It has become a controversial diagnosis in recent years. Some experts believe that this is rare and over diagnosed; others think otherwise. At the moment it is difficult to understand how common this is.

Another diagnosis, called disruptive mood dysregulation disorder, has also been established to describe children between the ages of 6 and 18 who exhibit severe and persistent irritability and outbursts of anger that do not meet commonly accepted definitions of bipolar disorder.

Therefore, it is important not to rush to conclusions. If your child has been diagnosed with bipolar disorder, you may want to get a second opinion before starting a treatment plan. Make sure you are comfortable with your child's health care provider.

Bipolar disorder in young children

Diagnosing bipolar disorder in young children is difficult because many of the symptoms are similar to those of attention deficit hyperactivity disorder or conduct disorder—or even just normal childhood behavior. One concern is that the drugs used to treat attention deficit hyperactivity disorder are often stimulants that have the potential to induce mania in children with bipolar disorder.

Young children in the manic phase may be more irritable than adults; they may be more likely to have psychotic symptoms and may hear and see things that are not real. During a depressive episode, they are more likely to complain of physical symptoms, such as body aches.

One of the most notable differences is that bipolar disorder in children progresses much more quickly. While in adults there can be weeks, months or years between manic and depressive periods, in children they can occur within a single day.

How can I help my child with bipolar disorder?

As a parent of a child with bipolar disorder, there are many things you can do to keep your child healthy. Here are some suggestions.

Follow your medication schedule. It's important to make sure your child gets the medicines they need to treat bipolar disorder. Use timers, pillboxes, sticky notes and anything else you need to remember. If your child needs medication at school, talk to their teacher or school nurse - schools may not allow students to take their own medication.
Control side effects. Most drugs used for bipolar disorder (including mood stabilizers, antipsychotics, and even antidepressants) were originally tested in adults, and few have been well studied in children and teens. Some children are more prone to the side effects of some of these drugs, such as weight gain and changes in blood sugar and cholesterol levels caused by some atypical antipsychotics. Ask your child's doctor what symptoms to look out for, and you may need to have your blood tests checked regularly. The use of certain types of antidepressants or other drugs used to treat depression may increase the risk of suicide in children, teens, and young adults under the age of 24.
Talk to your child's teachers. In some cases, a child with bipolar disorder may need special allowances at school. They may need extra breaks or less homework during difficult times. Therefore, arrange with your child's teachers or the school principal. In some cases, you may need to take your child out of school for a while, at least until the symptoms of bipolar disorder stabilize.
Keep a routine. Children with bipolar disorder can really benefit from a daily schedule. Help them get up, eat, exercise, and go to bed around the same time each day. Do your best to reduce family stress.
Consider family therapy. Having a child with bipolar disorder can affect the entire family. This can put additional stress on your marriage. Your other children may not understand what is wrong with their brother or sister, or they may not be happy with all the attention they receive. Attending family therapy can help you recognize and deal with these problems.
Take suicidal threats seriously. No parent wants to think that their children are hurting themselves. But, unfortunately, this can happen even with young children. So if your child starts expressing a death wish or life-threatening behavior, don't ignore it. Remove any dangerous weapons or drugs from your home. And get help right away.

Teens with bipolar disorder

In older teens, the symptoms and treatment of bipolar disorder are much more similar to those seen in adults. But having a teenager with the condition presents many different challenges.

As teenagers get older, they may feel resentful if they feel you are forcing treatment on them. So let them join in the conversation. Talk frankly with your child's doctor or therapist about treatment options. Try not to develop a hostile relationship with your child because of his treatment or medication.

Like adults, it is important for teens with bipolar disorder to avoid alcohol and drugs that can interact with medications or cause or exacerbate mood swings. Teens with bipolar disorder are much more likely to develop a substance abuse problem than their peers. It is also important to maintain a regular sleep-wake schedule and develop effective coping strategies for stress and distress.