Supporting children and young people with Bipolar Disorder

What is Bipolar Disorder?

Bipolar Disorder (BD) is a mood disorder where people experience extremely high or low moods. An episode of these extreme mood swings can last for several days, or sometimes for several weeks. Bipolar disorder symptoms usually start to be seen in adolescence between 15 and 19 years of age.

Signs that a child or young person may be affected by Bipolar Disorder

Not all, or any, symptoms of Bipolar Disorder will be present all the time. However, you may be able to pick up on some possible signs and symptoms of Bipolar Disorder early on and seek help if required.

Symptoms of Bipoloar Disorder include a reduced appetite and thoughts of self-harm and difficulties with concentration and decreased energy. People with Bipolar Disorder may also present with extreme mood swings, ranging from a low mood, to manic episodes where we see over-confidence, racing thoughts, sudden increase in activity and excessive talking. During these mood swings we may also see a disturbance in sleep, where a person may have difficulty sleeping during low moods and feel like they hardly need any sleep at all during manic episodes.

It is important to note that these symptoms can overlap with many other disorders, and some of these symptoms may also be present at some points in time without necessarily indicating a diagnosis of Bipolar Disorder. If you suspect that a child or young person may have Bipolar Disorder, it is important to talk to your GP and follow the process to get a proper medical diagnosis. 

Potential issues or common issues parents and carers may have to contend with

The first step in treating Bipolar Disorder is to manage the extreme mood changes. This may be an initial challenge for you as a family to contend with. However, as you learn more about Bipolar Disorder, you will be able to better manage changes in your child or young person’s mood and there are further treatment options available which may be helpful to your family.

Treatments may include the use of anti-psychotic drugs during manic episodes, or drugs such as Lithium may be prescribed to help stabilise a child or young person’s mood. Additionally, individual, group or family psychological therapy may be recommended. Adhering to the treatment may be a challenge for your child and this may cause stress and worry for the entire family.

Children and young people and their families may also have to contend with the stigma surrounding the diagnosis of Bipolar Disorder, use of medication and requiring psychological help. Feelings of isolation and being misunderstood by others may be another issue that families have to face.

How to support a child or young person with Bipolar Disorder

The best way to support a child or young person with Bipolar Disorder is to allow them to be open about their experiences. This can help them to feel supported and accepted. There may be times where, during a manic episode, they may do things that are strange or upsetting to you. Try not to be overly critical or judgemental about these actions but do talk through these calmly once the young person’s mood has stabilised. Try to explain how specific actions made you feel and find ways to address this in future.

When children or young people with Bipolar Disorder share their experience with you, there may be times when they are in a manic episode and see or hear things that you don’t. This may cause confusion and feelings of anger and can be unsettling for everyone involved. It is helpful for you to try and stay calm and let them know you understand the experience feels real to them. Try to focus on these feelings that a young person is having during the experience, rather than trying to confirm the experience or deny it.

It may also be helpful to set up a plan to manage episodes of extreme mood changes ahead of time. This can provide a sense of stability and help everyone to feel more in control of the disorder. This can include setting up and helping young people to keep a routine, including having regular meals and a consistent sleeping pattern. It may also be helpful to include creative or relaxing activities in the plan that you can all enjoy and that can help to stabilise extreme mood swings.

Establish the warning signs and triggers that a young person may have. There are usually a few consistent behaviours that occur before an episode, and it is important to know what these are and to be aware of them. In this way, you can gently let the young person know when you see these behaviours, and you can all work together to get through the episodes. You may also find that certain triggers, such as stress, can lead to an episode. Try to establish these triggers and see how you can help to avoid or manage these.

What to say to schools and colleges

One of the triggers for young people with Bipolar Disorder may be stress, and this may be especially prevalent within the school setting. Therefore, it is important that schools and teachers are aware of the diagnosis and know that some adjustments may be required in order to support your child.

Flexibility in terms of assignments and lesson plans may be needed in order to lessen stress and allow the young person to complete tasks. It may be helpful to break larger assignments down into smaller, more manageable subsections.

A consistent schedule with frequent, planned breaks may be helpful to support a child or young person’s self-esteem and help them stay positive during school tasks. It may also be particularly helpful to minimise distractions in the classroom as these may disrupt their schedule causing additional stress and feelings of failure. It is therefore very important that there is open, consistent communication between families, schools and colleges, and teachers in order to know what the signs and triggers of an episode may be, and what to do to manage this within the classroom.

What to say to siblings

It is important for siblings to be a part of the discussions around Bipolar Disorder. Siblings should be made aware of what Bipolar Disorder is, how to help manage it, and made aware of any signs or triggers that may cause an episode so they can be aware of this and help to manage it.

It is important for siblings to know how to react when an episode occurs. Explain to siblings that it is best to remain calm, and to wait until the episode has passed and the young person’s mood has stabilised to discuss anything that caused distress. Trying to “rationalise” behaviours during an episode may only worsen the situation.

It is normal for siblings to sometimes feel overwhelmed, stressed and unsure of how to help manage Bipolar Disorder. Allow for an open conversation where they can express the effect of Bipolar Disorder on them as well. In this way, the entire family can be better equipped to manage both Bipolar Disorder and any tensions between the family.

What to say to extended family

It is important for extended family members to know that the extreme mood swings associated with Bipolar Disorder are not always present. With proper treatment, these mood swings can be managed and stabilised.

By showing patience, and realising that Bipolar Disorder is a lifelong diagnosis, extended family members can help support children and young people. It may also be helpful to learn about the disorder, and for extended family members to be understanding of the difficulties that people, especially children and young people, may face.

Acceptance is very important in supporting children and young people with Bipolar Disorder. This includes open communication about the disorder and stress that may be associated with it, as well as having everyone know their limits in dealing with the complexities of the disorder. 

Additional support for parents and carers

The following organisations offer specific support for Bipolar Disorder:

• Bipolar UK - information for family and friends

• Helpguide - advice and guidance