How to Help Children and Teens With Bipolar Disorder

Although bipolar disorder more commonly develops in older teenagers and young adults, it can appear in children as young as 6. In recent years, it’s become a controversial diagnosis. Some experts believe it is rare and becoming over-diagnosed; others think the opposite. At this point, it’s hard to be sure just how common it is.

So it’s important not to jump to conclusions. If your child is diagnosed, you might want to get a second opinion before embarking on a treatment plan. Make sure you’re comfortable with your child’s health-care provider.

The Difference in Children

Diagnosing bipolar disorder in young children is difficult, because many of the symptoms are similar to those of attention deficit hyperactivity disorder (ADHD) or conduct disorders -- or even just normal, childhood behavior. One problem is that the medications used for ADHD are stimulants, which can trigger mania in children with bipolar disorder.

Young children in a manic phase might be more irritable than adults; they may be more likely to have psychotic symptoms, hearing and seeing things that aren’t real. During a depressive episode, they might be more likely to complain of physical symptoms, like aches and pains.

One of the most notable differences is that bipolar disorder in children cycles much more quickly. While manic and depressive periods may be separated by weeks, months, or years in adults, they can happen within a single day in children.

How Can I Help?

As the parent of a child with bipolar disorder, there’s a lot you can do to keep your child well. Here are some suggestions.

• Follow the medication schedule. You absolutely must make sure that your child gets the medication he or she needs. Use timers, pillboxes, notes, or whatever it takes for you to remember. If your child needs medication at school, talk to his or her teacher or school nurse -- schools may not allow students to take medication on their own.
• Monitor side effects. The drugs used for bipolar disorder were tested in adults, and unfortunately, not enough is known about their effects on children. Children do seem to be more prone to side effects from some of these drugs. Ask your child’s health-care provider what symptoms to watch for. The FDA has issued a warning that using some types of antidepressants may increase the risk of suicide in children.
• Talk to your child’s teachers. In some cases, your child may need special allowances at school. He or she may need extra breaks or less homework during difficult times. So work out an agreement with your child’s teachers or the school principal. In some cases, you may need to take your child out of school for a while, at least until his or her symptoms stabilize.
• Keep a routine. Children with bipolar disorder can really benefit from a daily schedule. Help them get up, eat meals, exercise, and go to bed at roughly the same times each day. Do what you can to reduce stress in the household.
• Consider family therapy. Having a child with bipolar disorder can be disruptive to the whole family. It can put extra stress on your marriage. Your other children may not understand what’s wrong with their sibling, or they may be resentful of all the attention he or she is getting. Going to family therapy can help you all recognize and deal with these issues.
• Take suicidal threats seriously. No parent wants to think about their children hurting themselves. But unfortunately, it can happen, even with young children. So if your child begins to express a desire to die, or engages in life-threatening behavior, don’t ignore it. Remove any weapons or dangerous medications from the house. And get help right away.

Teenagers With Bipolar Disorder

In older teenagers, the symptoms and treatment of bipolar disorder are much the same as in adults. But having a teenager with this condition presents a lot of distinct problems.

As with adults, it’s key that teenagers with bipolar disorder avoid alcohol and drugs, which can interact with medications or bring on mood swings. The risks of developing a substance abuse problem are much higher in teens with bipolar disorder than in their peers.

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Reviewed: 08/2009