Bipolar Disorder In Kids
Frequent sadness or crying.
Withdrawal from friends and
Decreased energy level, lack of enthusiasm, or
Feelings of worthlessness or excessive
Extreme sensitivity to rejection or
Major changes in habits such as oversleeping or
Frequent physical complaints such as headaches
Recurring thoughts of death, suicide, or
Many of these symptoms can be indicative of conditions other than bipolar
disorder, but it's important to have the child evaluated to reach the right
diagnosis, says Tim Lesaka, MD, child psychiatrist with The Staunton Clinic in
suburban Pittsburgh. Many cases previously thought to be attention deficit
hyperactive disorder (ADHD) may, in fact, be bipolar disorder, he says.
"With kids with bipolar disorder, it's a matter of extremes," says
Lesaka. "With an ADHD kid, there's a five-minute tantrum and then an
apology. With the bipolar child, it can be eight hours of rage with no apology.
There is an explosiveness ... followed by a super-depression."
Treatment for bipolar disorder -- in kids as well as in adults -- usually
consists of a combination of medications that may include one or more of the
following: mood stabilizer, antipsychotic drug, antidepressant, or antiseizure
drug. Medication does work, Kowatch says, but there's always the problem of
getting kids to stay with the program. "It's a real pain for them," he
says. "The drugs have side effects ... but the alternative is to wind up in
Researchers at Ohio State University are looking into other treatment
options in two new studies, one funded by the National Institute of Mental
Health and the other by the Ohio Department of Mental Health.
The researchers are studying a promising new treatment called
psychoeducation that they believe can help children with early-onset bipolar
disorder and their families.
Though there have been a few studies evaluating medication in children, none
has examined psychosocial treatments, says Mary Fristad, PhD, leader of the
studies and a professor of psychiatry and psychology at Ohio State.
"Medications are vital for helping children with bipolar disorder, but
they can't do everything," says Fristad.
"If you have your first mood disorder as an adult, you have already
learned a lot of coping skills that can help you, such as how to hold a
conversation and how to treat friends," says Fristad. "But when you get
a mood disorder as a child, you often have never had a chance to develop these
interpersonal skills. We help kids 'catch up' with these skills, which in turn
helps them manage their symptoms."
While acknowledging that bipolar disorder in children does indeed exist,
Barry Cohn Markell, PsyD, a licensed clinical psychologist in Park Ridge, Ill.,
adds a note of restraint. "It's talked about more, but it's still very
rare." (According to Kowatch of Cincinnati Children's Hospital Medical
Center, approximately 1% of children in the general population suffer from