The Substance Abuse and Mental Health Services Administration's National Mental Health Information Center notes that in the United States, about 750,000 children have bipolar disorder. This mood disorder causes patients to cycle between lows and highs, or depression and mania. The right treatment can help patients manage their symptoms and function normally.
Indications for Treatment
People with bipolar disorder swing between two phases of their illness: depression and mania. When depressed, patients can become sad, irritable or feel worthless. The Child and Adolescent Bipolar Foundation points out that depressed children may have a hard time concentrating, which can lead to a drop in academic performance. Other signs can include a lack of energy, social withdrawal, or suicidal thoughts and behaviors. When patients become manic, they have surge of energy, becoming more talkative. Poor judgment can occur. Some patients may participate in risky behaviors, such as doing daredevil acts. Other symptoms of mania can include racing thoughts, irritability and hallucinations.
Diagnosis Controversy
The Diagnostic and Statistical Manual of Mental Disorders contains only diagnostic criteria for adult-onset bipolar disorder, not childhood-onset bipolar disorder. The idea that bipolar disorder starts during childhood remains a controversial topic. Anne Duffy, author of a 2007 review article published in "The Canadian Journal of Psychiatry" notes that bipolar disorder first manifests during adolescence rather than childhood. Duffy notes that young children labeled as bipolar may have another disorder. The Child and Adolescent Bipolar Foundation points out that disorders that mimic the symptoms of bipolar disorder include ADHD, depression, generalized anxiety disorder, pervasive developmental disorder and conduct disorder.
Goals
The Child and Adolescent Bipolar Foundation explains that when coming up with a treatment plan, the doctor and parents should keep certain goals in mind. For example, the treatment plan needs to control the dangerous symptoms of bipolar disorder, such as suicide or risky behaviors. The treatment should also stabilize the patient's mood, which can help her function at school, home and with friends. When choosing a medication, the doctor will try to choose one that causes the fewest side effects.
Types
The National Alliance on Mental Illness notes that lithium, a medication that helps with both mania and depression, can treat children ages 12 and 17. Other medication options are antipsychotics, which mainly control the mania symptoms. One antipsychotic, olanzapine, can treat children between the ages of 13 and 17. Children between the ages of 10 and 17 can take risperidone, quetiapine or aripipazole.
Psychotherapy is another option, with or without medication. Therapists can help patients manage their symptoms, such as developing coping mechanisms for depression. If the patient participates in risky behaviors when in the manic phase, the therapist can help her change her behavior by recognizing her triggers. The National Institute of Mental Health points out that psychotherapy may include other family members, to help them cope.
Considerations
The Child and Adolescent Bipolar Foundation points out that certain factors can influence the outcome of the treatment. For example, children who have an early diagnosis have a better treatment outlook. A good support network and keeping to the treatment plan can also improve the treatment outcome. However, children who experience traumatic life events may have a harder time coping with bipolar disorder. Not following the treatment plan and having another disorder, such as substance abuse, can lead to more negative outcomes.
References
- Substance Abuse and Mental Health Services Administration's National Mental Health Information Center: Children's Mental Health Facts -- Bipolar Disorder
- Child and Adolescent Bipolar Foundation: About Pediatric Bipolar Disorder
- National Alliance on Mental Illness: Facts About Childhood-Onset Bipolar Disorder
- National Institute on Mental Health: Bipolar Disorder in Children and Teens
- "Canadian Journal of Psychiatry"; Does Bipolar Disorder Exist in Children? A Selected Review; Anne Duffy; July 2007
