More threads by David Baxter PhD

David Baxter PhD

Late Founder
Child and Adolescent Bipolar Disorder: An Update from the National Institute of Mental Health
February 5, 2003

Bipolar disorder, also called manic-depressive illness, can occur in children and adolescents. Bipolar disorder is difficult to recognize and diagnose in youth, however, because it does not fit precisely the symptom criteria established for adults, and because its symptoms can resemble or co-occur with those of other common childhood-onset mental disorders. In addition, symptoms of bipolar disorder may be initially mistaken for normal emotions and behaviors of children and adolescents. But unlike normal mood changes, bipolar disorder significantly impairs functioning in school, with peers, and at home with family....

Symptoms and Diagnosis
Bipolar disorder is a serious mental illness characterized by recurrent episodes of depression, mania, and/or mixed symptom states. These episodes cause unusual and extreme shifts in mood, energy, and behavior that interfere significantly with normal, healthy functioning.

Manic symptoms include:

o Severe changes in mood — either extremely irritable or overly silly and elated
o Overly-inflated self-esteem; grandiosity
o Increased energy
o Decreased need for sleep — ability to go with very little or no sleep for days without tiring
o Increased talking — talks too much, too fast; changes topics too quickly; cannot be interrupted
o Distractibility — attention moves constantly from one thing to the next
o Hypersexuality — increased sexual thoughts, feelings, or behaviors; use of explicit sexual language
o Increased goal-directed activity or physical agitation
o Disregard of risk — excessive involvement in risky behaviors or activities

Depressive symptoms include:

o Persistent sad or irritable mood
o Loss of interest in activities once enjoyed
o Significant change in appetite or body weight
o Difficulty sleeping or oversleeping
o Physical agitation or slowing
o Loss of energy
o Feelings of worthlessness or inappropriate guilt
o Difficulty concentrating
o Recurrent thoughts of death or suicide

Symptoms of mania and depression in children and adolescents may manifest themselves through a variety of different behaviors. When manic, children and adolescents, in contrast to adults, are more likely to be irritable and prone to destructive outbursts than to be elated or euphoric. When depressed, there may be many physical complaints such as headaches, muscle aches, stomachaches or tiredness, frequent absences from school or poor performance in school, talk of or efforts to run away from home, irritability, complaining, unexplained crying, social isolation, poor communication, and extreme sensitivity to rejection or failure. Other manifestations of manic and depressive states may include alcohol or substance abuse and difficulty with relationships...

Once the diagnosis of bipolar disorder is made, the treatment of children and adolescents is based mainly on experience with adults, since as yet there is very limited data on the efficacy and safety of mood stabilizing medications in youth. The essential treatment for this disorder in adults involves the use of appropriate doses of mood stabilizers, most typically lithium and/or valproate, which are often very effective for controlling mania and preventing recurrences of manic and depressive episodes. Research on the effectiveness of these and other medications in children and adolescents with bipolar disorder is ongoing. In addition, studies are investigating various forms of psychotherapy, including cognitive-behavioral therapy, to complement medication treatment for this illness in young people...


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Wow, does this ever fit my 11 year old who is going to be seen very shortly by a child psychologist.

Ever since He was very young he was different from my other children. More happy to be a loner. Easily agitated, angers easily, has always threatened to run away from even when He was as young as 4 or 5, to which I had always informed him that he was not old enought to run away yet. And sadly his dad is an agitator. Once he knows that something anoys he will continue to do this.

I had always thought that given enough love by me that he would out grow this, however wishing he was not born and anxious to have his life over speaches have greatly increased over the past year. I just hope I did not do him more harm then good by thinking that mom can heal all.

I do have a concern regarding medications though. I'm not thrilled about the few that are mentioned previously in your post.

David Baxter PhD

Late Founder
Hello, momof5:

I'm happy to hear that you have already scheduled an appointment for your son - when it comes to issues like this one, accurate diagnosis is crucial.

In the meantime, I would encourage you to resist jumping to conclusions about bipolar disorder, though - while there seems to be little doubt that your son is not a happy child, there are other possibilities which could explain the symptoms you describe. Many of these would be treated with some sort of psychotherapy rather than medication.

Even if your child does indeed meet the criteria for bipolar disorder, depending on the degree or severity of symptoms medications may not be indicated. One thing that is worth trying even in advance of seeing the psychologist or determining the correct diagnosis is the use of omega 3 and 6 essential fatty acids (EFAs) or what is sometimes referred to as "fish oils" - at first glance that may sound rather disgusting but there are some good natural sources of the omega EFAs in various foods such as fish, flax seed, other whole grains, etc. There have been several research reports in recent years on success in using such dietary changes or supplements in treating depression, anxiety disorders, and bipolar disorder, either as an adjunct to medications or even instead of medications.


Actually the fish oil is not that disgusting, for others. I have some here that I am supposed to take, however i have an imense dislike for fish, and when I take them I tend to burp fish, ewwww big time!

He loves fish. During the summer i tend to cook salmon on the grill frequently. And he loves tuna for lunch.

Here we basically follow a low carb low fat diet most of the time.

He did have blood work etc.. done, and all turned out fine with all of this. No abnormalities showed up in any of the lab work. One of my concerns was thyroid as that runs on the paternal side of my family. I at one time had half of mine removed. Thankfully that was not an issue with him.

Thank you for your reply.
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