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Bipolar Disorder in Children and Teens

Dr. Kawthar Hameed Abdullah

Ed. D Educational Psychology & Special Education

Children that may have bipolar may go through intense mood swings. They might get much more excited than children their age about an activity or event, you may notice that others have commented about your child's behavior, excitability or moodiness. You may notice that your child goes through many highs and lows more often than other children his age. You may even notice that your child tends to lie a lot and make up a lot of stories that seem far-fetched.

Some children that have these types of symptoms may have bipolar disorder, a serious medical condition and a mental disorder.

What is bipolar disorder?

Bipolar disorder is a serious brain illness. It is also sometimes called manic depression.

Children with bipolar disorder go through unusual mood changes.

1. They may show intence happiness or silliness for long periods of time.

2. They may talk fast about a lot of different things,

3. They may have trouble focusing and express racing thoughts,

4. They may have trouble sleeping because of their racing thoughts,

5. They may have a short temper and be extremely moody and irritable.

This is called a manic episode.

Sometimes children with bipolar disorder feel very sad or unhappy and are much less active than usual such as:

1. Persistent feelings of sadness

2. Feeling hopeless or helpless

3. Having low esteem

4. Feeling inadequate

5. Loss of interest in usual activities that he/she once enjoyed.

This is called a depressive episode.

Bipolar disorder is not the same as the normal ups and downs every child goes through. Bipolar symptoms are more intense. The mood swings are more extreme and are accompanied by changes in sleep, appetite, energy level, and the ability to think clearly.

Bipolar symptoms can be so severe, they can make it hard for a child to concentrate in school or get along with friends and family members.

The illness can also be dangerous. Some young people with bipolar disorder try to hurt themselves or attempt suicide. Children and teens with bipolar disorder should get treatment. With help, they can manage their symptoms and lead successful lives.

Who develops bipolar disorder?

Anyone can develop bipolar disorder, including children and teens. However, most people with bipolar disorder develop it in their late teen or early adult years. The illness usually lasts a lifetime.

Why does someone develop bipolar disorder?

Doctors do not know what causes bipolar disorder, but several things may contribute to the illness. Family genes may be one factor because bipolar disorder sometimes runs in families. However, it is important to know that just because someone in your family has bipolar disorder, it does not mean other members of the family will have it as well.

Another factor that may lead to bipolar disorder is the brain structure or the brain function of the person with the disorder. Scientists are finding out more about the disorder by researching it. This research may help doctors do a better job of treating people. Also, this research may help doctors to predict whether a person will get bipolar disorder. One day, doctors may be able to prevent the illness in some people.

What are the symptoms of bipolar disorder?

Bipolar “mood episodes” include unusual mood changes along with unusual sleep habits, activity levels, thoughts, or behavior. In a child, these mood and activity changes must be very different from their usual behavior and from the behavior of other children. A person with bipolar disorder may have manic episodes, depressive episodes, or “mixed” episodes. A mixed episode has both manic and depressive symptoms. These mood episodes cause symptoms that last a week or two or sometimes longer. During an episode, the symptoms last every day for most of the day. Children and teens having a manic episode may:

▲ Feel very happy or act silly in a way that’s unusual for them and for other people their age

▲ Have a very short temper

▲ Talk really fast about a lot of different things

▲ Have trouble sleeping but do not feel tired

▲ Have trouble staying focused

▲ Talk and think about sexual content more often

▲ Do risky things

Children and teens having a depressive episode may:

▲ Feel very sad

▲ Complain about pain a lot, such as stomachaches and headaches

▲ Sleep too little or too much

▲ Feel guilty and worthless

▲ Eat too little or too much

▲ Have little energy and no interest in fun activities

▲ Think about death or suicide

Can children and teens with bipolar disorder have other problems?

Young people with bipolar disorder can have several problems at the same time. These include:

▲ Substance abuse. Both adults and kids with bipolar disorder are at risk of drinking or taking drugs.

▲ Attention-deficit/hyperactivity disorder (ADHD). Children who have both bipolar disorder and ADHD may have trouble staying focused.

▲ Anxiety disorders, like separation anxiety.

Sometimes behavior problems go along with mood episodes. Young people may take a lot of risks, such as driving too fast or spending too much money. Some young people with bipolar disorder think about suicide. Watch for any signs of suicidal thinking. Take these signs seriously and call your child’s doctor.

How is bipolar disorder diagnosed?

An experienced doctor (psychiatrist) will carefully examine your child. There are no blood tests or brain scans that can diagnose bipolar disorder. Instead, the doctor will ask questions about your child’s mood, behavior and sleeping patterns.

The doctor will also ask about your child’s energy and eating patterns. Sometimes doctors need to know about medical problems in your family, such as depression or alcoholism. The doctor may use tests to see if something other than bipolar disorder is causing your child’s symptoms.

How is bipolar disorder treated?

Right now, there is no cure for bipolar disorder. Doctors often treat children who have the illness in much the same way they treat adults. Treatment can help control symptoms. Steady, dependable treatment works better than treatment that starts and stops. Treatment options include:

▲ Medication. There are several types of medication that can help. Children respond to medications in different ways, so the right type of medication depends on the child. Some children may need more than one type of medication because their symptoms are so complex. Sometimes they need to try different types of medicine to see which are best for them.

Children should take the fewest number of medications and the smallest doses possible to help their symptoms. A good way to remember this is “start low, go slow.” Medications can cause side effects. Always tell your child’s doctor about any problems with side effects. Do not stop giving your child medication without a doctor’s help. Stopping medication suddenly can be dangerous, and it can make bipolar symptoms worse.

▲ Therapy. Different kinds of psychotherapy, CBT or “talk” therapy, can help children with bipolar disorder. Therapy can help children change their behavior and manage their routines. It can also help young people get along better with family and friends. Sometimes therapy includes family members.

What can children and teens expect from treatment?

With treatment, children and teens with bipolar disorder can make improvements over time. It helps when doctors, parents, and young people work together. Sometimes a child’s bipolar disorder changes. When this happens, treatment needs to change too. For example, your child may need to try a different medication. The doctor may also recommend other treatment changes. Symptoms may come back after a while, and more adjustments may be needed. Treatment can take time, but sticking with it helps many children and teens have fewer bipolar symptoms. You can help treatment be more effective. Try keeping a chart of your child’s moods, behaviors, and sleep patterns. This is called a “daily life chart” or “mood chart.” It can help you and your child understand and track the illness. A chart can also help the doctor see whether treatment is working.

How can I help my child or teen?

Help begins with the right diagnosis and treatment. If you think your child may have bipolar disorder, make an appointment with your family doctor to talk about the symptoms you notice. If your child has bipolar disorder, here are some basic things you can do:

▲ Be patient.

▲ Encourage your child to talk, and listen to your child carefully.

▲ Be understanding about mood episodes.

▲ Help your child have fun.

▲ Help your child understand that treatment can make life better.

How does bipolar disorder affect parents and family?

Taking care of a child or teenager with bipolar disorder can be stressful for you, too. You have to cope with the mood swings and other problems, such as short tempers and risky activities. This can challenge any parent. Sometimes the stress can strain your relationships with other people, and you may miss work or lose free time.

If you are taking care of a child with bipolar disorder, take care of yourself too. Find someone you can talk to about your feelings. Talk with the doctor about support groups for caregivers.

If you keep your stress level down, you will do a better job. It might help your child get better too.

It is worth noting that bipolar is not a common disorder, symptoms can mimic symptoms of other childhood psychological disorders. Therefore, a diagnosis of bipolar should only be diagnosed by a psychiatrist. A pediatrician or psychologist can give you a recommendation to a psychiatrist for the proper evaluations.

Psychiatrists in Muscat:

1. Dr. Amna Al-Shamsi

Child Psychiatrist

Malath Clinic

949 77755

2. Dr. Hassan Mirza

Child Psychiatrist

SQU Hospital / Whispers of Serenity Clinic

246 14268 (Whispers of Serenity )

3. Dr. Aziz Al-Namani

General Psychiatrist

SQU Hospital/ Top Medical Care

992 92979/ 245 11010

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