The first thing to do is get a full psychiatric evaluation. This is, of course, what we do at the CHAMP clinic, and what many specialty clinics do across the country: provide a thorough interview assessment to establish whether a child or adolescent has bipolar disorder or has a condition we consider to be along the bipolar spectrum. This usually requires talking at some length to the child, the parent(s), and sometimes other family members who know the child's history.
To be bipolar, a child or teen must have had at least one manic episode, with several days or more of elated and/or irritable mood, grandiose thinking (also called inflated self-esteem), increases in activity, decreases in sleep, increased energy, talking fast, and doing impulsive things, which might include getting in fights, having indiscriminant sex or talking inappropriately about sex, spending a lot of money, or driving recklessly.
Usually, but not always, kids with bipolar disorder have periods of depression, which means feeling very sad, losing interest in friends or activities, thinking about suicide or making suicide attempts, feeling very tired, feeling guilty and negative about oneself, and either having trouble sleeping or sleeping too much.
These episodes often last a few weeks each. Other kids have very short episodes of only a few days. Of course, having symptoms like this almost always disrupts a child's functioning at home or at school.
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