Bipolar disorder in children and young people:
information for parents, carers, young people and anyone
who works with them
About this leaflet
This is one in a series of leaflets for parents, teachers and young
people entitled Mental Health and Growing Up. These aim to
provide practical, up-to-date information about mental health
problems (emotional, behavioural and psychiatric disorders) that
can affect children and young people. This factsheet gives
some information about the symptoms and effects of bipolar disorder
and gives some practical advice on how to get help for this
problem.
Introduction
What is
bipolar disorder?
Bipolar disorder is a condition in which a
young person has extreme changes of mood - periods of being
unusually happy (known as mania or hypomania), and periods of being
unusually sad (depression). It is sometimes called manic
depressive disorder or bipolar mood
disorder.
The mood-swings are way beyond what would
be considered 'normal' for a particular individual, and are out of
keeping with their usual behaviour.
How common is bipolar disorder?
What causes it?
Although the causes are not fully understood, bipolar disorder
tends to run in families. Episodes can be triggered by physical
illness, stressful events or lack of sleep.
What are the
symptoms?
In bipolar disorder, a person can have:
- manic or hypomanic periods (or episodes) which can come on
quite rapidly and last for one week or longer;
- depressive periods lasting at least 2 weeks;
- mixed periods of the above.
Young people are likely to experience periods of highs and lows,
with 'normal' times in between which can last for weeks or months.
For some people, the cycles may be more rapid with few or no
periods of stability between episodes.
Hypomania is a milder form of mania (less severe and for shorter
periods). However, if left untreated, it can become more severe,
and may be followed by an episode of depression.
Below is a list of the symptoms which the
young person might have in each episode. The young person needs to
have at least one manic or hypomanic episode to be diagnosed with
bipolar disorder. If there is just one symptom then it is unlikely
to be bipolar disorder.
Symptoms during manic episodes include:
- feeling incredibly happy or 'high' in mood, uncontrolled
excitement
- irritability
- very rapid speech with lots of changes of topics
- racing thoughts
- increased activity and restlessness
- difficulty in concentrating
- constant changes in plans
- unreal ideas about themselves or their abilities
- not looking after themselves
- very sociable or over-familiar
- unusually talkative
- overspending of money or other types of 'reckless' or extreme
behaviour, including sexual promiscuity, excessive drinking or
taking illegal drugs.
At the extreme end, some people may also develop something
called psychosis.
Symptoms during a depressive episode include:
- feeling very sad
- little energy
- lack of interest in most activities
- unable to concentrate
- lack of appetite
- disturbed sleep
- not enjoying anything
- thoughts of suicide and self-harm.
Symptoms during mixed episode include:
- the young person may experience manic and depressive symptoms
at the same time.
What effects can it have?
The exaggeration of thoughts, feelings and
behaviour affects many areas of the young person's life. For
example, it can:
- lead to problems in relationships with friends and family
- interfere with concentration at school or work
- involve behaviour that places the young person's health or life
at risk
- bring about a loss of confidence and a loss of the sense of
control the young person feels over their life.
The longer the bipolar disorder continues without
treatment, the more harmful it is likely to be for the young person
and their family.
Where can I get help?
The first step towards getting help is to recognise that there
might be a problem. Seeking medical advice early on is very
important.
Effective treatments
The goal of treatment is to improve the symptoms, prevent the
illness from returning and help the young person lead a 'normal'
life.
Medication
Medication usually plays an important role in the treatment of
symptoms and 'prevention' of bipolar disorder, especially if the
episodes are severe.
The choice of medication can depend upon the type of episode
(manic or depressed). Everyone is different, and so the type of
medication that is recommended may also be different.
As with all medications, there can be side-effects. The specialist
can advise you on this and should provide information about the
medication they are recommending. The risk of side-effects needs to
be balanced against the risk of the damaging effects of the illness
on a person's life.
If the young person has had more than one severe episode of
illness, staying on medication can reduce the risk of further
episodes. Medication may ne needed for months or even years.
No young person should be taking medication unless they are
reviewed by a health professional regularly. This is to monitor the
dose of the drug and to check the side-effects.
- If you are concerned about your child being prescribed
medication, you need to discuss this with your specialist.
- If you are thinking of stopping the medication, you need to
discuss this with your specialist.
It is very important that the young person
with bipolar disorder and their family are helped to understand the
condition, how best to cope and what to do to reduce the chances of
it recurring.
Other treatments, support and help
- It is crucial that the young person and the family get
practical help as well as drug treatment.
- It is very important the the young person with bipolar disorder
and their family are helped to understand how best to cope and what
to do to reduce the chances of another episode.
- You may notice that there are particular 'triggers' to an
episode and/or early warning signs. Being aware of these can reduce
the chance of episodes happening again and allow you to
get help before the episode has got worse.
- Cognitive Behavioural Therapy
(CBT) is a talking therapy that the young person may find
helpful.
- Hospital treatment: some young people may need to go into
hospital for intensive support of the symptoms are severe or if the
young person is putting themselves or other at risk.
Recovery
It is important that the young person recognises that they are
not alone and keep up hope. Some young people only have a few mood
swings and then the problem goes away. For others, it becomes a
life-long pattern which they can learn to live with and
manage.
References
Sources of further
information
© September
2011. Royal College of Psychiatrists.
Reviewed by the Royal College of Psychiatrists' Child and Family
Public Education Editorial Board.
This factsheet may be downloaded, printed out, photocopied and
distributed free of charge as long as the Royal College of
Psychiatrists is properly credited and no profit is gained from its
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from the Head of
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Please note that we are unable to offer advice on individual cases. Please see our FAQ for advice on getting help.
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