No. 38; Updated March 2015
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Bipolar disorder (formerly called manic depressive illness) is an illness of the brain that causes extreme changes in a person’s mood, energy, thinking, and behavior. Children with bipolar disorder have periods (or episodes) of mania and depression.
Manic Episodes: An episode of mania includes a period where someone’s mood has changed and it is elevated (overly happy), expansive, or very irritable and the person also has increased energy at the same time.
Other manic symptoms may include:
- Unrealistic highs in self-esteem - for example, a child or adolescent who feels all-powerful or like a superhero with special powers
- Great increase in energy
- Decreased need for sleep such as being able to go with little or no sleep for days without feeling tired
- Increase in talking - when the child or adolescent talks too much, too fast, changes topics too quickly, and cannot be interrupted
- Distractibility - the child's attention moves constantly from one thing to the next
- Thinking more quickly - for example, thoughts are on “fast forward”
- Repeated high risk-taking behavior, such as abusing alcohol and drugs, reckless driving, or sexual promiscuity
Depressive Episodes: People who have bipolar disorder may also experience periods of depression. An episode of depression includes low, depressed, or irritable mood.
Other symptoms of a depressive episode may include:
- Decreased enjoyment in favorite activities
- Low energy level or fatigue
- Major changes in sleeping patterns, such as oversleeping or difficulty falling asleep
- Poor concentration
- Complaints of boredom
- Major change in eating habits such as decreased appetite, failure to gain weight or overeating
- Frequent complaints of physical illnesses such as headaches or stomach aches
- Thoughts of death or suicide
Some of these signs are similar to those that occur in children and adolescents with other problems such as drug abuse, attention-deficit hyperactivity disorder, major depressive disorder, disruptive mood dysregulation disorder, or even schizophrenia.
Bipolar disorder can begin in childhood or during the teenage years. The illness can affect anyone. However, if one or both parents have bipolar disorder, the chances are greater that their children may develop the disorder.
The diagnosis of bipolar disorder in children and teens is complex and involves careful observation over an extended period of time. A comprehensive evaluation by a child and adolescent psychiatrist or trained mental health professional can help identify bipolar disorder and is the first step to starting treatment. Children and teenagers with bipolar disorder can be effectively treated. Treatment for bipolar disorder usually includes education of the patient and the family about the illness, mood stabilizing medications such as lithium, or atypical antipsychotics, and psychotherapy. Medications often reduce the number and severity of manic episodes, and may also help to prevent depression. Psychotherapy helps the child understand himself or herself, adapt to stresses, rebuild self-esteem, and improve relationships.
Visit AACAP's Bipolar Disorder Resource Center and Bipolar Med Guide.
For additional information see Facts for Families:
#3 Teens: Alcohol and Other Drugs
#4 The Depressed Child
#6 Children Who Can't Pay Attention (ADHD)
#21 Psychiatric Medication for Children and Adolescents Part 1: How Medications Are Used
#29 Psychiatric Medication for Children and Adolescents Part II: Types of Medications
#33 Conduct Disorder
#51 Psychiatric Medications for Children and Adolescents Part III: Questions to Ask
#52 Comprehensive Psychiatric Evaluation
#55 Understanding Violent Behavior in Children
#72 Oppositional Defiant Disorder
#94 Preventing and Managing Medication Related Weight Gain
#110 Disruptive Mood Dysregulation Disorder
See also: Your Child (1998 Harper Collins) / Your Adolescent (1999 Harper Collins)
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