Bipolar disorder is a brain disorder characterized by extreme changes in mood, irritability, and energy. Researchers estimate that about 1 percent of children meet the criteria for the disorder and that it usually begins in late adolescence and early adulthood, says Ron Steingard, M.D., associate medical director of the Child Mind Institute in New York City, and a prominent expert on bipolar disorder in children.
There are two types of bipolar disorder:
Dr. Steingard emphasizes that all children experience mood swings, sleeplessness, and irritability from time to time. In order to be diagnosed as bipolar disorder, however, the symptoms must be persistent, they must be very different from a child's typical behavior, and they must appear in multiple settings. "They don't come and go," he says. "And if you're seeing them in school, you're also seeing them at home."
Researchers are unsure of the exact causes of bipolar disorder. But they do know there's a strong familial component. "Family history is the greatest predictor for the onset of this disorder in children and adolescents," says Dr. Steingard.
But that's not the only cause -- nor does every child with a bipolar parent or sibling develop the disorder. Abnormalities in brain function and structure may also be a factor. Some experts also believe that major life stress can trigger bipolar disorder in those who are genetically predisposed.
"Early recognition and careful management and treatment are very important for children with bipolar disorder," says Dr. Steingard. If you're concerned about your child, he recommends an evaluation by a mental-health provider with experience in diagnosing and treating bipolar disorder.
The disorder is typically treated with medication. "With other mental health conditions, I'm often advocating for behavioral intervention or behavioral intervention with medication," says Dr. Steingard, "but this is one condition where I support early treatment with medication." Often a mood stabilizer such as lithium is prescribed, sometimes in combination with other drugs. Cognitive behavioral therapy and family therapy may also be used to help the child, parents, and siblings understand and cope with the disorder.
The goal of treatment, he says, is to first reduce symptoms and then to move on to maintenance and prevention of future symptoms. Some children who are treated go into full remission, and others see a decrease in the frequency and severity of symptoms.
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