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    Bipolar Disorder In Kids

    Manic Symptoms

    • Severe changes in mood -- from unusually happy or silly to irritable, angry, or aggressive.
    • Unrealistic highs in self-esteem. May feel indestructible or believe they can fly, for example.

    • Great increase in energy level. Can go without sleep for days without being tired.

    • Excessive involvement in multiple projects and activities. May move from one thing to the next and become easily distracted.

    • Increase in talking. Talks too much, too fast, changes topics too quickly, and cannot be interrupted. This may be accompanied by racing thoughts or feeling pressured to keep talking.

    • Risk-taking behavior such as abusing drugs and alcohol, attempting daredevil stunts, being sexually active, or having unprotected sex.

    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."

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