Bipolar disorder is a mental illness characterized by extreme shifts in mood and thought. A person with bipolar disorder shifts between periods of mania or less severe hypomania and depression.
The onset of bipolar disorder typically occurs during young adulthood, but teens and children can also be diagnosed.
Similarly to many mental health disorders, there are a number of potential causes of bipolar disorder, with scientists unable to point to a single reason for it occurring.
Children are thought to be more at risk due to the following factors:
- drug and alcohol use
Stress can play a role in the development of bipolar disorder in children. More precisely, how a child responds to elevated stress has been suggested as a contributor to the development of bipolar disorder.
Therefore, children growing up in stressful situations may be at a higher risk of developing bipolar disorder.
Genetics represents another risk factor for developing bipolar disorder. A child who has a family member with bipolar disorder may be more likely to develop the disorder. However, some research indicates that this is not a definite cause and effect, and a child with a parent with bipolar disorder may never develop the disease.
Use of drugs or alcohol may increase the chances of a child developing bipolar disorder. Some individuals with bipolar disorder have drug or alcohol addictions, as well.
Biological differences may also play a role in increasing the risk of developing bipolar disorder during childhood. Researchers have found there is a difference in the activities in the brains of children and adults who have been diagnosed with bipolar disorder.
Symptoms will vary among people diagnosed with bipolar disorder. Some people may experience the symptoms to different degrees, and symptoms may also change over time.
During manic or less severe hypomanic episodes, a person experiences an elevated mood and energy level. Symptoms of mania and hypomania must include at least three of the following:
- increased energy and activity
- unusual talkativeness
- abnormally upbeat mood
- increased distractibility
- jumpy reactions
- heightened sense of self-worth or confidence
- decreased need for sleep or inability to sleep
- uncontrolled, fast-paced thoughts
- poor decision-making
During depressive periods, a person experiences an extreme low. Symptoms of depressive episodes must include at least five of the following symptoms:
- sleeping too much or insomnia
- feeling sad, hopeless, empty, or tearful
- feeling worthless
- inappropriate feelings of guilt
- slowed behavior
- lack of interest in activities, including ones normally enjoyed
- fluctuations in weight
- decreased or increased appetite
- lack of energy
- suicidal thoughts or tendencies
- decreased ability to think or concentrate
Children may also show symptoms of irritability, extreme anger, and may not reach expected physical milestones, lsuch as age-appropriate height and weight.
Symptoms in children are often difficult to identify. Children and teens go through natural stages of mood shifts, but these are generally less severe than those of bipolar disorder.
Stress or trauma could also trigger bipolar-like symptoms. A number of other mental health conditions may also cause similar symptoms to appear.
It is not uncommon for a child to have additional mental health conditions in addition to bipolar disorder. In some cases, the additional mental health conditions may aggravate the symptoms of bipolar disorder. However, the other conditions may make treatment less effective.
Some possible coexisting conditions might include the following:
Children with bipolar disorder are especially difficult to diagnose.
Symptoms of highs and lows often appear to parents, teachers, and caregivers as normal parts of development. It is also possible to mistake these, as the symptoms of other disorders.
In order for a child to be diagnosed with bipolar disorder, they need to exhibit symptoms of both mania or hypomania and depressive moods. Also, diagnosis of bipolar disorder requires that a child fit into one of the types of bipolar disorder.
There are several types of bipolar disorder, each with their own diagnosis criteria:
Bipolar I disorder is characterized by having one manic episode that is either preceded or followed by a hypomanic or depressive episode. In some cases, the child may experience psychosis or a detachment from reality.
Bipolar II disorder is diagnosed when a person has at least one major depressive episode and at least one hypomanic episode. With bipolar II disorder, a person cannot have had a manic episode.
Cyclothymic disorder occurs when a person has several episodes of hypomania symptoms and periods of depressive symptoms over at least a 2-year period. In children, the period is shortened to being at least 1 year.
Other types include periods of mania or depressive episodes induced by substance use or another medical condition. Excessive alcohol use and multiple sclerosis (MS) may trigger symptoms.
Bipolar disorder is treated with a combination of medication and therapy.
A doctor may try a number of different drugs to help get symptoms under control, as every child responds differently to these. A doctor may need to try different types or combinations before finding the right one.
Children's developing bodies can alter how effective medication is, as well. A doctor will be consistently monitoring and adjusting medications to help find the right balance.
While receiving medication, a child should also see a therapist. Therapy can consist of talking through emotions, as well as helping to manage behaviors.
Helping a child with bipolar disorder can be frustrating and difficult at times. It is important for caregivers and parents to provide a stable, nurturing environment for the child to feel safe and supported.
Parents and caregivers may consider doing some or all of the following:
- be patient and understanding through the changes in mood
- seek and follow through with treatment
- encourage communication with questions and by actively listening
- be encouraging and positive about treatments, stressing that they can make life better while always listening to concerns about side effects
- encourage and help the child have fun
Parents and caregivers should note that finding the right treatment may take some time, but a loving and supportive home environment can help the child or teen manage their symptoms.