Like many childhood mental disorders, bipolar can be extremely difficult to properly diagnose. This is because bipolar disorder, which is sometimes called mania or manic depression, can mimic the symptoms of other disorders. Bipolar disorder may present with symptoms similar to conduct disorder or attention-deficit hyperactivity disorder (ADHD).
Also, childhood bipolar disorder can manifest itself very differently from the symptoms we typically see in adults with the condition. In order for the diagnosis of bipolar disorder to be made, the symptoms must be causing the child serious problems at home and school. The child with bipolar disorder will have difficultly functioning normally with family, friends, and schoolmates. Current findings indicate that bipolar disorder in children is much more common than we once thought, and there may be as many children with the condition as adults.
What are the symptoms?
Bipolar disorder characteristically has alternating episodes of mania and depression. Here is what those episodes “look” like. The child will have a significant number (but not necessarily all) of the following symptoms:
Depression:
- Distracted and unable to focus.
- Weight loss or weight gain that seems abnormal.
- Lack of energy, lethargic.
- Can’t sleep, or can’t wake easily.
- Suicidal thoughts, either obvious or subtle. “I wish I were never born,” or “I want to run away,” etc.
- Activities that were once enjoyed are now abandoned.
- Guilt which seems displaced or overwhelming. “I’m sure it’s my fault.” etc.
- Seems strangely interested in death and dying.
- Is generally in a sad mood.
- Frequently complains of muscle aches, pains, feeling ill, or may be overly focused on body ailments.
Mania:
- Silliness which almost makes the child seem drunk or wired. It feels out of place for the current circumstances.
- “Chatty Kathy.” The child jabbers on and on, seemingly unaware or unconcerned about the listener’s participation in the conversation. Talks quickly and keeps changing the subject. It’s hard to get a word in.
- Boundless energy; restlessness, fidgety.
- May make inappropriate sexual comments or seems obsessed with sexual topics. The child might get attention by flashing private body parts or makes other children uncomfortable by talking about sex.
- Doesn’t seem to be concerned about danger. Engages in risky behavior.
- Giddy or irritable.
- Brags or boasts about herself. The child who previously said she “didn’t deserve to live,” is now queen of the universe. Has an attitude of self-importance.
- The child might be able to stay awake for days without getting sleepy.
- Unlike adults with the disorder who may be euphoric, mania may present as destructive, out-of-control behavior in children.
This sounds like my child! What can I do?
Your son or daughter needs an assessment right away. You might start with a psychological evaluation through the public school system. Speak with your child’s teacher or school administration and request an assessment. Or, visit your child’s pediatrician and insist on an evaluation. A child psychiatrist or psychologist who has experience with bipolar disorder would be ideal.
While you’re waiting for these assessments, make careful notes of the behaviors you’ve observed, how long they last, and what triggers them. It’s very important that you get an accurate diagnosis for your child, because certain drugs prescribed for ADHD may actually worsen symptoms in bipolar disorder. You want to have unbiased, straightforward information for your child’s doctor to work with. Whether or not there’s a family history of bipolar disorder would be significant.
What is the treatment?
The current treatment is a combination of medications which can help lessen the symptoms during manic and depressive episodes. Behavioral therapy is also recommended. However, many studies are underway to find medications and therapies which are more effective. If your child is diagnosed with bipolar disorder, you may want to contact the National Institute of Mental Health to see what studies your child might be able to participate in.
Children with bipolar disorder are eligible for special education, according to the Individuals with Disabilities Education Improvement Act of 2004 (IDEA).
Kristyn Crow is the author of this blog. Visit her website by clicking here. Some links on this blog may have been generated by outside sources are not necessarily endorsed by Kristyn Crow.
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Differentiating ADHD and Bipolar in Children