What Is Childhood Bipolar Disorder? Signs, Diagnosis & Remedies

Childhood bipolar disorder, also known as pediatric bipolar disorder or early-onset bipolar disorder, is a mental health condition characterized by extreme mood swings, alternating between periods of intense highs (mania) and lows (depression). 

While it was once believed to primarily affect adults, it has become increasingly recognized that children can also develop bipolar disorder. Understanding the symptoms, diagnosis, and treatments for childhood bipolar disorder is crucial for providing proper care and support to affected children. 

Grady Shumway, LMHC, says

Children with bipolar disorder may exhibit behaviors such as irritability, impulsivity, and extreme emotional reactions, which can make diagnosis challenging. Early intervention, including therapy and medication, can help manage symptoms and improve long-term outcomes. Parents and caregivers need to seek professional guidance if they notice signs of mood instability or unusual behavior in their child.

So, let’s understand what childhood bipolar disorder is, how it affects children, its symptoms, potential causes, diagnostic methods, strategies to support such children, and recommended treatments.

What is childhood bipolar disorder?

Childhood bipolar disorder is a chronic mental health condition that causes unusual and extreme shifts in a person’s mood, energy, and activity levels. It is characterized by two main phases:

• Mania: During manic episodes, individuals experience elevated mood, increased energy, impulsivity, and a heightened sense of self-esteem. They may engage in risky behaviors, have racing thoughts, and require less sleep.
• Depression: Depressive episodes are marked by overwhelming sadness, fatigue, changes in appetite and sleep patterns, and a lack of interest in previously enjoyed activities. Suicidal thoughts and feelings may also be present.

So, at what age can you be diagnosed with bipolar? Usually, a person is diagnosed with bipolar disorder during the late teenage or young adult years.

How does bipolar disorder affect children?

Bipolar disorder in children can manifest differently than in adults, making it challenging to diagnose. The mood swings are often more rapid, and the symptoms can be mistaken for typical childhood behavior.

Children with bipolar disorder may have difficulty in school, maintaining relationships, and participating in daily activities. Left untreated, it can have a significant impact on their emotional and social development.

9 common symptoms of bipolar disorder in children

Identifying bipolar disorder in children can be challenging due to its varied presentation. However, several common symptoms of childhood bipolar disease may indicate the presence of this condition:

• Extreme mood swings: Children with bipolar disorder exhibit drastic mood fluctuations, moving between intense highs and lows rapidly.
• Irritability: Severe irritability is often a hallmark of pediatric bipolar disorder. The child may become easily angered, frustrated, or agitated.
• Impulsivity: Children may engage in impulsive behaviors, such as excessive spending, risky sexual activity, or substance abuse.
• Decreased need for sleep: During manic episodes, children may experience a decreased need for sleep without feeling tired.
• Hyperactivity: Increased energy levels and restlessness are common during manic episodes.
• Grandiosity: Children may exhibit an inflated sense of self-importance and believe they have special powers or abilities.
• Rapid speech: One of the early childhood signs of bipolar disorder is that the child may talk excessively and quickly, often jumping from one topic to another.
• Depression: Depressive episodes in children with bipolar disorder involve persistent sadness, hopelessness, and a loss of interest in activities they once enjoyed.
• Suicidal thoughts: In severe cases, children may experience thoughts of self-harm or suicide, which require immediate intervention.

What causes bipolar disorder in children?

The exact cause of bipolar disorder in children is not fully understood, but it is likely a combination of genetic, environmental, and neurobiological factors. 

Family history plays a significant role, as children with a family history of bipolar disorder are at a higher risk. Additionally, traumatic events, high-stress environments, and substance abuse can trigger or exacerbate symptoms in susceptible individuals.

Grady Shumway further adds,

Research suggests that an imbalance in brain chemicals, such as neurotransmitters, may also contribute to the development of bipolar disorder. Early life stressors and inconsistent parenting can further influence how the disorder manifests, making it essential for caregivers to provide a stable, supportive environment.

5 ways bipolar disorder is diagnosed in children

Diagnosing bipolar disorder in children can be challenging, as it often mimics other psychiatric conditions. Here are 5 methods used by healthcare professionals to arrive at a bipolar diagnosis in childhood:

1. Comprehensive assessment

The process of diagnosing bipolar disorder in children begins with an in-depth evaluation conducted by a mental health professional. This comprehensive assessment includes detailed interviews with parents and caregivers, aiming to gather extensive information about the child’s symptoms, behavior, and overall mental health history. 

The approach is essential because it helps differentiate bipolar disorder from other psychiatric conditions that may present similar symptoms.

2. Observation

A critical aspect of diagnosing bipolar disorder in children involves ongoing observation. This means closely monitoring the child’s mood, behavior, and emotional responses over time. Health professionals look for patterns and triggers in mood swings and behavioral changes. 

Such consistent and careful observation is critical to understanding the severity and frequency of mood fluctuations, which are characteristic of bipolar disorder.

3. Diagnostic criteria

Utilizing the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), health professionals apply specific criteria to diagnose bipolar disorder in children. However, these criteria are often adapted to better suit children’s developmental stages and behavioral patterns. 

The DSM-5 provides a structured framework for diagnosis, ensuring that key symptoms and their duration are evaluated systematically.

4. Mood charts and diaries

To aid in the diagnosis of bipolar disorder, parents and caregivers are often encouraged to maintain detailed records of the child’s mood, behavior, sleep patterns, and daily activities. These mood charts and diaries offer valuable insights and contribute to a more accurate assessment. 

By tracking these patterns over time, healthcare providers can better understand the nature of the child’s mood swings and identify potential bipolar disorder characteristics.

5. Psychological testing

In diagnosing bipolar disorder in children, psychological testing plays a significant role. These tests and assessments are designed to rule out other mental disorders and provide a clearer picture of the child’s psychological profile. 

Through various standardized tests, healthcare professionals can gain further insights into the child’s mental state, cognitive abilities, and emotional regulation, which are crucial for an accurate diagnosis of bipolar disorder.

5 strategies for parents to support children with bipolar disorder

Supporting a child with bipolar disorder can be challenging, but there are various strategies parents can implement to provide the necessary care and understanding. Below are 5 strategies parents can use to support their child’s healing journey:

1. Educate yourself

Understanding bipolar disorder, its symptoms, and the various treatment options available is vital. By educating themselves, parents can gain insight into what their child is experiencing and how best to support them. 

The knowledge can empower parents to make informed decisions regarding their child’s care and to advocate effectively for their needs.

2. Create a structured routine

Establishing a consistent daily routine is beneficial for children with bipolar disorder. A structured environment can help stabilize their mood swings and reduce feelings of anxiety and uncertainty. 

Routine in daily activities such as sleep, meals, homework, and leisure can provide a sense of security and predictability. This regularity is particularly important as it can help in managing the highs and lows associated with bipolar disorder.

3. Open communication

Parents should create a safe and supportive environment where the child feels comfortable sharing their feelings and experiences. Being a nonjudgmental listener is key. This open dialogue helps the child feel understood and supported.

Also, it gives parents valuable insights into the child’s emotional state and any challenges they are facing. Such communication enables a stronger parent-child relationship and aids in the child’s healing process.

4. Medication management

For many children with bipolar disorder, medication is a critical component of their treatment plan. Parents need to work closely with healthcare providers to find the most effective medication regimen for their child. 

It involves monitoring the child’s response to medication, being vigilant about side effects, and maintaining regular communication with medical professionals. Proper medication management can significantly improve the child’s quality of life and overall stability.

5. Seek professional help

Accessing professional therapy and counseling services is another vital strategy. These services offer specialized support and teach coping strategies that are specifically tailored to children with bipolar disorder. 

Therapy can significantly improve a child’s emotional well-being, helping them to understand and manage their condition more effectively. For parents, family therapy can provide additional strategies for supporting their children and enhancing family dynamics.

Grady Shumway states,

In addition to therapy, medication may also be prescribed to help stabilize mood swings and manage symptoms. It’s important for parents to work closely with healthcare providers to create a comprehensive treatment plan that addresses both the child’s and the family’s needs.

7 recommended treatments for childhood bipolar disorder

Treatment for childhood bipolar disorder typically involves a combination of therapies and medication. However, the question is, is bipolar disorder curable? While this condition cannot be cured completely, its symptoms are manageable with the proper treatment.

Professionals commonly recommend the following 7 treatments to manage the symptoms of bipolar disorder in children:

1. Medication

A fundamental aspect of treating childhood bipolar disorder involves mood-stabilizing medications. Drugs such as lithium or anticonvulsants are often prescribed to help manage the erratic mood swings characteristic of bipolar disorder. 

These medications are crucial in maintaining balance in a child’s mood, thereby reducing the severity and frequency of episodes of mania or depression. A healthcare professional must monitor and adjust these medications to ensure optimal effectiveness and minimal side effects.

2. Psychotherapy

Various forms of therapy, like cognitive-behavioral therapy (CBT), are employed to help children understand and manage their condition. CBT focuses on changing negative thought patterns and behaviors, which can be particularly beneficial in managing mood swings. 

Additionally, family therapy is recommended to improve communication within the family and equip all members with effective coping strategies, enhancing the overall support system for the child.

3. Supportive services

Children with bipolar disorder often benefit from specialized educational services and accommodations in school settings. These supportive services are designed to address the unique learning and behavioral challenges that these children might face. 

Such accommodations can include individualized education plans (IEPs), extra time for assignments, or a more flexible classroom environment. These tailored approaches help ensure that children with bipolar disorder have the same opportunities for success in their educational pursuits as their peers.

4. Lifestyle modifications

Encouraging a healthy lifestyle is another key treatment strategy. Regular physical exercise, balanced nutrition, and adequate sleep are essential in promoting mood stability in children with bipolar disorder. 

A healthy lifestyle can help mitigate the severity of symptoms and contribute to overall well-being. Parents and caregivers are often advised to establish consistent routines for their children to support these lifestyle changes.

5. Electroconvulsive therapy (ECT)

In severe cases of bipolar disorder, particularly those unresponsive to medication and psychotherapy, Electroconvulsive Therapy (ECT) may be considered. This treatment is administered under close medical supervision. 

It involves a brief electrical brain stimulation while the patient is under anesthesia. ECT is generally reserved for the most severe cases due to its invasiveness and potential side effects.

6. Hospitalization

For children experiencing extreme episodes of mania or depression, mainly when there is a risk of self-harm or harm to others, hospitalization may be necessary. This approach provides a safe and controlled environment for stabilization. 

In a hospital setting, children can receive intensive treatment and continuous monitoring by mental health professionals, ensuring their safety and the safety of those around them.

7. Family support

Support groups and resources for families are invaluable in managing childhood bipolar disorder. These resources provide parents and caregivers with education, emotional support, and practical advice. Family support helps create a more informed and supportive home environment, crucial for the child’s treatment and overall well-being. 

Sharing experiences with others who face similar challenges can also be a source of comfort and strength for families managing the complexities of childhood bipolar disorder.

Watch this video where Tricia Schutz, a licensed therapist, explains how a family can support a child’s mental & behavioral health:

FAQs

Bipolar disorder in children is a complex and often misunderstood condition. It raises many questions for parents and caregivers seeking to understand and support affected children. Here are some commonly asked questions to provide clarity on this critical topic.

• How common is bipolar disorder in children?

Bipolar disorder in children, while less common than in adults, is a significant mental health concern. Its prevalence is challenging to determine due to overlapping symptoms with other disorders. However, it’s recognized that early-onset bipolar disorder, although rare, does occur and requires attentive diagnosis and treatment.

• Can bipolar disorder be prevented?

Preventing bipolar disorder isn’t currently possible due to its complex interplay of genetic and environmental factors. Early intervention and management are key. 

Recognizing early symptoms and seeking prompt, professional help can mitigate the severity and improve long-term outcomes, but outright prevention of the disorder is not yet achievable.

• Is my child bipolar or ADHD?

Differentiating between bipolar disorder and ADHD in children can be challenging as they share symptoms like impulsivity and hyperactivity. 

However, bipolar disorder is marked by episodic mood changes, while ADHD involves consistent attention difficulties and hyperactivity. Accurate diagnosis by a mental health professional is crucial for appropriate treatment.

• Is bipolar a genetic disease?

Bipolar disorder has a significant genetic component, with research indicating a higher risk in individuals with a family history of the disorder. However, it’s not solely genetic; environmental factors also play a role. The exact inheritance pattern is complex and not fully understood, making it a multifactorial condition.

• What are children of bipolar parents like?

Children of bipolar parents may have a higher risk of developing bipolar disorder due to genetic predisposition. They might also experience challenges related to the family environment, such as stress or instability. 

However, not all children of bipolar parents develop the disorder, and many lead healthy, stable lives with proper support and awareness.

To summarize

Childhood bipolar disorder is a complex mental health condition characterized by extreme mood swings, impacting children’s daily lives and development. Symptoms may include mood swings, irritability, impulsivity, and depression. 

While the exact causes remain uncertain, genetics, environmental factors, and brain chemistry likely play a role. Diagnosing bipolar disorder in children involves a comprehensive assessment, diagnostic criteria, and ongoing observation. 

Treatment options often include medication, therapy, and support services. Parents can support their children by educating themselves, maintaining a structured routine, and promoting open communication.

With proper diagnosis and treatment, children with bipolar disorder can lead fulfilling lives and manage their symptoms effectively. Early intervention and a supportive environment are essential for their well-being and future success.