Frequently Asked Questions
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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.
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.