How is bipolar disorder treated in kids & teens?

To treat children and teens with bipolar disorder, doctors often rely on information about treating adults, because there haven’t been many studies on treating young people with the illness.

Currently, there is no cure for bipolar disorder. However, treatment with medications, psychotherapy, or both may help people recover from their episodes, and may help to prevent future episodes.

One large study with adults funded by NIMH was the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). This study found that treating adults with medications and intensive psychotherapy for about 9 months helped them get better. These adults got better faster and stayed well longer than adults treated with less intensive psychotherapy for six weeks. Combining medication treatment and psychotherapies may help young people with early-onset bipolar disorder as well. However, children sometimes respond differently to psychiatric medications than adults.

Bipolar disorder treated in kids – with psychotherapy

bipolar disorder treated in kids & teensIn addition to medication, psychotherapy can be an effective treatment for bipolar disorder. When treating bipolar disorder, psychotherapy is usually prescribed in combination with medication. Studies in adults show that it can provide support, education, and guidance to people with bipolar disorder and their families. Psychotherapy may also help children continue taking their medications to stay healthy and prevent relapse.

Some psychotherapy treatments used for bipolar disorder include:

  • Cognitive behavioral therapy, which helps young people with bipolar disorder learn to change harmful or negative thought patterns and behaviors.
  • Family-focused therapy, which includes a child’s family members. It helps enhance family coping strategies, such as recognizing new episodes early and helping their child. This therapy also improves communication and problem-solving.
  • Interpersonal and social rhythm therapy, which helps children and teens with bipolar disorder improve their relationships with others and manage their daily routines. Regular daily routines and sleep schedules may help protect against manic episodes.
  • Psychoeducation, which teaches young people with bipolar disorder about the illness and its treatment. This treatment helps people recognize signs of an impending relapse, allowing them time to seek treatment early, before a full-blown episode occurs. Psychoeducation also may be helpful for family members and caregivers.
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Other types of therapies may be tried as well, or used along with those mentioned above. The number, frequency, and type of psychotherapy sessions should be based on your child’s treatment needs.

A licensed psychologist, social worker, or counselor typically provides these therapies. He or she should work with your child’s doctor to monitor care.

In addition to getting therapy to help reduce symptoms of bipolar disorder, children and teens may also benefit from therapies that address problems at school, work, or in the community. Such therapies may target communication skills, problem-solving skills, or skills for school or work. Other programs, such as those provided by social welfare programs or support and advocacy groups, can help as well.

Some children with bipolar disorder may also have learning disorders or language problems. Your child’s school may need to make accommodations that reduce the stresses of a school day and provide proper support or interventions.

What can children and adolescents with bipolar disorder expect from treatment?

There is no cure for bipolar disorder, but it can be treated effectively over the long term. You and your child’s doctor should keep track of your child’s symptoms and treatment effects to decide whether changes to the treatment plan are needed.

One way to do this is by creating a mood or daily life chart, where you and the doctor can track your child’s moods, treatments, sleep patterns, and life events. The chart can help you track and treat the illness more effectively. (Download a free mood chart blank form here.)

Be sure to work closely with your child’s treatment providers. Talk openly and frequently with them about treatment choices.

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Sometimes a child may switch from one type of bipolar disorder to another. This calls for a change in treatment.

In the NIMH-funded Course and Outcome of Bipolar Illness in Youth (COBY) study, researchers found that roughly 30 percent children with BP-NOS later switched to bipolar I or II. Also, roughly 20 percent of children who started out with a diagnosis of bipolar II switched to bipolar I. Because different medications may be more helpful for one type of symptom than another (manic or depressive), your child may need to change medications or try different treatments if his or her symptoms change.

The COBY study also showed that treatment helped around 70 percent of children with bipolar disorder recover from their most recent episode (either manic or depressive) over the course of about a year and half. However, within the next year or so, symptoms returned in half of the children who recovered. Children with bipolar I or II tended to recover faster than those with BP-NOS, but their symptoms returned more frequently as well.

If your child has other psychiatric illnesses, such as an anxiety disorder, eating disorder, or substance abuse disorder, he or she may be more likely to experience a relapse — especially of depressive symptoms. Scientists are unsure how these co-existing illnesses increase the chance of relapse.

Where can families of children with bipolar disorder get help?

As with other serious illnesses, taking care of a child with bipolar disorder is very hard on the parents, family, and other caregivers. Caregivers often must tend to the medical needs of their child while dealing with how it affects their own health and the health of their other children. The stress that caregivers are under may lead to missed work or lost free time. It can strain relationships with people who do not understand the situation and lead to physical and mental exhaustion.

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Stress from caregiving can make it hard to cope with your child’s bipolar symptoms. One study shows that if a caregiver is under a lot of stress, his or her loved one has more trouble sticking to the treatment plan, which increases the chance for a relapse of symptoms.42 It is important to take care of your own physical and mental health. You may also find it helpful to join a local support group. If your child’s illness prevents you from attending a local support group, try an online support group.

If you are unsure where to go for help, ask your family doctor. Others who can help are listed below.

  • Mental health specialists, such as psychiatrists, psychologists, social workers, or mental health counselors
  • Health maintenance organizations
  • Community mental health centers
  • Hospital psychiatry departments and outpatient clinics
  • Mental health programs at universities or medical schools
  • State hospital outpatient clinics
  • Family services, social agencies, or clergy
  • Peer support groups
  • Private clinics and facilities
  • Employee assistance programs
  • Local medical and/or psychiatric societies.

You can also check the phone book under “mental health,” “health,” “social services,” “hotlines,” or “physicians” for phone numbers and addresses. An emergency room doctor can also provide temporary help and can tell you where and how to get further help.

What if my child is in crisis?

If you think your child is in crisis:

  • Call your doctor
  • Call 911 or go to a hospital emergency room to get immediate help or ask a friend or family member to help you do these things
  • Call the toll-free, 24-hour hotline of the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255); TTY: 1-800-799-4TTY (4889) to talk to a trained counselor
  • Make sure your child is not left alone.

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