Adolescent Bipolar Disorder
Bipolar disorder is a mental disorder characterized by recurrent episodes of depression, mania,
and/or mixed symptom states. These episodes cause unusual and extreme shifts in mood, energy,
and behavior that interfere significantly with normal, healthy functioning.  Mood swings are typically
out of proportion, or totally unrelated, to things going on in the life of the Bipolar child.  These swings
affect thoughts, feelings, physical health, behavior, and functioning.

Researchers are discovering that not only can bipolar disorder begin very early in life, it is much more
common than ever imagined. Yet the illness is often misdiagnosed or overlooked.

Bipolar disorder is difficult to recognize in young people because:

  • it does not fit precisely the symptom criteria established for adults
  • symptoms can resemble or co-occur with those of other common childhood-onset mental
    disorders
  • symptoms may be mistaken for normal emotions and behaviors of children and adolescents

As a result, Bipolar children may be given any number of psychiatric labels (e.g., ADHD, Oppositional
Defiant Disorder, Conduct Disorder, Obsessive Compulsive Disorder, Separation Anxiety Disorder,
etc.). Too often they are treated with stimulants or antidepressants -- medications which can actually
worsen the bipolar condition.

Manic symptoms include:

· Severe changes in mood, either extremely irritable or overly silly and elated
· Overly-inflated self-esteem; grandiosity
· Increased energy
· Decreased need for sleep, ability to go with very little or no sleep for days without tiring
· Increased talking, talks too much, too fast; changes topics too quickly; cannot be interrupted
· Distractibility, attention moves constantly from one thing to the next
· Hyper-sexuality, increased sexual thoughts, feelings, or behaviors; use of explicit sexual language
· Increased goal-directed activity or physical agitation
· Disregard of risk, excessive involvement in risky behaviors
or activities

Depressive symptoms include:

· Persistent sad or irritable mood
· Loss of interest in activities once enjoyed
· Significant change in appetite or body weight
· Difficulty sleeping or oversleeping
· Physical agitation or slowing
· Loss of energy
· Feelings of worthlessness or inappropriate guilt
· Difficulty concentrating
· Recurrent thoughts of death or suicide

The brain scan of the hypomanic and depressed phase:
Bipolar kids often find themselves in a negative feedback loop in which behavior generates harsh
rebuke from parents, which can trigger their heightened over-sensitivity.

For example, the Bipolar child begins to feel anxious >>> his anxiety turns to anger >>> his anger is
misdirected toward the parent >>> the parent becomes offended and pursues some form of
punishment >>> the child’s anxiety increases >>> the conflict escalates.

The essential treatment for this disorder involves the use of mood stabilizers, most typically Lithium,
Valproate and Carbamazepine, which are often very effective for controlling mania and preventing
recurrences of manic and depressive episodes. In addition, psychotherapy, including cognitive-
behavioral therapy, may complement medication treatment for this illness in young people.

Parenting techniques that help calm children when they are symptomatic and help prevent and
contain relapses include:

  • relaxation techniques
  • prioritizing battles and letting go of less important matters
  • reducing stress in the home
  • using good listening and communication skills
  • using music and sound, lighting, water, and massage to assist the child with waking, falling
    asleep, and relaxation
  • helping the child prepare for stressful situations by developing coping strategies beforehand
  • engaging the child's creativity through activities that express their gifts and strengths
  • providing routine structure
  • removing objects from the home (or locking them in a safe place) that could be used to harm
    self or others during a rage
  • keeping medications in locked box

Your child can reduce mood swings and stresses that sometimes lead to more severe episodes by
adhering to the following:

  • Go to bed around the same time each night and get up about the same time each morning
  • Make time for some form of meditation or relaxation techniques
  • Do not use alcohol or illicit drugs
  • Be very careful about the use of even small amounts of caffeine, and some over-the-counter
    medications for colds, allergies, or pain
  • Seek support from family and friends