NAMI NORTH CAROLINA

BIPOLAR DISORDER IN CHILDREN & ADOLESCENTS: FACT SHEET

Fairly common characteristics of childhood-onset

Unusual sleeping patterns.
Intense emotions that change rapidly.
Extreme difficulty sharing; extreme difficulty losing.
Organizational difficulties.
Rapid change from energetic to lethargic and vice-versa.
Strong bodily sensations – perhaps of pain, heat, noise, odors, or touch.
Insists on certain foods; hypersensitive to food texture.
Strong craving for sugar and other carbohydrates.
Intrusive thoughts and/or nightmares involving blood and gore.
Groggy, hard-to-awaken in morning.
Overactive as evening progresses. Difficulty going to sleep.
Problems with short-term memory.
Flooding with many thoughts all at once, or “racing” thoughts.
Extreme talkativeness.
Wants a toy intensely, then doesn’t play with it, wants to throw it out or return it to the store as soon as it is acquired. (insatiability).

· Argues with adults. Tells adults how to do things. Assumes he/she can do anything an adult does (drive car, use credit cards, rearrange living room, etc.) (grandiosity)

Can’t keep friends – bossy, argumentative.
Bouts of silliness or goofiness.
Provokes others. Tries to orchestrate the lives of the entire family.
Hallucinations, delusions. Sexual thoughts or behaviors.
Intrudes into others’ space or belongings.
Suicidal thoughts, gestures, or attempts.
Charming, creative, miserable.

Quote from Philadelphia Inquirer, March 15, 2003, “As Barbara Geller, professor of psychiatry at Washington University's School of Medicine in St. Louis, points out, ‘a child who is bipolar can have the best parents in the world, but that won't keep him from outrageous behavior like stripping down naked in church.’” -- from “All that's clear is the pain”, by Gloria Hochman www.philly.com/mld/inquirer/5376931.htm.

Differences between AD(H)D and Bipolar Disorder

Both may have tantrums, but –

AD(H)D tantrum results from overstimulation, whereas
Bipolar tantrum results from frustration or limit-setting (being told “no,” for example).
AD(H)D tantrums are over fairly quickly, whereas

o Bipolar tantrums may last for hours and involve more destruction.

Both may break things, but –

AD(H)D destructiveness is often accidental, due to impulsivity, whereas
Bipolar destructiveness is often intentional.

Both may annoy, but – AD(H)D children annoy unintentionally, whereas children with bipolar are more likely to intentionally annoy others.

Descriptions of Bipolar by Children – “A volcano in my chest.” “I want to jump out of my skin.” “I feel rage like a bolt of lightning.” “My thoughts need a stop sign.”

Treatment – most effective combines medication with therapy.

Medications – Mood stabilizers, anticonvulsants*, neuroleptics.

Mood stabilizers: Lithium (Lithobid, Eskalith), Depakote*, Tegretol*, Neurontin*,Topamax*, Gabitril*, Trileptal*, among others.

Neuroleptics (“atypical antipsychotics”): Zyprexa, Risperdal, Seroquel, among others.

Therapy: Emphasizing bodily sensations first.

Education about bipolar disorder and how it is impacting the child’s life.

Re-integration of opposites (depression-mania, good child-bad child,etc.)

Coping strategies, Management strategies.

Famous People with Bipolar Disorder : Sir Isaac Newton (childhood-onset), Winston Churchill (statesman), Charles Dickens (writer - teen-onset or earlier), Patty Duke (actress). Tony Dow (Beaver’s older brother, Wally), Dick Cavett (talk show host), Vivian Leigh (actress), Buzz Aldrin (astronaut), Virginia Woolf (onset age 13), Ben Bradley (editor, Washington Post), Margot Kidder (teen onset), Jonathan Winters (comedian), Edgar Allan Poe (writer, poet), Ludwig van Beethoven (composer), Robert Schumann (composer), Leo Tolstoy (writer) … and many others (see http://www.nami.org/helpline/peoplew.htm)

Different Behaviors at school and at home: Often it sounds like parents and teachers are describing two different children. Teachers describe a charming, capable student, while parents describe an oppositional, raging kid. Both descriptions are accurate. These kids very often are groggy in the morning, progress to normal arousal during school hours, and then progress to mania during late afternoon and evening hours – when parents are trying to get them to do homework! Kids are highly motivated to “hold it together” in school to avoid embarrassment in front of peers. While they may appear capable at school, kids with this level of impairment can handle only about 2/3 the volume of school work as typically developing kids, and may need to complete any homework by late afternoon. (See Teaching the Tiger, A Handbook for Individuals Involved in the Education of Students with Attention Deficit Disorders, Tourette Syndrome or Obsessive-Compulsive Disorder by Marilyn P. Dornbush and Sheryl K. Pruitt, Hope Press. 1995.)

A Terrific Video: Day for Night: Recognizing Teenage Depression, a look into depression as told through teenage testimonies, intended for use in schools, offers an in-depth look at the signs, symptoms and treatment of teenage depression. It includes interviews with teens who experienced clinical depression and/or bipolar disorders. The video, which costs $60, is available by calling 410-955-4647. Produced by Johns Hopkins University.

Two Helpful Books –

The Bipolar Child: The Definitive and Reassuring Guide to Childhood's Most Misunderstood Disorder (Revised and Expanded Edition) by Demitri, F., M.D. Papolos, Janice Papolos ISBN: 0767912853. The most-used reference by parents. Authoritative, comprehensive, compassionate, realistic.

Survival Strategies for Parenting Children with Bipolar Disorder: Innovative parenting and counseling techniques for helping children with bipolar disorder and the conditions that may occur with it, by George T. Lynn, practical, day-to-day strategies by a parent and counselor. ISBN: 1853029211.

Super websites: www.nami.org NAMI. Click on “Children and Adolescents.”

www.cabf.org - Child and Adolescent Bipolar Foundation. Everything you need!

www.bipolarchild.com - Demitri and Janice Papolos’ site. Great e-newsletter.