Bipolar Disorder

A growing number of children and teens are being diagnosed with bipolar disorder. Mental illnesses present differently in younger people than in adults, and research clearly shows that younger brains do not respond to treatments in the same ways as adults. We know now that children and adolescents physically and mentally are not just mini-adults. This makes the need for accurate diagnosis and appropriate treatments for mental health illnesses very important.

How do I know if my child has bipolar disorder?
Pediatric bipolar disorder is a debilitating mental illness that causes significant disruption for the child and his or her family. In many cases, other family members also have been diagnosed with or experienced symptoms of bipolar disorder. Parents should watch for symptoms of the disorder that can alert them to the need for specialized interventions.

Children with bipolar disorder may express the disorder in slightly different ways, but most children will experience a combination of the following:

• Rapid, wide mood swings. Their mood may vary from overly happy to very sad several times in a day and seemingly without warning.
• Irritability. Regardless of current mood, they almost always are irritable and "touchy" with the smallest things affecting their emotional state.
• Euphoria. They experience such an expansive mood at times that they are excessively silly and giddy, to such an extent that it is odd or annoying to those around them.
• Decreased need for sleep. Often their sleep may be abbreviated with an apparent inability or lack of desire to sleep but accompanied by no loss of energy during the day.
• Increased energy or activities. They often are excessively hyperactive, despite not seeming to need much sleep, and at times this hyperactivity may be uncontrollable or even result in the child engaging in dangerous behaviors.
• Rapid, pressured speech. Their speech can become extremely fast and expansive, with frequent tangents such that it is difficult to follow and at times impossible to interrupt.
• Inflated self-esteem. They may experience periods of time when they seem to truly believe they are bigger, stronger, smarter or better than others, perhaps even to an extent that seems very irrational.

Children with bipolar disorder can successfully be treated and significant improvements can be made in their behavior and development. However, it is important the illness is accurately diagnosed, as early as possible, and treated appropriately. If inaccurately diagnosed or treated, symptoms could potentially worsen or the child may experience unnecessary barriers to his or her social, emotional and cognitive development.

If you know a child who is experiencing symptoms of bipolar disorder, seek psychiatric consultation or ask your primary care physician how to find psychiatric support.

Jennifer Niskala Apps, PhD, is a pediatric neuropsychologist at the Children's Hospital of Wisconsin Child and Adolescent Psychiatry and Behavioral Medicine Center. Dr. Apps also is an associate professor of Psychiatry and Behavioral Medicine at The Medical College of Wisconsin.