Children with symptoms of childhood bipolar disorder urgently need to see a mental healthcare professional (usually a psychiatrist) for diagnosis. There are many other conditions that can have some of the same symptoms, such as oppositional defiant disorder, attention deficit hyperactivity disorder and conduct disorder. The child may even have multiple disorders. Only a professional can evaluate the symptoms and make a diagnosis.
Why Parents WorryAfter the diagnosis of childhood bipolar disorder is confirmed, the next issue is treatment. Just as with adults, medications are the first-line therapy for bipolar kids - but many parents have significant worries about giving their children psychiatric medications.
These concerns are legitimate and mostly have to do with side effects. For example, some drugs may worsen symptoms. Many can cause significant weight gain. High blood sugar and metabolic syndrome are possible. In addition, just as with adult bipolar disorder, it can take time and several trials to find the best medication or mix of drugs to help the child. All of these and similar issues can make a parent hesitant to put their child on psychiatric drugs. Some parents are opposed to psychiatric medications in general.
Unfortunately, there aren't many other options at present. Talk therapy alone hasn't been shown to be effective for children with bipolar disorder. Not only is there a basic biochemical problem underlying the illness, but youngsters may not even be able to understand or retain the substance of the therapy - at least, not until after the condition is stabilized by medication. Even older children may be powerless to control what biology forces on them, despite therapy.
Why You Should Consider Medicating Your Bipolar ChildThe fact is, children whose bipolar disorder is left untreated are highly likely to continue to have significant problems as they grow up. Violent behavior in a child can escalate into incidents severe enough to involve law enforcement. There is a higher risk of illegal drug use. These children are more likely to drop out of school and have trouble holding a job. And the danger of suicide is much higher for a child whose bipolar disorder is not treated by medication.
In addition, researchers have found that pediatric-onset bipolar disorder often goes undiagnosed for many years and is more difficult to treat than adult-onset bipolar disorder. One study found that adults who had bipolar symptoms as children and adolescents, but whose treatment was long delayed, had fewer days well - with more depression, more rapid cycling and more episodes overall than patients whose symptoms began in adulthood. In addition, there was a greater risk of anxiety, substance abuse and suicide, along with greater resistance to treatment.
Of course you should be concerned about the side effects of any medication given to your child. Parents need to know what to watch for; both they and the child's doctor need to be vigilant in monitoring side effects and working together in deciding what to do about them.
As mentioned above, you need to be aware, too, that more often than not it will take time to find what works best for your child's bipolar disorder. Yes, the process can be frustrating, but remember always: The goal is to give your child a better quality of life, now and in the future.
Child Psychiatric Workgroup on Bipolar Disorder Treatment Guidelines for Children and Adolescents With Bipolar Disorder. 19 Sept 2004. (PDF)
Leverich, GS et al. The Poor Prognosis of Childhood-Onset Bipolar Disorder. The Journal of Pediatrics. 150:5 May 2007 485-490.
Delayed Treatment Of Childhood-Onset Bipolar Disorder Results In Negative Outcome In Adults. Science Daily. 1 May 2007.