Does your child experience intense mood swings, from feeling overly excited to suddenly feeling sad or withdrawn? Do these shifts seem more extreme than what you’d expect for their age, and do they impact your child’s daily life at home, school, or with friends? While all children go through emotional ups and downs, for some, these drastic shifts could be a sign of bipolar disorder.
Bipolar disorder is a mental health condition that causes significant shifts in mood, energy, and behavior. While more common in young adults, bipolar disorder can also affect children and teens, making early diagnosis and treatment key to managing symptoms and improving your child’s mental well-being. In this article, we explore bipolar disorder in children and teens, including symptoms, diagnosis, and treatment options.
What is bipolar disorder?
Bipolar disorder, previously known as manic depression, is a mental health condition that causes dramatic shifts in mood, energy, and behavior. These mood swings go beyond the typical ups and downs of childhood and adolescence and are accompanied by changes in sleep, energy levels, and the ability to think clearly. While most people are diagnosed with bipolar disorder in late adolescence or adulthood, the symptoms can also appear during childhood.
Bipolar disorder is characterized by two distinct mood phases: manic episodes and depressive episodes:
- During manic episodes, children or teens might feel unusually happy, irritable, or overly energetic.
- Depressive episodes, on the other hand, bring intense feelings of sadness, hopelessness, or fatigue, making it difficult for children to function in daily life.
The extreme mood changes associated with bipolar disorder can affect a child’s ability to maintain relationships, focus at school, or engage in normal activities. Some might try to hurt themselves or attempt suicide. Sometimes, bipolar disorder symptoms can overlap with other mental health conditions, such as attention-deficit hyperactivity disorder (ADHD), major depression, or anxiety. This can make diagnosis more complex, requiring careful evaluation by a trained mental health professional.
Early diagnosis and proper treatment is essential to helping kids and teens with bipolar disorder manage their symptoms and lead fulfilling lives. With the right support, children and teens can find stability and improve their well-being.
See: Bipolar Disorder in Women: Signs, Symptoms and Treatments
Is bipolar disorder in children and teens common?
Because bipolar disorder is most often diagnosed in young adults, there’s a common misconception that children cannot have the disorder. This is untrue, however. Studies show that around 4% of people under the age of 18 have bipolar disorder. Here’s how that compares to other common mental health disorders:
- 9.8% have attention-deficit/hyperactivity disorder (ADHD)
- 9.4% have anxiety disorder
- 4.4% have depression.
Symptoms of bipolar disorder in children and teens
Children and teens with bipolar disorder will cycle through manic episodes, depressive episodes, and ‘mixed’ episodes (both depressive symptoms and manic symptoms).
Episodes can last anywhere from several days to several weeks. During an episode, symptoms will appear for most of the day, every day, showing clear differences from the child’s usual behavior and that of healthy kids and teens. Between episodes, children and teens might return to their usual mood and behavior.
Symptoms of manic episodes in children and teens
Manic episodes in kids and teens can look like:
- Abnormal happiness or silliness
- High or euphoric feelings
- Hyperactivity
- Impulsive behavior
- Short temper or extreme irritability
- Talking quickly and jumping from topic to topic
- Racing thoughts
- Difficulty sleeping but not feeling tired
- Difficulty focusing and easily distracted
- Interest or involvement in risky activities that are out of character, e.g. reckless driving, spending sprees, or drug and alcohol abuse
- Poor judgment
- Inflated self-esteem or sense of ability, knowledge, or power
- Loss of contact with reality, e.g. hallucinations or delusions.
Hypomania is a milder version of mania. The same symptoms will appear but at a lesser severity.
Symptoms of depressive episodes in children and teens
Depressive episodes in kids and teens can look like:
- Persistent sadness
- Complaints of physical aches and pains, usually without cause
- Difficulty concentrating
- Excessive sleeping
- Increased anger, irritability, or hostility
- Feelings of despair, guilt, hopelessness, or worthlessness
- Appetite changes, eating too much or too little
- Fatigue
- Low self-esteem
- Difficulty in relationships
- Self-criticism
- Lack of interest in activities they usually enjoy
- Thoughts of death, dying, or suicide.
It’s important to note that these symptoms alone aren’t enough to diagnose bipolar disorder. Many of these behaviors can be linked to other mental health issues, including:
- Anxiety disorders
- Attention-deficit/hyperactivity disorder (ADHD)
- Autism spectrum disorder
- Conduct disorder
- Major depression
- Oppositional defiant disorder
- Substance use
- Traumatic experiences.
More Reading: Depression vs. Anxiety: Which One Do I Have? Symptoms & Treatment
How is bipolar disorder diagnosed in children and teens?
Diagnosing pediatric bipolar disorder can be a complex process that requires careful evaluation by a trained mental healthcare provider. Because there are no specific blood tests, brain scans, or genetic markers to definitively diagnose the disorder, the process relies heavily on observation, detailed medical history, and behavioral assessments.
During a consultation, you might be asked about your child’s mood, energy levels, behavior, and sleeping patterns. The healthcare provider might also inquire about your child’s medical history and family history of mental health conditions such as depression or substance use. This information can help rule out other conditions with similar symptoms, like ADHD, anxiety disorders, or disruptive mood dysregulation disorder.
Generally, to be diagnosed with bipolar disorder, your child or teen must have experienced at least one manic or hypomanic episode, with or without a depressive episode. This diagnosis might be reached through a combination of physical examination, mental health evaluations, and questionnaires filled out by both the child or teen, caregivers, and teachers.
How is bipolar disorder treated?
Bipolar disorder is a lifelong condition, but treatment can significantly improve a child or teen’s quality of life. Treatment usually involves a combination of medication, psychotherapy, and lifestyle adjustments, and the exact protocol will depend on your child’s symptoms, age, and the severity of the condition.
Below, we look at how to treat bipolar disorder in kids and teens.
Medications
There are several types of medications that can help manage symptoms of bipolar disorder. Each child will respond to medications differently, so a few options may need to be tried before finding the best fit. In some cases, more than one medication may be needed to address all symptoms.
The most common medications used to manage bipolar disorder are mood stabilizers. These include:
- Lithium (Eskalith, Lithobid)
- Valproic acid (Depakene)
- Carbamazepine (Tegretol).
Sometimes, a second-generation or ‘atypical’ antipsychotic medication will also be prescribed. These might include:
- Cariprazine (Vraylar)
- Lurasidone (Latuda)
- Quetiapine (Seroquel).
If your child is prescribed bipolar medication, it’s important to monitor for side effects and never stop medication without first consulting the medication management provider. This can be dangerous and worsen symptoms.
See More: Mood Stabilizers for Depression and Anxiety: What You Need to Know?
Psychotherapy
Also known as talk therapy, psychotherapy is a term used for various treatment techniques that can help your child identify and manage troubling thoughts, behaviors, and emotions. Different types of psychotherapy that can be used for bipolar disorder include:
- Cognitive behavioral therapy (CBT): This can help kids and teens understand and better manage their moods, thoughts, and behaviors.
- Family-focused therapy: This involves the whole family learning how to support the child, improve communication, and recognize early signs of mood episodes.
- Chronotherapy: This involves helping your child establish a regular sleep routine, including waking up and sleeping at the same time each day.
- Interpersonal and social rhythm therapy (IPSRT): This involves helping your child work with biological and social rhythms to improve their moods.
Lifestyle changes
Lifestyle changes can support bipolar disorder treatment. This might include things like maintaining a regular sleep schedule, incorporating physical activity, and practicing stress-management.
Treating bipolar disorder requires patience. This is a lifelong condition, and it can take several months to several years before you, your child, and their provider find a treatment plan that works. Try not to be discouraged and continue treatment as prescribed. Sticking with the treatment plan is the best way to reduce the likelihood of future episodes and improve mental well-being.
Keep Reading: How Diet and Exercise Affect Your Mental Health
How to help your child or teen with bipolar disorder
Supporting a child or teen with bipolar disorder can feel overwhelming, but your involvement is important. Below are some ways you can provide support:
- Be patient and understanding: Bipolar disorder is a lifelong condition that requires ongoing treatment and patience. It can take time to find the right medication or therapy that works for your child. Stay committed and encourage your child by reminding them that, while the process can be slow, it’s worth it.
- Encourage open communication: Create a safe space for your child to talk about their feelings, thoughts, and worries. Regular, open conversations can also help you catch early signs of mood changes and address issues before they escalate.
- Track moods and watch for changes: Monitoring your child’s moods can give important insights into their triggers and help mental healthcare providers adjust their treatment. Keeping a symptom diary is one way to track patterns and identify early signs of manic or depressive episodes.
- Create a stable routine: Maintaining a consistent daily schedule, especially when it comes to sleep, can go a long way in stabilizing moods. Routines provide a sense of security and help regulate the body’s natural rhythms, which is important for kids and teens with bipolar disorder.
- Teach stress-management techniques: Stress can trigger mood episodes in people with bipolar disorder. Teaching your child calming strategies, like deep breathing, meditation, or creative outlets, can help them learn to manage stress in healthier ways.
- Be involved in treatment: It’s important to stay active in your child’s treatment. Make sure they follow the treatment plan, take prescribed medications as directed, and attend all scheduled appointments.
- Create a safe environment: Make your home a safe space, both emotionally and physically. Store any prescription medications in a locked cabinet, and if you have firearms in the home, store them unloaded in a locked safe with ammunition kept separately. Take any threats of suicide or self-harm seriously and work with your healthcare provider to create an emergency plan in case of crisis.
- Take care of yourself: Caring for a child or teen with bipolar disorder can be emotionally taxing. Remember to also take care of yourself. Support groups for parents of children with bipolar disorder can be helpful for sharing your experiences and learning from others who understand what you’re going through.
When to get professional support
If you’re concerned about your child or teen’s mental health, it’s important to know when to seek professional help. Below are some indicators that your child might need professional support:
- Do mood shifts interfere with daily life? If your child’s emotional ups and downs are making it difficult for them to manage school, friendships, or daily activities, it might be time to consult a mental health professional.
- Are mood swings intense? Sudden and severe changes in your child’s moods, like periods of extreme highs followed by deep lows, could signal the need for professional help.
- Is this behavior new? If your child’s thoughts, feelings, or behaviors are noticeably different from how they used to be, it’s worth looking into the underlying causes.
Even if your child isn’t diagnosed with bipolar disorder, any mental health symptoms that disrupt their daily life require attention from a professional. Without proper help, these symptoms can get worse and continue affecting their life for several years. Getting help early on can make a huge difference in your child’s well-being.
Red flags that require immediate help
If you spot any of the below signs from your child or teen, call your healthcare provider immediately:
- Extreme depression, anxiety, fear, or anger directed at themselves or others
- Withdrawing from friends
- Excessive sleeping
- Refusal to eat
- Feeling out of control or overwhelmed by emotions
- Hearing voices or seeing things that others don’t
- Unable to sleep or eat for three days or more
- Shows behavior that alarms friends, family, or teachers.
If your child or teen has thoughts of harming themselves or others, or if they have a plan and the means to follow through, contact the National Suicide Prevention Lifeline immediately by calling or texting 988. This free service connects you to trained crisis counselors 24/7. You can also visit the Lifeline online chat at www.suicidepreventionlifeline.org or call 800-273-TALK (800-273-8255).
Get support for bipolar disorder
Bipolar disorder is a serious mental health condition, but with the right support and treatment, children and teens can manage their symptoms and lead fulfilling lives. If you think your child or teen may be experiencing signs of bipolar disorder, don’t hesitate to reach out to the team at BestMind Behavioral Health for an evaluation.
Our experienced professionals are here to guide your family through every step of the process, with compassionate care, personalized treatment plans, and ongoing support to help your child improve their mental well-being. Early intervention can make a significant difference – contact us today.
