How is Childhood-Onset Bipolar Disorder Treated?

A. Pasbjerg

Treatment of childhood-onset bipolar disorder typically needs to be approached using several techniques. Medication is generally the most critical part of treatment, both to stabilize the child's mood and address any psychotic issues and other conditions which may accompany the bipolar. Psychotherapy is then often used to help the child cope with daily stressors and other issues precipitated by his or her disease. It is also usually important to engage the child's educators to ensure the school environment is supportive so he or she can learn.

Medication and therapy are common treatments for child-onset bipolar disorder.
Medication and therapy are common treatments for child-onset bipolar disorder.

In order to regulate the rapid mood cycling associated with childhood-onset bipolar disorder, most children with the disease require some type of medication. Some of the standard, most common drugs used for this purpose include lithium, divalproex sodium, and carbamazepine. There are also newer drugs such as gabapentin, lamotrigine, and topirimate which may help stabilize mood as well.

Having childhood-onset bipolar disorder makes learning difficult for many patients.
Having childhood-onset bipolar disorder makes learning difficult for many patients.

Often those with childhood-onset bipolar disorder experience psychotic features, anxiety, and sleep problems, and they may have other psychiatric conditions as well. Separate medications may be necessary to address these issues. Antipsychotic medications used in children include risperidone, olanzapine, and thioridazine. Clonazepam and lorezapam can help address sleep and anxiety issues in these patients. Some common conditions that accompany bipolar include attention deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder; each of these disorders may require specific drugs to treat them as well.

Psychotherapy is another form of treatment often used for childhood-onset bipolar disorder. These children often have trouble coping with stressful situations, which can trigger episodes of mood swings. Many times they have difficulties with interpersonal relationships, become frustrated very easily, or have trouble controlling anxiety or anger. They are also often impulsive and tend to be oppositional, which can lead them to engage in risky behaviors. Therapy can help address these issues and teach children techniques to deal with situations more appropriately.

Having childhood-onset bipolar disorder makes learning difficult for a majority of patients, so it is usually important to work with teachers and other educators as part of treatment to ensure they understand the child's challenges. This is especially important if the disorder is accompanied by learning disabilities, which is common. If the parents are open with educators about their child's limitations, they will be more likely to make special arrangements that can accommodate the child and help him or her learn more effectively.

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