Diagnosing and Treatment a Child or Adolescent with Bipolar Disorder

Bipolar disorder puts on a different mask when it afflicts a child or an adolescent. Children and teenagers have immature mood systems to start with; kids are, by definition, less emotionally regulated than adults, so determining bipolar patterns is very challenging. Children and adolescents may experience more mixed episodes with co-occurring depression and mania, or they may have more background noise consisting of irritability and explosiveness. In addition to the cycles of mood episodes. A child´s mood episodes are often briefer than an adult´s.

Because bipolar disorder often manifests itself differently in children and adolescents than it does in adults, the diagnosis can be much more difficult to make. Some symptoms can be similar to symptoms of other mental illnesses, such as unipolar depression, ADD (Attention Deficit Disorder), or ODD (Oppositional Defiant Disorder). Furthermore, the child or adolescent may have two or more comorbid (co-existing) conditions--for example, bipolar disorder and ADD. Bipolar disorder in children and adolescents commonly presents itself with the following symptoms:

• Extended periods of sadness or irritability.
• Extended periods of silliness/dizziness or raging anger.
• Periods of high activity levels and/or racing thoughts or pressured speech (the need to talk constantly)
• Exaggerated emotional sensitivity- huge emotional responses to little things.
• Significant changes in sleep patterns and energy levels.
• A cyclic quality to the mood and behavior changes clasically seen over a period of days to weeks rather than moment to moment.
• Noticeable increase in risk taking and pleasure seeking.
• Noticeable increase in withdrawal, isolation, or dropping activities.
• History of difficult temperament in infancy/toddler periods.
• Grandiose thinking ""I am great at everything" or I am better than everyone.
• Night terrors/sleep problems during early childhood
• Suicidal thoughts or self-injury.
• Violence or threats to harm others.
• Decline in function at school, home, or with friends.

Accurately diagnosis is the most critical step in helping a child or adolescent with bipolar disorder. Too often, a child or adolescent with bipolar disorder is misdiagnosed with ADD or depression, and doctors place the children on medications that can worsen the course of the illness.

Source: Bipolar Disorder, Candida Fink, MD, Joe Kraynak