Overview
Bipolar disorder affects millions of people worldwide. Its onset can be as early as childhood. This mental health condition can bring about significant emotional and behavioral challenges. Therefore, early detection and intervention are essential for managing it effectively. If you dismiss your child’s extreme mood swings as just typical teenage behavior, you might miss a crucial opportunity to address their bipolar disorder and its potential impact on their life. Read on to become your child’s guiding light on their journey towards wellness.
What Is Bipolar Disorder?
Bipolar disorder is a mental health condition characterized by dramatic shifts in mood, energy, and activity levels. It includes extreme mood episodes of mania/hypomania (overly energetic and intensely happy) and depressive episodes (sadness and low energy)[1]. The episodes may last from days to weeks and can significantly affect a person’s ability to function[2].
According to the World Health Organization (WHO), about 40 million people worldwide (or 0.53% of the global population) were diagnosed with bipolar disorder in 2019. The condition affects working-age adults more commonly, but young people can also be affected. According to some studies, approximately 4% of individuals under the age of 18 are diagnosed with bipolar disorder, with some cases occurring as early as age 5.
Although this condition can have a significant impact on a child’s life, it is less common than other mental health disorders in this age group. For instance, attention-deficit/hyperactivity disorder (ADHD) affects about 9.8% of children, anxiety disorders affect around 9.4%, and depression affects approximately 4.4%[3].
Causes of Bipolar Disorder
The exact causes of bipolar disorder in children are still unclear, but research suggests that a combination of genetic, environmental, and neurochemical factors may contribute to its development. Here’s a closer look at these factors[4]:
- Genetic Factors. Genetics appear to play a significant role in the development of bipolar disorder in children. Studies indicate that genetic predisposition contributes to up to 50% of the risk. However, only 6% of children with a parent diagnosed with bipolar disorder develop the condition themselves, highlighting the complex nature of genetic risk.
- Environmental Factors. Children who face poverty, ongoing environmental stresses such as parental mental illness or substance abuse, harsh or abusive parenting, violence, trauma, or those who abuse drugs or alcohol, are at an increased risk for developing bipolar disorder. These factors can contribute to the onset of the disorder, especially in genetically predisposed individuals.
- Neurochemical Factors. Both genetic and environmental factors can alter brain chemistry and development, specifically affecting neurotransmitters like serotonin, norepinephrine, and dopamine. These chemicals are believed to play a critical role in the onset of bipolar disorder.
Types of Bipolar Disorder
Bipolar disorder can be particularly complex when it comes to children. Recognizing the different types can empower you to better support your child on their journey to wellness. Below is an overview of the various types[5]:
- Bipolar I Disorder: This type involves alternating episodes of mania and depression. During a manic episode, a child may exhibit intense happiness, silliness, extreme irritability, rapid speech, hyperactivity, and engage in risky behaviors. Conversely, depressive episodes are characterized by sadness, hopelessness, low energy, and a loss of interest in activities.
- Bipolar II Disorder: Children with this type of condition usually have alternating periods of depression and hypomania. Hypomania is a less severe form of mania, with symptoms like elevated mood, increased energy, and talkativeness. However, unlike full-blown mania, hypomania does not significantly impair a child’s daily functioning.
- Cyclothymia: Although this type of bipolar disorder involves milder hypomanic and depressive symptoms compared to hypomania or major depression, children may exhibit chronic irritability and mood instability. These symptoms can closely resemble those of ADHD.
Complexities of Bipolar Disorder in Children
Bipolar disorder in children presents unique complexities compared to its adult form. Key challenges include:
- Diagnostic Challenges: Symptoms of bipolar disorder often overlap with those of ADHD and conduct disorder. Moreover, because children’s brains are still developing, it can be tricky to make an accurate diagnosis.
- Treatment Challenges: Many medications for bipolar disorder haven’t been thoroughly studied in children, making their effectiveness and side effects uncertain. Moreover, ensuring that children adhere to therapeutic treatment plans, such as cognitive-behavioral therapy, can be quite challenging. These factors make treating bipolar disorder in kids particularly difficult.
- Other Challenges: Children with bipolar disorder often deal with other conditions like anxiety and ADHD, which can make treatment even more complicated. This disorder can also affect their social lives, emotional well-being, and academic progress, creating stress not just for the child but for the whole family.
Signs & Symptoms of Bipolar Disorder in Children
The moods and behaviors of children and teens can be difficult to navigate. However, when mood swings become more extreme and persistent, these may be a red flag for bipolar disorder. The key indicators below are definitely worth the attention of parents[6][7][8][9]:
- Mood Swings: Extreme shifts between periods of intense highs (mania) and lows (depression). These episodes can last for hours, days, or weeks.
- Mania: Inflated self-esteem, decreased need for sleep, racing thoughts, irritability, reckless behavior (such as drug use or risky sexual activity), pressured speech, excessive spending, grandiosity, and sometimes hallucinations or delusions. In children, mania may manifest as excessive silliness or irritability.
- Depression: Persistent sadness, irritability, frequent crying, loss of interest in activities, fatigue, changes in appetite or sleep, low energy, difficulty concentrating, feelings of hopelessness, worthlessness, or suicidal thoughts.
- Mixed Episodes: Experiencing symptoms of both mania and depression simultaneously.
- Rapid Cycling: Four or more mood episodes within a year.
Effective Strategies for Dealing With Your Child’s Bipolar Disorder
Effective communication is essential for helping your child understand bipolar disorder. This journey can be daunting, but with the right approaches, you can foster a supportive environment to facilitate your child’s treatment. Consider the following strategies[10][11]:
- Educate and Clarify. Thoroughly educate yourself on your child’s specific type of bipolar disorder. Explain the condition in simple terms—describe it as a brain-based condition that affects mood, energy, and daily functioning. Tailor your explanations to match your child’s maturity level.
- Emphasize Feelings and Positivity. Discuss how bipolar disorder affects emotions, highlighting those intense feelings—both highs and lows—are part of the condition and not their fault. Frame the conversation positively, reassuring your child that bipolar disorder is treatable and manageable.
- Create Open Communication. Foster a safe space for dialogue, encouraging your child to express their feelings and ask questions. Regular check-ins can help maintain this ongoing communication.
- Involve Experts and Address Stigma. Include your child’s doctor or therapist in discussions to provide authoritative information. Explain that while some people may not understand bipolar disorder, it’s important to have supportive friends and family who accept them for who they are.
Treatment Options for Children with Bipolar Disorder
A child’s bipolar disorder requires a treatment plan that’s carefully put together and regularly checked. We need to think about their age, how serious their symptoms are, and the possible side effects of treatment. It’s a team effort between the child, their family, and their healthcare providers to find what works best and keep adjusting it as needed. This typically involves a combination of the following:
- Several classes of medication are used, including mood stabilizers (lithium, valproic acid, carbamazepine, lamotrigine), antipsychotics (atypical antipsychotics are often preferred in children), and in some cases, antidepressants (used cautiously due to potential risks of triggering manic episodes). The choice of medication, dosage, and monitoring are determined by a psychiatrist specializing in child and adolescent mental health. It’s crucial to closely monitor medication’s side effects and adjust the treatment plan as necessary.
- Therapy is a key part of treatment, often involving psychoeducation (learning about the disorder), family-focused therapy (improving family communication and problem-solving), interpersonal and social rhythm therapy (regulating daily routines and social interactions), and/or cognitive behavioral therapy (CBT) to address negative thought patterns and behaviors.
- Lifestyle Modifications. Making healthy lifestyle changes can significantly improve mood stability. This includes establishing a regular sleep schedule, eating a balanced diet, getting regular exercise, and learning stress management techniques like deep breathing or mindfulness.
Final Thoughts
Caring for a child with bipolar disorder presents unique challenges, but cultivating empathy and awareness is key. By encouraging honest discussions and exploring effective resources, you can help your child better understand their feelings. Each proactive step contributes to a more positive outlook. Your unwavering support and understanding can significantly impact their ability to thrive.
Sources:
- World Health Organization. (2024, July 8). Bipolar disorder. Retrieved December 11, 2024, from Who.int website: https://www.who.int/news-room/fact-sheets/detail/bipolar-disorder
- American Psychiatric Association. (2024). What Are Bipolar Disorders? Retrieved December 11, 2024, from Psychiatry.org website: https://www.psychiatry.org/patients-families/bipolar-disorders/what-are-bipolar-disorders
- Cleveland Clinic. (2023, August 25). Bipolar Disorder in Children: Symptoms, Diagnosis & Treatment. Retrieved December 11, 2024, from Cleveland Clinic website: https://my.clevelandclinic.org/health/diseases/14669-bipolar-disorder-in-children
- Boston Children’s Hospital. (2024). Boston Children’s Hospital. Retrieved December 11, 2024, from Childrenshospital.org website: https://www.childrenshospital.org/conditions/bipolar-disorder
- Mount Sinai. (2014). Bipolar disorder Information | Mount Sinai – New York. Retrieved December 12, 2024, from Mount Sinai Health System website: https://www.mountsinai.org/health-library/report/bipolar-disorder
- Nationwide Children’s. (2023). Bipolar Disorder in Teens. Retrieved December 13, 2024, from Nationwidechildrens.org website: https://www.nationwidechildrens.org/conditions/health-library/bipolar-disorder-in-teens
- NYU Langone Health. (2024). Diagnosing Bipolar Disorder in Children. Retrieved December 13, 2024, from Nyulangone.org website: https://nyulangone.org/conditions/bipolar-disorder-in-children/diagnosis#:~:text=Other%20signs%20of%20mania%20include,alcohol%20use%2C%20reckless%20driving%2C%20or
- National Institute of Mental Health. (2023). Bipolar Disorder in Children and Teens. Retrieved December 13, 2024, from National Institute of Mental Health (NIMH) website: https://www.nimh.nih.gov/health/publications/bipolar-disorder-in-children-and-teens
- National Institute of Mental Health. (2024). Bipolar Disorder in Teens and Young Adults: Know the Signs. Retrieved December 13, 2024, from National Institute of Mental Health (NIMH) website: https://www.nimh.nih.gov/health/publications/bipolar-disorder-in-teens-and-young-adults-know-the-signs
- bp Magazine. (2017, March 26). 7 Tips To Explain a Bipolar Diagnosis To Your Child. Retrieved December 13, 2024, from bpHope.com website: https://www.bphope.com/kids-children-teens/7-tips-to-explain-a-bipolar-diagnosis-to-your-child/
- Jensen, K. (2023, June 30). 7 Tips to Explain a Bipolar Disorder Diagnosis to Your Child. Retrieved December 13, 2024, from Healthline website: https://www.healthline.com/health/bipolar-disorder/explaining-to-kids#ask-for-support