Bipolar Disorder in Children and Teens - What Happens

SYMPTOMS & TREATMENTS

Often the first signs of bipolar disorder are severe moodiness, unhappiness, or other symptoms of depression. It is common for children with bipolar disorder to be diagnosed first with only depression and then later to be diagnosed with bipolar disorder.

A first manic or hypomanic episode can be triggered by a stressful situation or by certain medicines, or it may occur without an obvious cause.

Children with bipolar disorder may:

  • Have trouble getting going in the morning but then have intense energy later in the day.
  • Miss school often or talk about running away from home.
  • Become socially isolated and overly sensitive to any kind of rejection or criticism.
  • Behave irresponsibly, take risks and not think about the consequences, or have trouble making and keeping friends.

Young children

Children may have severe, seizure-like temper tantrums when they are told "no." A bipolar child may kick, bite, hit, and make hateful comments, including threats and curses. During tantrums, which may last for hours, a child may destroy property or become increasingly violent.

Young children with bipolar disorder may have more extreme happy or silly moods than most children have.

Teens

Manic behavior by a teen with bipolar disorder may result in such problems as:

  • Suspension from school.
  • Arrest as a result of fighting or drug use.
  • An unwanted pregnancy.
  • A sexually transmitted infection (STI) from unsafe sexual behavior.

During depressive episodes, a teen may do poorly in school and may stop participating in activities he or she enjoyed in the past, such as a sports team.

Watch for warning signs of suicide, which can include preoccupation with death or suicide or a recent breakup of a relationship.

Substance abuse is common. Your child's doctor may recommend an evaluation for both substance abuse problems and bipolar disorder if your child appears to suffer from either condition.

Treating other conditions

Sometimes treatment for other conditions can make your child's bipolar disorder worse. For example:

  • Treating depression with antidepressants can trigger a manic episode or make one worse.
  • Treating attention deficit hyperactivity disorder (ADHD) with stimulants may also trigger severe mania, depression, and even psychosis (loss of touch with reality).
  • Treatment with corticosteroids for conditions such as asthma may also trigger a manic or depressive episode.

Medicines that intensify bipolar symptoms may need to be stopped or changed to a different dose or medicine. Sometimes an additional medicine (such as a mood stabilizer) can solve the problem. But each child responds to medicines differently. And it may take several tries before your doctor can identify an effective medicine or combination of medicines for your child's conditions.

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