What is bipolar disorder in children and teens?

Bipolar disorder causes mood swings with extreme ups (mania) and downs (depression). When children with this problem are up, they have brief, intense outbursts or feel irritable or extremely happy several times almost every day. They have a lot of energy and are very active. When they're down, they feel depressed and sad.

Bipolar disorder causes cycles of mania and depression.

Manic symptoms

A manic episode lasts at least a week. It's a period of being extremely happy, irritable, or motivated. The child or teen may:

• Have little need for sleep.
• Have high energy levels.
• Have extreme self-confidence.
• Talk very fast.
• Have many thoughts at once.
• Seem very distracted and unable to focus.
• Touch their genitals, use sexual language, and approach others in a sexual way.
• Act inappropriately or intrude in social settings.
• Show risky, wild, thrill-seeking behavior.

Depressive symptoms

A depressive episode is a period of a sad, low, or cranky mood. The child or teen may:

• Not find pleasure in things that they normally enjoy.
• Have low energy or feel "slowed down."
• Have sleep and appetite changes.
• Have low self-esteem.
• Feel guilty or worthless.
• Withdraw from friends or family.
• Have trouble focusing.
• Have thoughts about death or suicide.

Doctors make the diagnosis through a combination of:

• A medical history. The doctor will ask questions to help find other past and present health conditions that could cause the symptoms.
• A family history. This can identify bipolar disorder, other mood disorders, or a substance use disorder in close relatives. (All of these conditions are linked to bipolar disorder.)
• A physical exam. It can rule out other conditions with similar symptoms.
• A mental health assessment. It can help identify your child's current mental state and the severity of depression or mania.
• Asking questions about your child's feelings and behavior. And the doctor may ask questions to rule out conditions with similar symptoms, such as disruptive mood dysregulation disorder (DMDD).
• Other written or verbal mental health tests.

The doctor may do other tests (such as a blood test) to rule out other health problems.

The mood changes that come with bipolar disorder can be a challenge. But with the right treatment, they can be managed. Treatment usually includes medicines (such as mood stabilizers) and counseling. Often a combination of both is needed.

Treatment options include:

Medicines.

Make sure your child takes their medicine. Children and teens with this disorder sometimes stop taking their medicines when they feel better. But without medicine, the symptoms usually come back.

Counseling.

Counseling works best when symptoms of bipolar disorder are controlled with medicines.

Home treatment.

This includes helping your child get regular exercise, eat healthy foods, and have a regular sleep schedule.

Hospital treatment.

If your child's behavior is suicidal, aggressive, reckless, or dangerous, or if they have symptoms of psychosis such as hallucinations, your child may need to go into the hospital for a while.

Learning as much as you can about bipolar disorder may help you recognize mood changes in your child as they start to occur. You can then take steps to help reduce your child's symptoms and control moods. Find a counselor your child trusts, and make sure they take any medicines.