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There are many ways you can help children and their families get the care they need.
If your child experiences phases of extreme moods—from bursting with so much energy that he may not be able to sleep or sit still, to crippling depression that leaves him sad and withdrawn—he may have bipolar disorder.
What is bipolar disorder?
Bipolar disorder, which is also known as manic-depressive illness or bipolar affective disorder, is a chronic mental health condition that:
Can kids really be bipolar, too?
Yes. While not nearly as common in children as it is in adults, research studies have revealed that bipolar disorder affects as many as 3 percent of all children, and up to 7 percent of children receiving outpatient psychiatric care. (The numbers are even higher in children hospitalized for inpatient psychiatric treatment.)
Bipolar disorder has been diagnosed in children as young as 5. When young children experience symptoms, this is called early-onset bipolar disorder.
What are mood episodes?
A child or adolescent who has bipolar disorder experiences both manic phases (periods of abnormally high energy and activity) and depressive phases (periods of intense sadness, tiredness, irritability or hopelessness) that last days or even weeks before dying down. These periods are known as mood episodes.
Sometimes, a child will experience manic and depressive symptoms at the same time. This is called a mixed mood episode.
While all children, and especially adolescents, experience peaks and valleys in their moods and energy levels, the mood episodes of someone with bipolar disorder are very different:
What are the different types of bipolar disorder?
There are three described varieties of bipolar disorder:
Is pediatric bipolar disorder treatable?
Yes. Unfortunately, there is no complete cure for bipolar disorder—but with early diagnosis and careful, multidimensional treatment, the illness can generally be controlled, allowing children and adolescents to return to more normal functioning.
In the pages that follow, we hope you will find answers to your most pressing questions about bipolar disorder. When you meet with our experts here at Children’s Hospital Boston, we will carefully assess and then fully explain your child’s condition and treatment options.
What causes bipolar disorder?
No one knows exactly why bipolar disorder develops. Current research has revealed that there are multiple biological and life experience factors that increase the risk of a child developing the disorder:
It’s suspected that the brains of children with bipolar disorder grow and develop differently than those of other children. We are hopeful that current treatment methods—including both medication and talk therapy—can restore some degree of normality to the brain’s chemical balance and development over time.
What are the symptoms of bipolar disorder?
A child or adolescent may have bipolar disorder if he:
What are the symptoms of a manic episode?
Manic symptoms can include one or more of the following:
What are the symptoms of a depressive episode?
Depressive symptoms can include:
What are the symptoms of a mixed episode?
If a child is going through a mixed episode, he may:
If you suspect your child is considering suicide, always seek help immediately—do not wait. Call 911 or bring your child to the closest emergency room.
Q: How common is bipolar disorder in children?
A: It is estimated that more than 3 percent of all children and adolescents have some form of bipolar disorder, which is about half the incidence in adults.
The most severe form of bipolar disorder, bipolar I, affects 0.5 percent of all children. It is found much more often in children who are either receiving outpatient psychiatric treatment, or who have been hospitalized for mental health care.
Q: How serious is bipolar disorder?
A: If left untreated, or if treated inadequately, bipolar disorder can be highly disruptive and lead to:
For all of these reasons, prompt and ongoing care from a qualified clinician is a must.
Q: How can I tell if my child or adolescent has symptoms of bipolar disorder or is just going through a “typical mood swing”?
A: Just about every child, and especially adolescents, goes through “mood swings.” However, a child or teen with bipolar disorder experiences periods of extraordinary high moods and activity levels, called mania, accompanied by (either before, after or during the mania) unusually low moods and activity levels.
These periods occur in cycles and must last for at least several days or a week at a time during the manic phase, and for at least two weeks during the depressive phase.
Q: Does bipolar disorder cause multiple personalities?
A: No. People sometimes confuse bipolar disorder with dissociative identity disorder (also referred to as “multiple personality disorder”). However, these are two separate conditions with very different symptoms.
Q: If my child has bipolar disorder, does that mean her siblings are also at risk?
A: Yes, they are at some risk—but keep in mind that the majority of siblings will not develop bipolar disorder.
There is clear evidence that bipolar disorder does have a genetic link, and the incidence is especially high (50 percent) among identical twins. If your child has a sibling who is showing possible signs of bipolar disorder, you should seek an evaluation from a qualified mental health professional.
Q: Can I do anything to keep my child from developing bipolar disorder?
A: Because we still don’t understand exactly how or why bipolar disorder occurs—and because many researchers believe a defect in the genes plays a role—there is no way to prevent the disease altogether.
However, parents who have been diagnosed with bipolar disorder themselves (and/or who are dealing with another mental illness, or with substance abuse) can take steps to lessen the likelihood of their children developing the disease by getting prompt treatment from a licensed mental health professional.
Q: Could my child have another mental health condition along with bipolar disorder?
A: It’s possible, since bipolar disorder, like many mental health disorders, often occurs alongside a second condition. Bipolar disorder can accompany:
If your child is diagnosed with another condition, it’s essential that both disorders be treated at the same time. Your treating clinician will develop a plan for managing both conditions and meeting all of your child’s individual needs.
Q: What is the long-term outlook for my child?
A: Bipolar disorder is most often a chronic (long-lasting) mental health condition that requires careful monitoring and ongoing care, often including a long-term medication regimen.
In adults, where there has been more data collected, long-term care that combines medication and “talk therapy” has proven very effective in containing and controlling the illness. Unfortunately, we still don’t have all of the data we need to give a clear picture of the long-term outlook for bipolar disorder in children.
However, we do know that—although there is no cure for pediatric bipolar disorder—as long as your child follows his treatment plan, he can grow up to be healthy, happy and productive despite the challenges of his illness.
You and your family play an essential role in your child’s treatment for bipolar disorder. It’s important that you share your observations and ideas with your child’s treating clinician, and that you have all the information you need to fully understand the treatment team’s explanations and recommendations.
You’ve probably thought of many questions to ask about your child’s condition and prognosis. It’s often very helpful to jot down your thoughts and questions ahead of time and bring them with you, along with a notebook, to your child’s appointment. That way, you will have all of your questions in front of you when you meet with your child’s treating clinician and can make notes to take home with you. (If your child is old enough, you can encourage him or her to write down questions, too.)
Initial questions to ask your doctor might include:
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