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There are many ways you can help children and their families get the care they need.
For almost 60 years, the Department of Psychiatry at Boston Children's Hospital has been a leader i in the mental health care of children, adolescents and their families, delivering leading-edge care, research and advocacy. .
Our experienced psychiatrists, psychologists, social workers and nurses understand the wide-reaching impact of a child's bipolar disorder, and we will give your child and family all of the tools you need to manage your unique situation.
How is bipolar disorder treated at Children's?
We typically treat bipolar disorder through a combination of:
Children's approach to mental health care is evidence-based—which means that our treatments have been tested and proven effective through scientific studies, both here at our hospital and by other leading institutions worldwide.
Psychotherapy, or “talk therapy,” is designed to help your child learn the best ways to identify and respond to his manic and depressive symptoms when they occur.
Here at Children's, a mental health clinician will teach your child to:
In addition, family counseling can help you and your child's other loved ones learn how to live with and manage the ups and downs arising from his bipolar disorder.
Unfortunately, no matter how hard you or your child try, most often it's not possible to stop mood episodes with talk therapy or willpower alone.
Just like a congenital heart defect or asthma, bipolar disorder is a medical condition, and a biological process or imbalance is responsible for it. In almost every case, the best way to correct this faulty biological process is through medication. Here at Children's, our Psychopharmacology Clinic is devoted to helping children, families and clinicians incorporate medication into a treatment plan.
Many people with bipolar disorder need to take medication for long periods (over several years) to best combat the illness. Though this isn't always easy, the benefits of the medication far outweigh the inconvenience and possible side effects.
There are several different medications that can be prescribed for bipolar disorder. Your child's treating clinician will advise you on the best choice for her and her symptoms. We will carefully go over the specifics of the drug and explain any and all of the potential benefits, alternatives and side effects that you should watch for.
Here are some of the basic facts about the various medications used to manage bipolar disorder: (Please note that the bolded medications have the best evidence of effectiveness and are supported by the U.S. Food and Drug Administration.)
Mood stabilizers are medications that stop the rapid shift from high to low moods and back again. They are particularly useful in preventing manic episodes.
Some of the most common mood stabilizers used to treat bipolar disorder are:
Antipsychotic medications can serve two purposes: They can act as mood stabilizers (like the drugs above), and they also can treat children who have mood episodes that are so severe that they experience a break in reality—an inability to distinguish what's real from what isn't. This is called a psychosis.
Antipsychotic medications include:
Antidepressants are a class of medications that can be used to control depressive episodes in bipolar disorder. These are usually prescribed along with a mood stabilizer or antipsychotic—generally not as a standalone, since antidepressants can't manage the manic symptoms experienced by a child with bipolar disorder and may even activate or worsen mania when used alone.
Commonly prescribed antidepressants include:
Since 2004, the U.S. Food and Drug Administration has placed a black box warning label on all antidepressant medications. The warning label states, in part:
“Antidepressants increased the risk of suicidal thinking and behavior (suicidality) in short-term studies in children and adolescents with Major Depressive Disorder (MDD) and other psychiatric disorders. Anyone considering the use of [Drug Name] or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Patients who are started on therapy should be observed closely for clinical worsening, suicidality, or unusual changes in behavior.”
Parents should note that even with the above warning, almost all psychiatrists find that the benefits of antidepressants, when used properly, far outweigh the risks.
Here at Boston Children's Hospital, our team has years of experience in managing the use of psychiatric medications in children of all ages and with a wide variety of conditions. We will closely monitor your child for any sign of a negative response to her medication, and are always here to address any concerns you may have.
Learn more about psychiatric medications.
Is bipolar disorder ever considered “cured”?
This is not clear at this time. Although the condition responds to treatment in most cases, bipolar disorder is generally seen as a chronic (long-lasting) disease that may come and go for many years.
Your child will need to follow the treatment plan outlined by her care team, and any changes should be carefully discussed among all members of her treatment team.
The ups and downs experienced by a child—and family—living with bipolar disorder can feel overwhelming. In addition to the information provided here, you may find comfort and support from the following resources
Patient and family resources at Children's
Visit our “For Patients and Families” page for what you need to know about:
Please note that neither Boston Children's Hospital nor the Children's Department of Psychiatry unreservedly endorses all of the information found at the sites listed below. These links are provided as a resource.
Helpful links for parents and families
Helpful links for teens
Helpful links for younger children
We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”