Does your child's mood swings often? This could be due to Bipolar Disorder.

Does your child seem very happy and playful one moment, and then suddenly start yelling and screaming for no reason? Or does he just stay in his room and act sad for no reason? As a parent, you might think, "What about these kids?" But sometimes, these extreme mood swings can be more than just a simple tantrum. Today, we're talking about a condition called Bipolar Disorder in children.

Simply put, what is bipolar disorder?

Bipolar disorder is a lifelong mental health condition that causes extreme changes in a person's mood, energy levels, thoughts, and behavior. It was previously called 'manic-depressive illness'.

Think of it like riding a roller coaster. One moment you feel so high, so happy, so full of energy. Another moment you feel so low, so sad, so helpless. This is what happens with bipolar disorder. There are two main stages:

• Mania: This is a period of extreme mood elevation. During this time, the person feels high energy and happiness. Sometimes, a mild episode called hypomania can also occur.
• Depression: This is the time when the mood is at its lowest, and the mind is filled with sadness. During this time, you lose interest in anything and feel very sad.

How does this affect children more than adults?

In adults with bipolar disorder, these episodes of mania and depression are clearly distinguishable and last for a week or more. But this is different in children and young adults .

Children's mood swings are very rapid. They can go through several of these mood swings in a single day. Imagine, in the morning they are very happy and joking, in the afternoon they get angry and yell at the smallest thing, and in the evening they start crying for no reason. Such rapid changes can be seen in children.

This is very different from the mood swings that are common in childhood. In bipolar disorder, these mood swings are more extreme, often for no apparent reason . They can also be caused by:

• Change in sleep pattern.
• Changes in the body's energy level.
• Difficulty concentrating and thinking clearly.

These symptoms can make it difficult for a child to do well in school, get along well with friends, and have difficulty interacting with family. Some children may even attempt to harm themselves or commit suicide.

What are the symptoms seen in the child?

When a child has bipolar disorder, they show different symptoms during both periods of mania and depression. Some children may experience mixed episodes. Let's break down what these symptoms are.

Why do children have this condition?

No one specific reason has been found for this, but there are a few key things that scientists believe.

• Genetics: The main reason for this is the genetic influence that comes from heredity. More than two-thirds of people with bipolar disorder have a close family member with the condition. However, just because one family member had it does not mean that everyone will develop it.
• Brain changes: Some children experience certain changes in the structure and function of their brain.
• Trauma and stress: Experiencing severe, stressful events, such as the death of a family member or severe abuse, can also cause this condition to develop in a child with a genetic predisposition.

How do you know for sure if this is bipolar disorder?

This is the hardest and most important thing to do, because the symptoms of bipolar disorder are similar to those of several other mental health conditions that are common in children. For example:

• Attention problems (ADHD - Attention-Deficit/Hyperactivity Disorder)
• Anxiety Disorders
• Major Depression

Therefore, this diagnosis must be made by a trained, experienced physician, especially a psychiatrist.

When you take your child to a doctor, he or she will do these things:

• Physical examination of the child.
• Asking and learning in detail about the child's behavior and symptoms from you, the child, and perhaps even the child's teachers.
• Doing things like blood tests to make sure there are no other medical conditions.
• Conducting a complete mental health evaluation.

How is it treated?

Bipolar disorder is a lifelong condition. That means treatment is needed throughout life. A successful treatment plan usually includes a combination of the following:

Medications

The main treatment for this condition is medication. The doctor will assess the child's condition and prescribe mood stabilizers and other antipsychotics. It is extremely important to give the child the medication prescribed by the doctor, in the correct dosage, at the correct time.

Psychotherapy

This treatment is as important as the medication. It provides the child and family with an understanding of the condition and how to live with it.

• Family-focused therapy (FFT): Here, the child and parents participate together. They are taught about the illness, how to improve communication between each other, and how to solve problems.
• Chronotherapy: This helps the child establish a consistent, regular sleep pattern.
• Interpersonal and Social Rhythm Therapy (IPSRT): Helps manage mood by managing the child's daily routine, social relationships, and biological rhythms.

Side effects of medications and things to watch out for

Like any medication, medications for bipolar disorder can have side effects. Weight gain, drowsiness, and restlessness are common. Talk to your doctor about these and be well-informed.

Children taking the drug lithium should be especially careful. Lithium toxicity can occur anytime a child's sodium (salt) levels are low (e.g., excessive sweating, vomiting, diarrhea, fever).

If your child shows any of these symptoms, immediately take them to the nearest hospital's Emergency Department (ETU) or inform your doctor.

• Blurred vision or double vision
• Irregular heartbeat (beating too fast or too slow)
• Difficulty breathing
• Severe confusion and dizziness
• Severe tremors or seizures
• Uncontrolled eye movement

If you need advice in such a situation, you can also call the National Poison Information Centre located at the Colombo National Hospital .

How can you as a parent help your child?

Caring for a child with this condition is a big challenge for parents, but your support is invaluable to the child.

• Be patient: It takes time to find the right treatment plan and for your child to improve. So be patient.
• Listen to your child: Encourage your child to talk about their feelings. Be a good listener.
• Maintain a consistent routine: Especially consistent bedtimes and wake-up times. This helps a lot with mood regulation.
• Pay attention to your child's mood: Keep a record of changes in your child's behavior. This will help the doctor decide on treatment.
• Explain the importance of treatment: Teach your child that treatment can improve their life. Encourage your child to take their medication correctly and participate in treatment.
• Take care of yourself: This journey is very tiring. So think about your mental health as well. Seek counseling and support if necessary.

When should you seek emergency medical help?

If your child shows any of the following behaviors, immediately take him to the Emergency Department (ETU) of the nearest hospital.

• If you are talking or thinking about death or suicide.
• If you are thinking or planning to harm yourself or others.
• If you are experiencing conditions such as seeing or hearing things that are not there (hallucinations and delusions).
• If you are showing the symptoms of lithium toxicity mentioned above.

Bipolar disorder, children's mental health, mood swings, mania, depression, mental illness, treatment for children