Childhood Onset Bipolar Disorders

Once thought to be exclusive to adults, bipolar disorder is now known to affect children as well, some as young as age six. According to the National Alliance on Mental Health, as many as 7 percent of children in the United States suffer from this complex disorder. It's a scary illness for the children afflicted and their families, but help is available, and treatment is often successful.

Misdiagnosis

• Bipolar disorder is often misdiagnosed as attention deficit hyperactivity disorder (ADHD). Irritability and excessive energy are characteristic of both disorders, and because ADHD frequently occurs alongside bipolar disorder, it's important to differentiate between the two. Treating a child for a disorder he doesn't have is, at best, ineffective; at worst, it can be dangerous. Bipolar disorder can also look like oppositional defiant disorder (ODD), with both disorders featuring reckless behavior and periods of moodiness.

Symptoms

• Bipolar disorder can present differently in children than it does in adults. In adults, the things that stand out are the variable highs and lows in mood. This is a symptom of childhood bipolar, but there are other things that can be more visible. A child with bipolar disorder may have severe tantrums, separation anxiety or sexualized behavior inappropriate for his age. He may be quite bossy and think he can do things like flying or reading minds. Night terrors and gruesome nightmares are common in childhood bipolar disorder, and his drawings may reflect that. He may talk nonstop, seem giddy or driven in creative pursuits. He may seem very sad, and even young children with bipolar disorder may have suicidal thoughts.

Who Gets Bipolar Disorder?

• Bipolar disorder affects boys and girls at about the same rate, and it is not limited by race, income, social status or age. Research done by the National Institute of Mental Health suggests a strong hereditary component; if one parent has bipolar disorder, the chances of each child developing it are between 15 and 30 percent. If both parents have the disorder, the risk jumps to between 50 and 75 percent. Sometimes kids develop bipolar disorder and we don't know why.

Finding Help

• Your child's pediatrician is the best place to begin seeking help if you think your child may have bipolar disorder. This doctor knows your child and can refer you to a child psychologist or developmental pediatrician who can assess the situation. Before the first appointment, make sure your child gets plenty of sleep. Make sure she knows that this isn't a doctor that gives shots or will swab her throat or do anything else that might hurt (though you may be referred for blood tests to rule out physical causes for her behavior). It's almost automatic to warn your child to behave when you're going out, but remember that the more the doctor sees of the way she really is, the better the chance of getting the help she needs. Be prepared to answer lots of questions about your child's symptoms and to provide a full medical history, including any psychiatric issues that have been present. The doctor may want to visit with you and your child several times before a diagnosis is made.

Treatment

• A therapist may work with your child to help him learn to manage his symptoms. Family therapy may be suggested, so that everyone understands and can help your child. If medication is prescribed, your child will start on a very low dose and have it increased incrementally if necessary. Be sure to report any side effects to the doctor right away. Bipolar disorder isn't curable, but it is treatable, and the outlook is bright for kids who get help.