From the National Mental Health Assoc.

Children and Bipolar Disorder

Bipolar disorder (also referred to as manic-depressive illness) usually starts in adult life, before the age of 35. Although rare in young children, it can appear both in children and teenagers. This illness can affect anyone. If one or both parents have bipolar disorder , the chances are greater that their children will develop the disorder.

Recognizing The Warning Signs Of Bipolar Disorder

Bipolar disorder may begin with manic or depressive symptoms.

The manic symptoms include:

• Severe changes in mood, when compared to peers, either unusually happy or silly, or highly irritable.
  
• Unrealistic highs in self-esteem.
  
• Great energy increase; can go with little or no sleep for days without tiring.
  
• Increased talking - talks too much, too fast; changes topics too quickly; cannot be interrupted.
  
• Distractibility - attention moves constantly from one thing to the next.
  
• High risk behavior - such as, jumping off a roof and believing no harm will occur to them.

The depressive symptoms include:

• Persistent sadness; frequent crying; depression.
  
• Loss of enjoyment in favorite activities.
  
• Frequent physical illnesses - such as, headaches or stomach-aches.
  
• Low energy level - poor concentration, complaining of boredom.
  
• Major change in eating or sleeping - such as oversleeping or overeating.

Both bipolar disorder with ADHD (Attentive Deficit-Hyperactivity Disorder) and childhood onset bipolar disorder begin early in life and occur mainly in families with a high genetic propensity for both disorders. Adult bipolar disorder is common in both sexes, however most children with bipolar disorder and/or ADHD, are boys.

Children with mania are seldom elated or euphoric; more often they are irritable and subject to outbursts of destructive rage. Childhood bipolar symptoms are often chronic and continuous rather than acute and episodic, as in adults. Bipolar disorder may account for a large proportion of children’s psychiatric hospitalizations.

Teens also have an ongoing combination of extremely high (manic) and low (depressive) moods. Highs may alternate with lows, or the person may feel both extremes almost simultaneously.

Confusion With Other Problems

Irritability and aggressiveness in children complicate the diagnosis, since they can also be symptoms of depression or conduct disorder, or even normal responses to stress. The irritability of bipolar children is especially severe and often leads to violence. The aggressiveness may suggest a conduct disorder, although it is usually less organized and purposeful than the aggression of predatory juvenile delinquents.

These signs are also similar to common teen problems such as, drug abuse, delinquency, attention-deficit hyperactivity disorder, or even schizophrenia. The diagnosis requires careful observation over an extended time period. An evaluation by a child and adolescent psychiatrist can be helpful in identifying the problem, whether it is bipolar disorder or other mental health illness; and for starting specific treatment. Some children with bipolar disorder (or a combination of bipolar and ADHD) my be diagnosed as having only ADHD. The two disorders appear to be genetically linked.

Treatment Of The Bipolar Disorder

In children unstable moods, which are generally the most serious problem, should be treated first. Not much can be done about ADHD while the child is subject to extreme mood swings.

Teens with bipolar disorder can be effectively treated. Treatment usually includes:

• psychotherapy which helps the teen adapt to stress; to rebuild self-esteem and to improve relationships.
  
• medications which often reduce the frequency and severity of manic episodes and help to prevent depression.
  
• education of the entire family about the illness.

Information compiled by the American Academy of Child and Adolescent Psychiatry

For More Information:
Contact your local Mental Health Association, community mental health center, or:

National Mental Health Association
1021 Prince Street
Alexandria, VA 22314
Phone 800-969-6642
Stigma Watch Line 800-969-NMHA
TTY line 800-433-5959
http://www.nmha.org

American Association of Suicidology
4201 Connecticut Ave., NW
Suite 310
Washington, DC 20008
Phone: (202) 237-2280

American Academy of Child and Adolescent Psychiatry
3615 Wisconsin Avenue., N. W.
Washington, DC 20016
Phone 800-333-7636

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