Bipolar Disorder

Doctors estimate that up to one-third of the 3.4 million children and teens with depression in the United States actually may be experiencing the early onset of bipolar disorder.

What is Bipolar Disorder?  

Bipolar disorder, formerly known as manic-depression, is a chronic mental illness that causes extreme mood swings from high to low and vice versa. Episodes can last hours, days, weeks, or months. The mood swings may even become mixed, resulting in feelings of elation and depression at the same time.

Bipolar disorder usually emerges in adolescence or adulthood. Yet doctors estimate that up to one-third of the 3.4 million children and teens with depression in the United States actually may be experiencing the early onset of bipolar disorder.

Children with bipolar disorder are at a greater risk for anxiety disorders and attention-deficit hyperactivity disorder. These "co-occurring" disorders can complicate diagnosis,

Stressful or traumatic events may trigger episodes of mania or depression in a child who has bipolar disorder. It may be normal for such events to cause mood changes. But for children with bipolar disorder, their reactions are much more extreme.

What are the Symptoms of Bipolar Disorder in Children and Teens?

Every child goes through ups and downs. Bipolar symptoms are more powerful. The mood swings are more extreme. They affect sleep habits, energy level, and the ability to think clearly.

Bipolar symptoms can make it hard for a child to do well in school. They can make it hard for children to get along with friends and family members. Some young people with bipolar disorder try to hurt themselves. Or even attempt suicide.

These are some common symptoms of bipolar disorder in children and teens:

Manic Symptoms

  • Severe changes in mood, from extremely irritable to overly silly and elated.
  • Increased energy.
  • Decreased need for sleep, such as going for days with very little sleep and not getting tired.
  • Talking too much or too fast, changing topics too quickly, not allowing interruptions.
  • Increased distraction and constantly moving from one thing to another.
  • Inflated self-esteem or a belief in unrealistic abilities or powers.
  • Increased sexual thoughts, feelings, activity, and use of sexual language (hypersexuality).
  • Increased obsession with reaching goals.
  • Becoming involved in too many activities.
  • Risky, wild, thrill-seeking behavior.

Depression 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 will abuse alcohol and drugs as an escape. If an addiction develops, it is essential to treat both the mental health disorder and the substance abuse problem at the same time.

What Causes Bipolar Disorder?

The causes are not clearly understood. Bipolar disorder seems to run in families. A child is at greater risk of having bipolar disorder if a close family member has it.

Stressful or traumatic events may trigger episodes of mania or depression. Sometimes bipolar symptoms result from another medical condition, or as a side effect to medication. There is also evidence that brain structure and brain function may play roles in the onset of bipolar disorder. 

How is Bipolar Disorder Diagnosed?

Diagnosis of bipolar disorder can be difficult. There are no blood tests or brain scans that can diagnose bipolar disorder definitively.

Doctors make the diagnosis through a combination of examination procedures:

  • Compiling a medical history of the patient.
  • Compiling a family history to identify instances of bipolar disorder, other mood disorders, or drug or alcohol problems in close relatives.
  • Completing a physical exam to rule out other conditions with similar symptoms.
  • Completing a mental health assessment to determine the severity of depression or mania.
Other written or verbal mental health tests.

How is Bipolar Disorder Treated?

There is no cure for bipolar disorder. But it is treatable through:

  • Medications.
  • Psychotherapy.
  • Electroconvulsive therapy (ECT).
  • Self-management strategies and education.
  • Complementary health approaches such as meditation, faith and prayer.
Treatment takes time. And it’s a “team” effort, involving doctors and therapists, parents and the child. 

When Should You Seek Help for Bipolar Disorder?

Diagnosing bipolar disorder in children and teens can be extremely challenging and complex for trained professionals. Don’t try it yourself. If you notice any of the manic or depression symptoms in your child, talk with your family physician or pediatrician as a first step. If it seems appropriate, you’ll probably be referred to a bipolar specialist to begin a thorough diagnostic evaluation.

Even if the symptoms don’t fully “qualify” as bipolar, trust your own parental judgment that something is going on inside your child. It may be something that can be addressed before it becomes as serious as bipolar disorder.

Your child’s well-being – and the well-being of your family – are well worth the time invested in a thorough physical and psychological evaluation.