Children with Bipolar Disorder

“Early intervention and treatment offers the best chance for children with bipolar disorder to achieve stability, gain the best possible level of wellness, and grow up to enjoy their gifts and build upon their strengths. Proper treatment can minimize the adverse effects of the illness on their lives and the lives of those who love them.” ….from About Pediatric Bipolar Disorder

From About Pediatric Bipolar Disorder:

“However, the illness may look different in children than it does in adults. Children usually have an ongoing, continuous mood disturbance that is a mix of mania and depression. This rapid and severe cycling between moods produces chronic irritability and few clear periods of wellness between episodes.”  also…….

Behaviors reported by parents in children diagnosed with bipolar disorder may include:

  • an expansive or irritable mood
  • extreme sadness or lack of interest in play
  • rapidly changing moods lasting a few hours to a few days
  • explosive, lengthy, and often destructive rages
  • separation anxiety
  • defiance of authority
  • hyperactivity, agitation, and distractibility
  • sleeping little or, alternatively, sleeping too much
  • bed wetting and night terrors
  • strong and frequent cravings, often for carbohydrates and sweets
  • excessive involvement in multiple projects and activities
  • impaired judgment, impulsivity, racing thoughts, and pressure to keep talking
  • dare-devil behaviors (such as jumping out of moving cars or off roofs)
  • inappropriate or precocious sexual behavior
  • delusions and hallucinations
  • grandiose belief in own abilities that defy the laws of logic (ability to fly, for example)

Here is a list of some of the organizations that help parents with Bipolar Children:

What are the Symptoms Of Bipolar Disorder in Children and Adolescents?

One of the biggest challenges has been to differentiate children with mania from those with attention deficit hyperactivity disorder. Both groups of children present with irritability, hyperactivity and distractibility. So these symptoms are not useful for the diagnosis of mania because they also occur in ADHD. But, elated mood, grandiose behaviors, flight of ideas, decreased need for sleep and hypersexuality occur primarily in mania and are uncommon in ADHD. Below is a brief description of how to recognize these mania-specific symptoms in children.

Elated children may laugh hysterically and act infectiously happy without any reason at home, school or in church. If someone who did not know them saw their behaviors, they would think the child was on his/her way to Disneyland. Parents and teachers often see this as “Jim Carey-like” behaviors.

Grandiose behaviors are when children act as if the rules do not pertain to them. For example, they believe they are so smart that they can tell the teacher what to teach, tell other students what to learn and call the school principal to complain about teachers they do not like. Some children are convinced that they can do superhuman deeds (e.g., that they are Superman) without getting seriously hurt, e.g. “flying” out of windows.

Flight of ideas is when children jump from topic to topic in rapid succession when they talk and not just when a special event has happened.

Decreased need for sleep is manifested by children who sleep only 4-6 hours and are not tired the next day. These children may stay up playing on the computer and ordering things or rearranging furniture.

Hypersexuality can occur in children with mania without any evidence of physical or sexual abuse. These children act flirtatious beyond their years, may try to touch the private areas of adults (including teachers), and use explicit sexual language.

In addition, it is most common for children with mania to have multiple cycles during the day from giddy, silly highs to morose, gloomy suicidal depressions. It is very important to recognize these depressed cycles because of the danger of suicide.

What treatments–medications and psychosocial–have been shown to be effective for children and adolescents with this condition?

At this time there are several ongoing studies of how to best treat children, but until more scientific data is available clinicians are left using their best judgement on how to manage using medications that have been effective in adults. These are largely three main types of drugs — Lithium, anticonvulsants (e.g., Depakote or other valproate products) and atypical neuroleptics (e.g., risperidone, olanzapine, ziprasidone, aripiprazole, quetiapine).

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