Severe mood swings and bursts of rage are two hallmark symptoms of child and adolescent bipolar disorder. Please see the sections below for more information about these difficulties, as well as to learn about the best-supported treatment options.
What is Bipolar Disorder?
Bipolar Disorder (BPD), formerly known as "Manic Depression", is characterized by extreme changes in mood that range from depressive "lows" to manic "highs" (typified by feelings of excessive happiness or rage). It is important to note that these moods exceed normal responses to life events, represent a change from the individual's normal functioning, and cause problems in daily activities --- for instance, in getting along with family, friends and teachers, or in completing schoolwork.
Depressive symptoms of BPD often include sadness, irritability, an inability to enjoy one's usual activities, changes in appetite or weight, and/or sleeping more than normal or having difficulty falling/staying asleep even when tired. For a more comprehensive description of common symptoms of depression, or if a child or adolescent's experience of these difficulties does not include the manic symptoms listed below click here.
Manic symptoms of BPD may include the following: inflated or unrealistic self-esteem; needing less sleep than normal and still feeling energetic; talking more/faster than normal; changing the topic of conversation so quickly/often that it interferes with communication; feeling that one's thoughts are "racing"; increased distractibility; difficulty sitting still; an unusual drive to engage in activities or pursue goals (e.g., excessive cleaning, making clearly unrealistic plans); and engaging in risky or dangerous behaviors (e.g., riding a bike on the highway; inappropriate sexual behaviors).
Identifying BPD in youth is challenging. While adults with BPD often have distinct periods of depression and mania that last for weeks, months, or longer, youth with BPD frequently have depressive and manic symptoms that occur daily, sometimes even simultaneously. As co-occurring disorders are common, determining what symptoms are signs of BPD and which are due to other disorders (e.g., depression, ADHD, disruptive behavior problems) is critical.
As can be seen below, family therapy currently has the most research evidence for the treatment of children and adolescents with bipolar disorder.
Child & Adolescent BPD
Sources: Fristad, M.A., Verducci, J.S., Walters, K., & Young, M.E. (2009). Impact of multifamily psychoeducational psychotherapy in treating children aged 8 to 12 years with mood disorders. Archives of General Psychiatry, 66(9), 1013-1021.
Goldstein, T.R., Axelson, D.A., Birmaher, B., & Brent, D.A. (2007). Dialectical behavior therapy for adolescents with bipolar disorder: A 1-year open trial. Journal of the American Academy of Child and Adolescent Psychiatry, 46(7), 820-830.
Miklowitz, D.J., Axelson, D.A., Birmaher, B., George, E.L., Taylor, D.W., Schneck, C.D., Beresford, C.A., Dickinson, L.M., Craighead, W.E., & Brent, D.A. (2008). Family-focused treatment for adolescents with bipolar disorder: Results of a 2-year randomized trial. Archives of General Psychiatry, 65(9), 1053-1061.
West, A.E., Jacobs, R.H., Westerholm, R., Lee, A., Carbray, J., Heidenreich, J., & Pavuluri, M.N. (2009). Child and family-focused cognitive behavioral therapy for pediatric bipolar disorder: Pilot study of group treatment format. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 18(3), 239-246.
Young, M.E. & Fristad, M.A. (2007). Evidence based treatments for bipolar disorder in children and adolescents. Journal of Contemporary Psychotherapy, 37, 157-164.