Bipolar disorder in children and adolescents (manic-depressive illness)

[Tracie Lynn]

In bipolar disorder (formerly called manic-depressive illness), periods of intense elation and excitation (mania) alternate with periods of depression and despair. Mood may be normal in between these periods.

Children may rapidly go from being excited, happy, and active to being depressed, withdrawn, and sluggish or full of rage and violent.
Doctors base the diagnosis on symptoms and results of psychiatric tests.
The diagnosis of bipolar disorder in young children is very controversial.
Treatment may include mood-stabilizing drugs to treat mania, antidepressants to treat depression, and psychotherapy.

Children normally have fairly rapid mood swings, going from happy and active to glum and withdrawn. These swings rarely indicate a mental health disorder. Bipolar disorder is far more severe than these normal mood changes, and the moods last much longer, often for weeks or months.
Bipolar disorder is rare in children. In the past, bipolar disorder was often diagnosed when young children (aged 4 to 11 years) became intensely irritable many times a day. Such children are now thought to have a disruptive mood dysregulation disorder instead.
Bipolar disorder typically begins during mid-adolescence or early adulthood. Bipolar disorder in adolescents is similar to bipolar disorder in adults.
The cause is unknown, but a tendency to develop bipolar disorder can be inherited. Chemical abnormalities in the brain may be involved. In children with the disorder, stress may trigger an episode. Also, certain other disorders, such as overactive thyroid gland or attention-deficit/hyperactivity disorder (ADHD), can cause some similar symptoms. Certain drugs and toxins in the environment (such as lead) can cause similar symptoms.
Recent research also indicates that there is an increased risk of developing certain psychotic disorders (namely, bipolar disorder and schizophrenia) among adolescents who use cannabis products. This increased risk is not explained by genetic factors. There is concern that the recent legalization of marijuana may give adolescents (and their parents) a false sense of security about using this drug.