Bipolar Disorder

Children with bipolar disorder go back and forth between extreme emotional and behavioral states described as: mania and depression. All children have “mood swings” from time to time, but children with bipolar disorder have more extreme mood and behavior changes that are often not related to any particular events and also have changes in sleep, energy, and thinking. The frequency of these mood changes can vary among children.

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Although bipolar disorder is usually diagnosed in teens or adults, the disorder can begin in childhood.
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Signs and Symptoms

Typical manic signs and symptoms of bipolar disorder include:

  • Severe changes in mood—either unusually happy or silly or very irritable, angry, agitated, or aggressive
  • Unrealistically high sense of ability, knowledge, and power
  • Significant increases in energy and the ability to go with little or no sleep for days without feeling tired
  • Increase in talking—the child talks too much or too fast, changes topics too quickly, and cannot be interrupted
  • Distractibility—the child’s attention moves constantly from one thing to the next
  • Repeated high risk-taking behavior, such as abusing alcohol and drugs, reckless driving, or sexual promiscuity

Typical depressive signs and symptoms of bipolar disorder include:

  • Irritability, depressed mood, persistent sadness, or frequent crying
  • Thoughts of death or suicide
  • Loss of enjoyment in favorite activities
  • Frequent complaints of physical illnesses, such as headaches or stomachaches
  • Low energy level, fatigue, poor concentration, or complaints of boredom
  • Major changes in eating or sleeping patterns, such as overeating or oversleeping
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Treatment

Treatment of bipolar disorder benefits from a team-based approach. The team includes the child, the guardian, healthcare providers (such as child and adolescent psychiatrist, advanced practice registered nurse, psychotherapist) and other community members (school personnel, case manager, insurance care manager, etc.)

The treatment should address school, work, social, and family functioning. Treatment may include psychoeducation, psychotherapy, and mood stabilizing medications. 

A family support group can also be helpful. If bipolar disorder is affecting the child’s ability to learn, adjustments may need to be made in their education program. 

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