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What Is Bipolar Disorder In Children

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Key Points About Bipolar Disorder In Teens

Raising Sadie: my bipolar child
  • Bipolar disorder is a type of depression. A teen with this disorder often has abnormal mood swings that shift between depression and mania.

  • The exact cause of bipolar disorder is unknown. But it tends to run in families.

  • A teen must have both depressive and manic symptoms to a varying degree to be diagnosed with the disorder.

  • A mental health provider makes a diagnosis after a mental health evaluation.

  • Treatment may include medicine and talk therapy.

Differences In Similar Illnesses

Mental health professionals may need to sift out bipolar disorder from other look-alike symptoms of illnesses. For example, if a child with ADD has insomnia, they will be tired the next day a child with bipolar wont feel a need for sleep, explains Benjamin Goldstein, MD, PhD, a psychiatrist at the Sunnybrook Research Institute in Toronto. Hypersexuality is another bipolar marker, as it is a symptom of mania but not characteristic of ADD.

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Watching For Mood Swings

  • 1Be alert for cyclical behavior. Bipolar disorder causes someone to cycle between mania, hypomania, depression, mixed states, and a normal mood.XExpert SourceLiana Georgoulis, PsyDLicensed PsychologistExpert Interview. 6 September 2018.XTrustworthy SourceMayo ClinicEducational website from one of the world’s leading hospitalsGo to source As a result, a child with bipolar will have much more severe and inconsistent emotional reactions, beyond the typical highs-and-lows of childhood.
  • Mania presents itself as an elevated mood and a surge of energy. Hypomania is a less severe form of mania.
  • Depression presents itself as reduced energy and a low mood.
  • Mixed states are a combination of mania and depression at the same time.XResearch source For example, a child might be extremely chatty and engage in highly risky behavior, but have low self-esteem and feel suicidal.
  • It’s possible for bipolar disorder to go into remission, and to have time without symptoms. However, this isn’t as common in childhood-onset bipolar.XResearch source
  • Did You Know? Some children experience full manic episodes, while others only have hypomanic episodes. It’s also possible to experience both.XResearch source

  • The moods associated with bipolar are far more severe than typical mood swings that a child or preteen might experience. Bipolar episodes also don’t blow over as quickly, don’t always have an identifiable cause, and parents typically find they can’t get their child to “snap out of it”.XResearch source
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    Diagnosing Bipolar In Children And Teens

    Diagnosing bipolar in children can be difficult, as it is a condition that requires time to truly establish a solid base of evidence. Generally, bipolar is misdiagnosed for up to ten years before it is accurately identified and treated. Often people with bipolar disorder receive a diagnosis based on what phase they are experiencing. For example, a severely depressed, lethargic person with social avoidance may be misdiagnosed with major depressive disorder if one isnt aware of the broader history of mood changes and behavioral shifts over time.

    Bipolar in teens can be less challenging to determine than bipolar in children since the mood dysregulation and behavioral shifts have had more time to establish a pattern. For bipolar disorder to be diagnosed in children or teens, it is important that a comprehensive assessment is completed that includes history, developmental experiences and behavioral patterns over time. Parental input is crucial in the diagnosis of bipolar in children of all ages, particularly with regard to history gathering and exploration of family mental health lineage.

    How To Recognize Bipolar Disorder In Children

    Bipolar Disorder in Children: Lifestyle changes to lead a normal life ...

    This article was co-authored by Liana Georgoulis, PsyD. Dr. Liana Georgoulis is a Licensed Clinical Psychologist with over 10 years of experience, and is now the Clinical Director at Coast Psychological Services in Los Angeles, California. She received her Doctor of Psychology from Pepperdine University in 2009. Her practice provides cognitive behavioral therapy and other evidence-based therapies for adolescents, adults, and couples.There are 25 references cited in this article, which can be found at the bottom of the page. This article has been viewed 20,703 times.

    Bipolar disorder in children, also known as pediatric bipolar disorder, is a mood disorder that causes a child to oscillate between mania, depression, or somewhere in between. However, the condition tends to look different in children, with more irritability, mixed episodes, and mood swings than in adult bipolar disorder.XResearch source While bipolar disorder is a lifelong condition, early diagnosis and treatment is associated with better outcomes, so recognizing the signs of the condition is important.

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    What Is The Prognosis For Bipolar Disorder In Children

    The prognosis for bipolar disorder is often poor unless its properly treated.

    If bipolar disorder goes untreated in children, it may make school, relationships and daily life very difficult. Children and teenagers with bipolar disorder are also at increased risk for:

    • Delinquent behavior that results in incarceration.
    • Misuse of alcohol and/or drugs.

    This is why its essential to seek medical care for your child if you think they may have bipolar disorder and to help them stay committed to treatment if they do have the condition.

    Regular and continued use of medication can help reduce episodes of mania and depression. By knowing how to recognize the symptoms and triggers of these episodes, theres a better chance for effective treatment and finding coping methods that may prevent long periods of illness, extended hospital stays and suicide.

    Limitations Of Epidemiological Surveys

    A limitation of epidemiological surveys is that questions are asked of lay public often by trained lay interviewers about mental symptoms usually without context. The public may understand such questions in diverse ways, affirmative answers might not equate with true pathology. The problem of making diagnoses based on decontextualized information in such surveys is greater than in clinical settings. This problem limits any narrative analysis of such surveys, but we would argue that it limits statistical meta-analysis of epidemiological surveys even more, as the nuances that can be described by narrative analyses are lost in statistical lumping of diverse data.

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    The Pediatric Bipolar Disorder Hypothesis

    The prevalence rate of bipolar disorder in children and adolescents has been hotly debated since the 1990s . The most controversial aspect has been whether BD affects pre-pubertal children in substantial numbers or whether the first hypomanic/manic episode is almost invariably post-puberty. The debate matters because either young children need pharmacotherapy for BD or such pharmacotherapy poses unwarranted iatrogenic risk.

    The former view presupposes that mania presents differently in children with one hypothesized PBD phenotype involving ultradian cycling of brief mood episodes shorter than one day or alternatively, as chronic irritability generally without mood elevation . The chronic irritability PBD phenotype was later subsumed under the new DSM-5 diagnosis of disruptive mood dysregulation disorder .

    In contrast, the classical or historical view since the time of Kraepelin , posits that hypomanic/manic episodes typically first manifest from mid-adolescence into young adulthood. True mania in pre-adolescent children occurs but is very rare .

    The PBD hypothesis found traction in several US academic institutions and was translated into US clinical practice to become the most common diagnosis on pre-adolescent inpatient units . In contrast, apart from a small number of academic units in other countries , the classical view held sway internationally.

    Bipolar Disorder In Children And Teens Can Be Challenging But It Is Possible To Monitor And Treat This Condition If You Know What To Look For

    Which children are at risk for bipolar disorder?

    Bipolar disorder in children is gaining more recognition in the field of mental health. Bipolar disorder was once relegated as a condition of adults, but pediatric bipolar disorder is now understood as a serious treatment need for those under age 18. The prevalence of bipolar disorder in children has been on the rise over several decades, prompting increased awareness and treatment options.

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    What Are The Types Of Mood Episodes And Symptoms

    • Mania: Symptoms include elevated mood or irritability
    • Depression: Symptoms include sadness, apathy or irritability
    • Mixed: Symptoms include a mixture of mania and depression

    To have bipolar disorder, someone must have experienced an episode with manic symptoms. Clinicians use other symptoms to clarify which mood episode is occurring.

    The intensity and duration of mood episodes determine the type of bipolar disorder.

    Recognizing Signs Of Mania

  • 1Watch for irritability. Unlike bipolar in adults, one of the defining features of bipolar in children is irritability.XTrustworthy SourceChild Mind InstituteNonprofit organization providing evidence-based care for children with mental health and learning disorders and their familiesGo to source A child in mania or hypomania may seem easily agitated or grumpy, and prone to snapping at people or even flying into rages.
  • The child may be more aggressive than usual, or threaten others.
  • 2Take note of euphoria. Mania or hypomania can result in euphoria, where the child is in an abnormally good mood for an extended period of time. They may be extremely excitable and giggly, to the point where it’s atypical for them, and seem very animated or energetic.XResearch sourceXResearch source It may seem like they have a surge of energy or happiness that’s come out of nowhere.
  • Consider whether anything seems to snap the child out of their euphoria for example, if the child is punished for misbehavior, do they continue laughing hysterically?XResearch source
  • Euphoria can quickly give rise to irritability and anger during mania or mixed episodes.XResearch source
  • 4Recognize rapid or hard-to-understand speech. During mania, a child with bipolar is likely to talk quickly and go off on tangents, and may be highly chatty.XResearch source They may suddenly switch topics in the middle of a conversation , seemingly without notice, and become difficult to follow.XResearch source
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    Diagnosing Bipolar Disorder In Children

    Bipolar disorder, also known as manicdepressive illness, is a chronic mental health condition that causes a child or teen to experience intense mood swings, in alternating episodes of depression and mania. These mood swings can last for hours, days, or even weeks, and can seriously disrupt usual patterns of activity, including schoolwork, sleeping, and eating.

    Mental health specialists at NYU Langones Child Study Center can help determine if your child has bipolar disorder and, if so, how best to manage his or her symptoms.

    How Is Bipolar Disorder Diagnosed In Children

    The Bipolar Child

    To be diagnosed with bipolar disorder, your child must have experienced at least one episode of mania or hypomania .

    To diagnose bipolar disorder, your childs healthcare provider may use many tools, including:

    • A physical examination.
    • A thorough medical history, which will include asking about your childs symptoms, lifetime history, experiences and family history.
    • Medical tests, such as blood tests, to rule out other conditions that could be causing your childs symptoms.
    • A mental health evaluation. Your childs provider may perform the evaluation, or they may refer your child to a mental health specialist, such as a psychologist or psychiatrist, to get one.

    Providers can often diagnose bipolar disorder in children more accurately when they ask the children, their teachers and their caregivers to fill out questionnaires that ask about mood, energy levels and other factors.

    Signs and symptoms of bipolar disorder may overlap with symptoms of other disorders that are common in children and teens, including:

    • Because of this, diagnosing bipolar disorder in children can be complicated and requires a careful and thorough evaluation by a trained, experienced mental health professional.

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    Bipolar Disorder In Children And Adolescents

    , MD, Nemours/A.I. duPont Hospital for Children

    Bipolar disorder is rare in children. In the past, bipolar disorder was diagnosed in prepubertal children who were disabled by intense, unstable moods. However, because such children typically progress to a depressive rather than bipolar disorder, they are now classified as having disruptive mood dysregulation disorder Disruptive mood dysregulation disorder Depressive disorders are characterized by sadness or irritability that is severe or persistent enough to interfere with functioning or cause considerable distress. Diagnosis is by history and… read more .

    What Is Bipolar Disorder

    Bipolar disorder is a mental disorder that causes people to experience noticeable, sometimes extreme, changes in mood and behavior. Sometimes children with bipolar disorder feel very happy or up and are much more energetic and active than usual. This is called a manic episode. Sometimes children with bipolar disorder feel very sad or down and are much less active than usual. This is called a depressive episode.

    Bipolar disorder, which used to be called manic-depressive illness or manic depression, is not the same as the normal ups and downs every child goes through. The mood changes in bipolar disorder are more extreme, often unprovoked, and accompanied by changes in sleep, energy level, and the ability to think clearly. Bipolar symptoms can make it hard for young people to perform well in school or to get along with friends and family members. Some children and teens with bipolar disorder may try to hurt themselves or attempt suicide.

    Most people are diagnosed with bipolar disorder in adolescence or adulthood, but the symptoms can appear earlier in childhood. Bipolar disorder is often episodic, but it usually lasts a lifetime.

    With treatment, children and teens with bipolar disorder can manage their symptoms and lead successful lives.

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    What Should I Know About Clinical Trials

    Clinical trials are research studies that look at new ways to prevent, detect, or treat diseases and conditions. Although individuals may benefit from being part of a clinical trial, participants should be aware that the primary purpose of a clinical trial is to gain new scientific knowledge so that others may be better helped in the future.

    Researchers at NIMH and around the country conduct clinical trials with patients and healthy volunteers. Talk to your health care provider about clinical trials, their benefits and risks, and whether one is right for you. For more information, visit the NIMH Clinical Trials webpage.

    How Can I Help My Teen Live With Bipolar Disorder

    Bipolar disorder (depression & mania) – causes, symptoms, treatment & pathology

    Bipolar disorder has no cure. But over time, your teens symptoms will get better. Being supportive and patient can help. Here are things you can do to help:

    • Keep all appointments with your teens healthcare provider.

    • Take part in family therapy as needed.

    • Talk with your teens healthcare provider about other providers who will be involved in your teens care. Your teen may get care from a team that may include school staff, counselors, therapists, social workers, psychologists, and psychiatrists. Your teens care team will depend on his or her needs and how serious the depression is.

    • Tell others about your teens bipolar disorder. Work with your teens healthcare provider and schools to create a treatment plan.

    • Reach out for support. Being in touch with other parents who have a teen with bipolar disorder may be helpful. If you feel overwhelmed or stressed out, talk with your teens healthcare provider about a support group for caregivers of people with bipolar disorder.

    • Take all symptoms of depression, mania, and suicide very seriously. Get treatment right away. Suicide is a health emergency. Talk with your teens healthcare provider for more information. Find out who to contact, and what to do if your teen has suicidal thoughts. Have an emergency plan in place.

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    What Is Disruptive Mood Dysregulation Disorder

    If a child is prone to severe irritability with explosive outbursts, but the behavior is not episodic, its possible that he may fit the criteria for the new diagnosis, disruptive mood dysregulation disorder, or DMDD. DMDD was added to the list of diagnoses in DSM-5 when it was published in 2013, to identify children with severe mood dysregulation who would previously have been diagnosed with pediatric bipolar disorder. The problem was that children who fit this description often did not go on to develop adult bipolar disorder.

    Children with DMDD are prone to outbursts that are out of proportion to the trigger, and are irritable in between outbursts, but this behavior differs from bipolar mania in that it does not alternate with periods of depression or normal mood.

    If a child fits the criteria for DMDD, he may still have ADHD, in fact Dr. Carlson estimates that about 75 to 80 percent of children in clinical samples do have ADHD, and treating the ADHD that underpins the explosive behavior may be the most important opportunity to help them. However, emotion dysregulation may be a severe problem with its own burdens leading to emergency room visits and psychiatric hospitalizations. Many children do not respond either to ADHD medications or to mood stabilizing medications. Finding appropriate interventions for these children, Dr. Carlson adds, is a high priority.

    Bipolar Disorder In Children And Teens

    Does your child go through extreme changes in mood and behavior? Does your child get much more excited or much more irritable than other kids? Do you notice that your child goes through cycles of extreme highs and lows more often than other children? Do these mood changes affect how your child acts at school or at home?

    Some children and teens with these symptoms may have bipolar disorder, a brain disorder that causes unusual shifts in mood, energy, activity levels, and day-to-day functioning. With treatment, children and teens with bipolar disorder can get better over time.

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    What Should Parents And Caregivers Do

    Bipolar disorder is treatable. Early identification, diagnosis, and treatment will help children reach their full potential. Children who exhibit signs of bipolar disorder should be evaluated by a mental health professional who specializes in treating children. The evaluation may include consultation with a child psychiatrist, psychological testing, and medical tests to rule out an underlying physical condition that might explain the childs symptoms. A comprehensive treatment plan should include psychotherapy and, in most cases, medication. This plan should be developed with the family, and, whenever possible, the child.

    Symptoms And Signs Of Bipolar Disorder

    Understanding the two sides of bipolar disorder

    Bipolar disorder is characterized by recurrent episodes of elevated mood . Manic episodes alternate with depressive episodes, which can be more frequent. During a manic episode in adolescents, mood may be very positive or hyperirritable the 2 moods often alternate depending on social circumstances. Speech is rapid and pressured, sleep is decreased, and self-esteem is inflated. Mania may reach psychotic proportions . Judgment may be severely impaired, and adolescents may engage in risky behaviors .

    Prepubertal children may experience dramatic moods, but the duration of these moods is much shorter than that in adolescents.

    Onset is characteristically insidious, and children typically have a history of always being very temperamental and difficult to manage.

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