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	Bipolar Additional information about child and adolescent bipolar disorder is available from: National Institute of Mental Health American Academy of Child & Adolescent Psychiatry Child and Adolescent Bipolar Foundation For information on treatments for bipolar disorder that are available through CARE-NET, see Studies.	What is Bipolar Disorder (Manic Depressive)? Symptoms Facts About Bipolar Disorder Treatment What is Bipolar Disorder (Manic Depressive)? Bipolar Disorder, sometimes called manic-depressive illness, is an episodic psychiatric illness the key features of which are severe mood swings from one extreme (mania) to the other extreme (depression) with associated symptoms such as decreased need for sleep, irritability, impulsivity and excessive involvement in potentially harmful behaviors. These mood swings and associated symptoms are not similar to the normal mood changes that any of us may experience from time to time. The person suffering from Bipolar Disorder, while in an acute episode of mania or depression, does not function as usual and impairment occurs in all domains of life, including interpersonal, social, academic, and occupational. Bipolar Disorder symptoms, course, severity, and response to treatment differ from individual to individual. People in a manic state may have an inflated or a grandiose mood and can be vastly overconfident. They are often quite easily distractible, impulsive, and show very poor judgment. There are sometimes psychotic symptoms such as hallucinations, paranoia and delusions. The delusions are often of a grandiose variety - such as when the manic person claims to have special talents or a messianic mission (going to save the world, etc.). Manic symptoms usually begin suddenly, and symptoms increase over a few days. Specific features of Bipolar Disorder may include hypomania (moderate level of symptoms), mixed state (manic and depressive symptoms coexist simultaneously), and rapid cycling (episodes of mania and depression alternate very quickly). back to top Symptoms As previously mentioned, Bipolar Disorder (Bipolar I) is a cyclic psychiatric condition in which the individual afflicted experiences episodes of mania alternating with episodes of depression. A *Manic Episode* is a distinct period during which the individual experiences abnormally elevated and "high", expansive or irritable mood. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), to meet criteria for a diagnoses of Mania, in addition to the expansive or elevated mood, the child/teen must also present with at least three of the additional following symptoms: · inflated self-esteem or grandiosity · decrease need for sleep · pressure of speech · flight of ideas · distractibility · increase involvement in goal-directed activities or psychomotor agitation, · excessive involvement in pleasurable activities with a high potential for negative consequences. If the mood is irritable (rather than elevated or expansive), at least four other symptoms must be present. The disturbance must be severe to the point of causing significant impairment in social or occupational functioning or require hospitalization. According to the Diagnostic and Statistical Manual - IV (DSM-IV), a child with five or more of the above symptoms during the same two-week period may be diagnosed with a *Major Depressive Disorder. back to top Facts About Bipolar Disorder* · Bipolar Disorder tends to be highly genetic: when one parent has bipolar disorder, the risk to each child is 15-30%; when both parents have the disorder, the risk increases to 50-75%. Environmental factors are also influential in determining whether the illness will occur in a particular child. · It is suspected that a significant number of children diagnosed in the United States with attention-deficit disorder with hyperactivity (ADHD) have early-onset bipolar disorder instead of, or along with, ADHD. · According to the American Academy of Child and Adolescent Psychiatry, up to one-third of the 3.4 million children and adolescents with depression in the United States may actually be experiencing the early onset of bipolar disorder. back to top Treatment Medication is the primary treatment for Bipolar Disorder. Because Bipolar Disorder involves the cyclic alternating from one extreme episode to another (Mania and Depression), it is common to use a combination of medications in the treatment of Bipolar Disorder. Often, one medication may be needed to control/prevent the symptoms of mania and additional medication for the treatment of the depressive symptoms. The problems and impairment that occur for the individual with Bipolar Disorder are clearly applicable for therapeutic involvement. Therapeutic sessions may involve dealing with concerns related to taking prescribed medication, understanding, coping and managing with the illness as well as dealing with issues related to problem solving and relationship difficulties. In summary, there are beneficial outcomes usually achieved by simultaneously reducing symptoms with the medication and promoting learning and coping through psychotherapy. back to top