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Bipolar Disorder In Kids

Depressive Symptoms

  • Frequent sadness or crying.
  • Withdrawal from friends and activities.

  • Decreased energy level, lack of enthusiasm, or motivation.

  • Feelings of worthlessness or excessive guilt.

  • Extreme sensitivity to rejection or failure.

  • Major changes in habits such as oversleeping or overeating.

  • Frequent physical complaints such as headaches and stomachaches.

  • Recurring thoughts of death, suicide, or self-destructive behavior.

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 the hospital."

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 bipolar disorder.)

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