Frequently Asked Questions

Children with bipolar disorder have severe mood swings, from very high and energized (manic) to very low, unmotivated, and lethargic (depressed). High periods may last only a day or two, but for some, the episodes last a month or more. Low periods usually last longer than high periods.

About 1 in every 50 children in the United States has some form of bipolar disorder. It most often affects a person for the first time in adolescence or young adulthood.

Some kids become overly happy and excited or giddy or overly irritable and angry. They may feel like they can do things that no one else can do (grandiosity). They may sleep less than usual or not at all, do many things at once, have more energy, talk faster and express many ideas (some realistic and some unrealis-tic), and be easily distracted. They may do things that are impulsive when manic, like spend a great deal of money unwisely or drive recklessly.

Kids may experience the symptoms of depression at other times, which can include feeling very sad, down, irritable, or anxious, losing interest in people or things, sleeping too much or being unable to sleep, having little or no appetite, having trouble concentrating or making decisions, feeling fatigued or low in energy, moving or talking slowly, feeling very bad or guilty about oneself, or contemplating sui-cide or actually carrying out suicide attempts.

Many children with bipolar illness have “mixed” symptoms, in which they feel manic and depressed at the same time. They may feel (or act) irritable, sped up, “tired but wired,” and unable to sleep; at the same time they may feel worthless, have suicidal thoughts, or may lose interest in everything. Some children alternative rapidly between these different extremes of mood. Diagnosis can be challenging, and often requires extended periods of observation to confirm.

Bipolar disorder affects the child’s ability to relate to others in the family or in the school setting, especially when ill. Most commonly, parents and siblings of the bipolar child complain about the child or teen’s irritability, stubbornness, and impulsive outbursts of rage. Some families complain of a “toxic” atmosphere in the household when their child’s mood is cycling. Your family problems may be most apparent during or just after your child or teen’s episode of mania or depression, but then may improve as he or she gets better. Part of our treatment program at Max Gray CHAMP involves teaching families how to resolve family conflicts through good com-munication and problem solving.

Having bipolar disorder means that the child has dysregulations in the emotional regulation “circuitry” of the brain, especially the amygdala and the prefrontal cortex. Children often inherit these dysregulations from parents or grandparents, even though these relatives may not have the disorder themselves. Children with bipolar disorder are also be affected by life stress or sudden changes in sleep–wake habits.

Children who are admitted into Max Gray CHAMP get a diagnostic evaluation first. This usually means two sessions with a psychologist and one with a psychiatrist. After these sessions, a treatment plan within the clinic is developed, or we will give you a set of referrals for care outside Max Gray CHAMP if we don’t think we can help.

As is true in most clinics in the U.S. that treat bipolar children, a variety of medications are employed to treat the disorder. It is common for mood stabilizing medications such as lithium, Depakote, or Lamictal; or “atypical antipsychotic” medications like Seroquel, Risperdal, Zyprexa, Abilify, or Geodon to be prescribed, though more research is needed to define the safe and optimal use of these agents. Some children also take antide-pressant medications for depression, anxiety, or sleep. Some children require treatment with several of these medications at once. These medications require close monitoring and frequent check-ups of both behavior and possible side effects. If your child has attention deficit hyperactivity disorder (ADHD) as well, s/he may take a stimulant medication.

Children and families also benefit from family educational sessions or support groups. Therapy may help the family to learn more about the disorder, how to prevent relapses, how to monitor moods and sleep–wake cycles, and how to function better in the family and school environment. The Max Gray CHAMP clinic specializes in one type of therapy that has been shown to be effective in pediatric bipolar disorder: family-focused treatment (FFT), which combines education about coping with bipolar disorder, communication enhancement training, and training in problem-solving skills.

Many children with bipolar disorder have recurrences of mood disorder throughout their lifetimes, but there is every reason to be hopeful. With the help of a regular pro-gram of medication, therapy, and support from others, mood dis-order episodes become less frequent and less extreme. With your help, your child may be able to accomplish many of his or her goals for the future. By working closely with children with bipolar disorder and their families, our hope is that the Max Gray CHAMP program will significantly advance our knowledge of effective diagnosis, treatment, and prevention of serious mood disorders in children and adolescents.