Paediatric Bipolar Disorder: Causes, Symptoms, Risks and Treatment

The mental well-being of children is the need of the hour. However, unlike in the past, the world recognises the importance of identifying the symptoms of mental health issues and treating them. Paediatric bipolar disorder is one such issue, which causes children, and sometimes teenagers, to experience the symptoms of common bipolar disorder.

Do you wish to know more about paediatric bipolar disorder? Find out more about it in this article.

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What Is Paediatric Bipolar Disorder?

Children usually show a variety of emotions and responses, which are often more intense than adults. However, if you notice that your child has rapid mood swings, going through cycles of extreme highs and lows, it might be a matter of concern. Paediatric Bipolar Disorder is a mood disorder and mental health condition seen in children.

How Is Paediatric Bipolar Disorder Different From Bipolar Disorder?

This disorder is different from bipolar disorder, which affects adults. While adults might experience longer and more precise manic episodes, children and teenagers are more likely to exhibit phases of anger, silliness, sudden outbursts and unprovoked crying.

Apart from typical mood swings, children might also experience changes in their sleeping patterns, energy level and concentration abilities. This disorder makes it difficult for them to focus, thereby deteriorating their academic performance.

What Are the Symptoms of Paediatric Bipolar Disorder?

There are two types of symptoms of paediatric bipolar disorder, including manic and depressive episodes. Usually, these are not as clear as bipolar episodes in adults. Instead, you might observe a mix of these in your child. Here are the symptoms of the manic episodes of this disorder.

Common Symptoms of Paediatric Bipolar Disorder

Extremely happy and excited behaviour
Bursts of energy
Overly active
Unusually silly compared to the actual age
Defiant and destructive
Rebelling against rules
Talking too fast
Distracted
Failing to pay attention
Indulging in risky activities
Unhealthy sleep routine
Impatient and restless

Depressive Symptoms of Paediatric Bipolar Disorder

Apart from that, depressive episodes are also common. Here are some of its symptoms.

Lack of interest
Withdrawn behaviour
Frequent crying
Irritable and frustrated behaviour
Unhealthy sleep routine with trouble falling asleep
Extremely sensitive to rejection or failure
Poor academic performance
Unhealthy diet
Negative thoughts and remarks
Suicidal thoughts and tendencies
Headaches and stomach pain
Muscle pain and fatigue

What Are the Causes of Paediatric Bipolar Disorder?

Clinical researchers are unaware of the exact reasons responsible for causing paediatric bipolar disorder. However, based on the case studies so far, they believe that the following factors might contribute to this disorder.

Genetic: Nearly two-thirds of children suffering from this disorder have at least one relative or family member suffering from the condition. This shows that the genetic factor can be strong for this condition. If any of your family members have had bipolar disorder, chances are high that their children might inherit the disorder.
Environment and Events: Another factor responsible for this condition can be the environment where a child grows up. Trauma and stressful life events can have a lasting impact on their minds. Observing abuse and violence in the surroundings can also cause similar problems.
Brain Chemicals: As this disorder directly connects to the mind, clinical researchers also believe brain chemicals might affect this condition. In some cases, the brains of a few children might be more inactive and fail to function appropriately compared to others. This might cause such a disorder.

What Are the Risk Factors of Paediatric Bipolar Disorder?

There might be some factors increasing the risks of paediatric bipolar disorder. Here are some of the common risks.

The rapid development of depression
Family history of mental health issues
Presence of psychotic behaviour
History of abuse and neglect

How to Diagnose Paediatric Bipolar Disorder?

If your child experiences at least one episode of mania or hypomania, you must visit the family physician, who will refer you to a professional psychologist. A psychologist might use a range of diagnostic tools and techniques. These are as follows.

A physical examination to check the physical symptoms
Medical lab tests, including blood tests, to rule out other physical conditions
Mental health evaluation

Moreover, therapists will likely ask detailed questions about

The child’s medical history, including the current symptoms, experiences and family medical records.
Then, based on the psychological evaluation, they might refer you to a specialised psychologist.
Moreover, they might also ask the child's caregivers and teachers to complete questionnaires.

Here, the therapists also rule out the possibilities of oppositional defiant disorder, conduct disorder, ADHD, disruptive mood regulation disorder, etc. However, it is often difficult to differentiate these disorders from paediatric bipolar disorder, as their symptoms often collide.

How to Treat Paediatric Bipolar Disorder?

When it comes to the treatment for paediatric bipolar disorder, psychologists have come up with several options. As bipolar disorder can be a lifelong disorder, the treatment procedure should be a long and critical one. Here are some of the popular treatment methods for this disorder.

Psychotherapy

This type of talk therapy is a commonly used treatment for this disorder among children. It can be a helpful way for therapists to identify troubling emotions, thoughts and behaviours. In addition, psychologists need to question in detail about the conditions of a child from his/her family members, friends, teachers and caregivers. The following types of psychotherapy can be used here.

Family-focused therapy (FFT): This therapy focuses on the caregivers and family members of the patient. It is essential for children, as their relatives might understand their condition better. In addition, therapists learn more about the symptoms by questioning them and also educating them about the disorder.
Chronotherapy: This therapy is beneficial in helping children develop a healthy sleep routine. This is again essential, as this disorder might make it difficult for them to get good sleep. With this therapy, they can improve their mental condition by developing a healthy sleep routine.
Interpersonal and Social Rhythm Therapy (IPSRT): This therapy is beneficial for therapists to identify and understand the biological and social rhythms of children. Based on this, they design strategies to help children improve their mood swings and changes in behaviour. It also helps to manage stressful life events and control disruptions in social rhythms.

Medication

Various medicines can help treat paediatric bipolar disorder. For example, therapists often use mood stabilisers and antipsychotic drugs. While these are usually effective for adults, one can also use them in severe cases of this disorder among children.

It is essential to select medicines carefully. For instance, if the child suffers attention-deficit/hyperactivity disorder (ADHD) along with paediatric bipolar disorder, they will experience more mood swings or manic symptoms. The psychologist will then prescribe medicines accordingly.

Common Mood Stabilisers

Some common mood stabilisers here can be as follows.

Lithium (Eskalith, Lithonate, Lithobid)
Carbamazepine (Tegretol, Equetro)
Divalproex sodium (Depakote)
Lamotrigine (Lamictal)

Other FDA Approved Drugs

Some other FDA-approved drugs include the following.

Lurasidone (Latuda)
Quetiapine (Seroquel)
Olanzapine-fluoxetine combination (Symbyax)

However, while taking the drugs, it is essential to know that they might have some side effects. Therefore, your child must continue the dosage despite these reactions. Stopping them abruptly can be a severe crisis.

Common Side Effects of Drugs

Here are some of the most common side effects.

Metabolic dysregulation, which includes high blood pressure and sugar levels, along with abnormal lipid levels
Fatigue
Dizziness and drowsiness
Weight gain
Akathisia, which is a feeling of restlessness

When to See a Doctor?

Consider seeing a doctor if you notice frequent mood swings and unusual behaviour patterns in your child. Apart from the primary symptoms, watch out for the following signs, making it mandatory to visit the emergency room.

Self-harming thoughts and tendencies
Tendencies to harm others physically
Having hallucinations and delusions frequently
Nausea and vomiting
Hand tremors
Vision change
Confusion

What Are the Common Co-occurring Conditions?

There might be some co-occurring conditions of paediatric bipolar disorder. It is a severe mental health issue that can cause other conditions. Some of these are as follows.

ADHD
Substance use disorders
Disruptive behaviour disorders
Anxiety disorders, such as panic disorder, obsessive-compulsive disorder, posttraumatic stress disorder,
Pervasive developmental disorders

How to Manage and Prevent Paediatric Bipolar Disorder?

Unfortunately, there is no particular method of preventing paediatric bipolar disorder. However, as a parent or relative, you can help your children manage and control the symptoms of this disorder with the following tips.

Provide Treatment and Support

One of the best ways to control the methods is by providing a formal treatment, combining both psychotherapy and medication. In addition, you should encourage your children to open up and talk about their conditions and feelings regularly. They should not be scared to express their problems. Moreover, make sure to let them know that you care about them and their health conditions.

Be Patient

Paediatric Bipolar disorder is a complicated condition. When it occurs in children, the symptoms often get out of control. Therefore, you need to be patient with your kid as a parent. Even if they are violent and aggressive, you need to be calm and handle the situation with a presence of mind. It will be beneficial for reducing the intensity of the triggers.

Identify Mood Shifts

It will be helpful to analyse your child's mood swings and identify a pattern in that. This way, you can understand the common triggers and try to keep your child away from such situations. This will also be beneficial for you to predict the episodes and try to control them. Here, you should stay in touch with the child's friends, tutors and caregivers.

Maintain a Diary

Maintaining a diary will be essential, as the treatment process will be lengthy. You can record the child's treatment, medicines and overall routine. Moreover, you can keep notes of their episodes and behaviour for the doctors to get a better idea. Knowing about the previous tendencies and experiences might help you control the episodes and aggression.

Build a Healthy Routine

A clear and consistent routine can help you improve your child's mental health. They will be able to follow a healthy timetable for their daily duties and maintain a healthy sleep routine. This will help them keep their physical health in check, which will gradually reflect in their mental health.

Provide Stress Management Tips

Adults usually deal with stress more often than kids. Hence, if your kids are suffering from stress due to mental health issues, you can help them by providing stress management tips. Here, relaxation techniques like meditation, deep breathing and music therapy can be helpful. Moreover, you can take them out to divert their minds from stressful situations.

Therefore, paediatric bipolar disorder can be a severe mental health condition affecting children and teenagers. While its symptoms are similar to bipolar disorder in adults, the episodes might be mixed and unclear. Therefore, you must identify the symptoms and ensure the proper treatment of your child, as discussed in this article. The tips mentioned here will help you control the symptoms.

Frequently Asked Questions

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What age does bipolar disorder start in children?

There is no particular age for this disorder. However, children as young as six can develop paediatric bipolar disorder. Older children and teenagers are also at equal risk.

How common is paediatric bipolar disorder?

Fortunately, paediatric bipolar disorder is not highly common. Currently, there is a global community prevalence of PBD of 1.8%.

Can you outgrow childhood bipolar disorder?

As per clinical research, children and teenagers who were diagnosed with paediatric bipolar disorder often outgrow the condition by the time they are about 30 years old.