Bipolar disorder in children and adolescence is beginning to receive the attention it needs. There are now health professionals who specialize in the area but services and support remains patchy and fragmented. For the concerned parent it’s not the most welcome news, but things are improving and child psychiatrists and many pediatricians have the necessary skills to properly recognize, assess, diagnose and treat bipolar disorder in children and young people.
So, why would a parent even think their son or daughter has bipolar disorder? Aren’t emotional ups and downs all part of growing up? It’s true that bipolar disorder isn’t the first thing that most parents associate with mood or behavior problems in their children. But, like ADHD for example, parents are increasingly becoming more aware of the signs and symptoms that constitute psychological distress in children. Of course it isn’t the job of parents to attempt a diagnosis, but they do need to be astute enough to recognize the signs that say help is required. If one or both parents have bipolar, they will almost certainly know the disorder can run in families. In that regard they have an advantage in spotting the signs and seeking early treatment.
Parents may be aware of their child getting over-excited or feeling very down at times. Sometimes it is not until they find themselves being pulled in by the school for yet another discussion over the conduct of their child that alarm bells start to ring. It is not uncommon for children with bipolar to get into trouble for behaving in silly or reckless ways, or for disrupting class, getting into fights, or making poor progress with school work. Some teachers are extremely good at spotting the signs of psychological distress and they may be the first to advise parents that specialist help is required.
Behavior doesn’t happen in isolation. It reflects the mood state of the child and is something that may last a few days or a few weeks. Moods will be consistent, intense and frankly, quite difficult to ignore. With bipolar disorder the child may exhibit signs of mania, depression, or may move from mania to depression.
During a manic episode the child or teen may feel themselves ‘totally wired’. They chatter endlessly about anything and everything but they may have a heightened interest in talking about sex. They feel tired but can’t sleep properly. They have problems concentrating on anything beyond very short periods of time. Behavior can be both silly and risky. Driving too fast, gambling, spending too much money, drinking alcohol or taking drugs are some examples.
During a depressed episode many children complain of somatic symptoms such as headaches, stomach pains, muscular aches and pains and a general sense of feeling unwell. The child looks and feels intensely sad. They may feel a sense of shame or guilt and have little in the way of self-worth. Diet may be affected and time spent sleeping often increases. Lack of motivation and lack of interest in friends or activities is typical. Thoughts about death and suicide may be verbalized and need to be taken seriously.
If your child has any of these symptoms it is time to see the doctor. Don’t be tempted to put off making an appointment in the hope things will pass. They probably won’t and if anything things will get worse because you are delaying treatment. You can help by taking notes of the signs and symptoms you have observed. Definitely seek help quickly if your son or daughter is verbalizing they, “see no point in going on”, or it would be, “better if they checked out”, or anything similar.
The National Institute of Mental Health (NIMH) give four action points for parents or adults who know a child or teen is in crisis. They are:
Do not leave him or her alone.
Call your doctor.
Call 911 or go to the emergency room.
Call a toll-free suicide hotline: 1-800-273-TALK (8225) for the National Suicide Prevention Life-line. The TTY number is 1-800-799-4TTY (4889)
Jerry Kennard, Ph.D., is a chartered psychologist and associate fellow of the British Psychological Society. Jerry’s clinical background is in mental health and, most recently, higher education. He is the author of various self-help books and is co-founder of positivityguides.net.