The Roller Coaster World of Children with Bipolar Disorder

Children with bipolar disorder live in a roller coaster world. One minute, they reach the highest high and the next they crash to the lowest low. Mood swings make school and home life unpredictable for children, parents and teachers. Bipolar disorder in children shares symptoms of, and may occur with, other problems such as attention deficit and hyperactivity disorder (ADHD). No specific lab tests or scans make diagnosis clear and misdiagnosis can be dangerous since receiving the wrong treatment can worsen bipolar symptoms and delay the right treatment. Bipolar patients have a greater risk for suicide and for obesity, heart disease, diabetes, and other disease. Bipolar disease is managed with drug therapy and talk therapy. A strong support group is vital to a good prognosis.

Bipolar Disorder Symptoms Can Begin Very, Very Early

Symptoms of bipolar disorder can occur early. Parents may notice that something is wrong from birth. A baby may be very difficult to calm and may sleep only rarely. A baby may suffer extreme anxiety when separated from parents and over-react to environmental stimulus such as light, noise, or even touch.

Young bipolar children are hyperactive and restless and have problems paying attention and focusing. They are prone to violent, prolonged temper outbursts, especially when parents tell them "no."

Early bipolar disease may manifest first as depression, followed by roller coaster highs and lows typical of bipolar disorder. Children with bipolar disorder may be extremely gloomy one minute and inappropriately happy the next. Mood swings in bipolar children are much more rapid than in adults. They may cycle between bipolar mania and bipolar depression many times during a day and may have episodes that include both mania and depression.

Bipolar Disorder in Children Affects School and Home Life

Since depression and mania alternate during the bipolar child's day, disruptions in school and home life are inevitable. During times of bipolar mania, they may talk fast and attention may flit from one thing to another. Problems with attention make learning difficult. During bipolar depression, they move very slowly and they often feel disapproved of or rejected.

Bipolar children may be unusually focused on sex. They may touch themselves or others inappropriately and may use sexually explicit language. Their behavior may make others avoid them.

A bipolar child has difficulty interpreting facial expressions and attaching the correct emotional meaning to words. Misunderstanding intent and meaning of others makes successful social interaction harder. As a result, the bipolar child feels isolated and alone.

Hallucinations, both visual and auditory, can occur during the manic and depressive phases. These imaginings can compel them to do things or seem threatening to them. They may also have irrational beliefs.

Medication used to treat bipolar disorder in children can cause drowsiness, confusion, poor coordination, and tremor. Excessive thirst, urination, and stomach upset may occur. Medication can cause weight gain, adding to feelings of isolation in bipolar children.

Children with bipolar disorder may be more prone to abuse drugs or alcohol in an attempt to blunt the discomfort of bipolar symptoms. They are more likely to disrupt classes or to run away from home.

Bipolar children are apt to take part in risky or dangerous behavior and they may exhibit suicidal tendencies or threaten others.

It is important for parents and teachers to understand that a bipolar child's problems cannot be solved by the traditional kick in the pants. Bipolar disease is a medical problem and the outcome depends on proper understanding and management.

Educated teachers and parents can become integral parts of a vital support system for children with bipolar disorder.

Getting the Right Diagnosis is Difficult but Imperative

Since bipolar disorder in children often coexists with other problems such as ADHD, diagnosis can be difficult. There is no definitive lab test or brain scan. Clinicians must diagnose based on evaluation of mood and energy and behavior and they must rule out other pathology that may be causing symptoms.

If a wrong diagnosis of depression or ADHD is given, the child may receive antidepressants or stimulants. Both of these medications can bring on or worsen bipolar symptoms.

The nightmare of roller coast mood swings can be coped with more effectively with a strong support system in place and when the child is learning coping skills during counseling.

The Right Treatment Makes a Difference

Daniel Kidney was a 12-year-old boy who hanged himself with a belt in his bedroom. His family knew something was wrong and had sought help. He exhibited many of the symptoms mentioned above but was diagnosed with and treated for ADHD. His case was evaluated after his death by David Shaffer, a professor of child psychiatry at Columbia University. Shaffer suspects that Daniel's problem was bipolar disorder. It is believed that the stimulants he was receiving to treat ADHD may have worsened his bipolar disease and may have played a part in his suicide.

Although Daniel's family believed he was depressed, and they asked the doctor about it, they were met with indifference and were told that he needed to be disciplined.

Daniel's mother says "If my husband and I learned one lesson from Daniel's death, it is that parents of children with emotional problems cannot simply leave their treatment to the professionals."

The event that immediately preceded Daniel's suicide was that he was told "no" by his parents when he asked permission to go to a friend's house for a sleepover.

Daniel's story helps to bring to life the symptoms of childhood bipolar disorder and it is a compelling read.

Summary

Bipolar disorder in children may have its beginnings shortly after birth. Increased awareness can help to insure early intervention that may help prevent problems at home and school and help to curb suicidal and other destructive tendencies. Bipolar children, their teachers and schoolmates, and their families face many challenges in dealing with bipolar disease. Recognizing and accepting that there is a problem with a child's manic-depressive behavior is primary.

Daniel Kidney's suicide points to the critical importance of parents' education about the disorder. His tragic death teaches parents to press for answers to questions about problems and behaviors that have not been addressed by a treating physician.

Suicide warning signs include talk about death and dying on the part of bipolar children. Suicide attempts and suicide completions rates are declining in bipolar children, thanks to a heightened awareness of the need for proper diagnosis and thanks to proper use of mood stabilizers and cognitive therapy (counseling).

Though obesity and associated diseases such as heart problems and diabetes are more prominent in bipolar patients, bipolar children who receive and stay on effective treatments, supported by family and friends, can lead full lives with satisfying careers.

According to Science Daily, "With symptoms often starting in early adulthood, bipolar disorder has been thought of traditionally as a lifelong disorder. Now, University of Missouri researchers have found evidence that nearly half of those diagnosed between the ages of 18 and 25 may outgrow the disorder by the time they reach 30." It is unclear how this research would apply to children with bipolar disorder, but its finding seems to indicate that maturing of the brain is instrumental to outgrowing this disease and its perpetual emotional roller coaster ride.

Sources:

No author given. Frequently Asked Questions About Early-Onset Bipolar Disorder. Juvenile Bipolar Research Foundation.

No author given. Providing Hope for Children with Bipolar Disorder and their Families: Teachers. BP Children.

No author given. Lithium Carbonate. Encyclopedia of Mental Disorders.

Sara Fritz. Daniel, 1988-2000: A child's suicide, unending grief and lessons learned. St Petersburg Times.

Anthony Kane. Helping You with your Bipolar Disorder Child. Add ADHD Advances.

No author given. Bipolar Disorder: Prognosis. New York Times.

No author given. What are Good Career Choices for those with Bipolar Disorder? Livestrong.

No author given. Young Adults May Outgrow Bipolar Disorder. Science Daily.