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- Understanding bipolar disorder
- What is bipolar disorder?
- The basics of bipolar disorder
- What causes bipolar disorder?
- How can we identify bipolar disorder?
- How is bipolar disorder diagnosed?
- How is bipolar disorder being treated?
- How can we help our child manage it?
- Self-care matters
- Mental health services
Understanding bipolar disorder
It is normal for our child to undergo mood swings as they grow and develop. However, when these mood shifts become more intense and begin to significantly affect their daily routines, it may be a sign that our child is experiencing bipolar disorder.
Although it can be difficult and confusing to navigate our child’s mood swings, it is important for us to recognise and differentiate normal shifts in mood from extreme ones. By identifying the signs of bipolar disorder early, we can help our child understand and manage the intense emotions they may experience.
Read on to learn more about bipolar disorder and how we, as parents or caregivers, can help our child manage it better.
What is bipolar disorder?
Bipolar disorder is a mental health condition that causes one to have recurring and
extreme mood episodes.
These can be either:
Depressive
When our child noticeably
and
persistently sad
Manic/Hypomanic
When our child noticeably and
persistently happy or irritable
These mood episodes, unlike our typical responses to everyday situations and stresses, can be quite unpredictable, sometimes stretching on for days, weeks, or even longer. They can create significant challenges, often affecting relationships and day-to-day life.
How does it affect us?
Depending on the type of episode our child experiences, they may have to deal with different kinds of intense and extreme emotions.
- Euphoric (immense joy)
- Unusually energetic
- Agitated
- An inflated sense of self-esteem
- Sad
- Hopeless
- Loss of interest in most activities
Between the two extremes, younger individuals are more likely to experience manic/hypomanic
episodes, or a mix of both types of episodes.
Since these states can have a major impact on our child’s quality of sleep, energy, judgment, and
behaviour, social situations or day-to-day life may become challenging for them. In severe cases, it
may even lead to serious consequences such as self-harm or suicide, or other risk-taking behaviours.
However, even in the most challenging times, we can help our child find healthier ways to deal with
their struggles with the right support and mindset.
Common misconceptions:
Causes
While we still don’t know the exact cause of bipolar disorder, it is usually a combination of genetic, psychological, and environmental factors that leads to someone developing it.
Biological factors Family History
- Having a family history of bipolar disorder increases one’s likelihood of developing it
- While it may run in families, it’s important to know that even when a family member is living with bipolar disorder, chances are most people in the family will not develop it
Biological factors Chemical imbalances in brain
- Having an excess or lack of certain chemicals in the brain, such as serotonin and dopamine, can lead to bipolar disorder
- It may also occur as a side effect of medication or alcohol, resulting in mood disturbances
Psychological and social factors Certain personality traits
Personality traits such as neuroticism, or the tendency to experience negative emotions like worry, anxiety, aggressiveness, and impulsivity are associated with bipolar disorder.
Psychological and social factors Traumatic or stressful life events
- Traumatic childhood experiences can increase tendencies of developing bipolar disorder
- Triggers from stressful life events, such as the death of a loved one, problems with friends, or academic stress, can also contribute to our child developing bipolar disorder
- The lack of a support system can worsen the effect of these triggers
Signs and symptoms
Manic episodes
During a manic episode, our child may feel a mixture of:
- Distinct, abnormal, and persistent periods of elevated or irritable mood
- An unusual increase in goal-directed activities or energy (e.g. being intensely focused working on a project all night until the point of sacrificing sleep)
- An inflated sense of self-esteem
- A reduced need for sleep
- Talking excessively on a variety of topics
- Racing thoughts
- Short attention span
- Risky or reckless behaviours with negative consequences such as truancy, playing dangerous pranks, and alcohol/drug abuse
These symptoms can last for 1 week or longer, and become severe enough to affect daily activities (e.g. our child’s ability to go to school), and in some cases, even require hospitalisation.
Depressive episodes
During a depressive episode, our child may struggle with a mixture of:
- Persistent sadness
- Loss of interest in activities previously enjoyed
- Restlessness or agitation
- An increase or decrease in appetite or weight
- Physical symptoms (e.g. stomachaches or headaches)
- Insomnia or excessive sleep
- Fatigue
- Difficulties concentrating
- Feelings of worthlessness or guilt
- Sensitivity to rejection
- Recurring thoughts of death
These symptoms can last 2 weeks or longer, and become severe enough to affect daily activities.
Diagnosis
Healthcare professionals may conduct several different assessments to check if one has bipolar disorder.
Our child may also be asked to record their daily mood, sleep, or other behaviours that may help reach a diagnosis in the form of a mood diary. We can actively support our child with this by helping them identify their moods, especially if they are younger.
Treatment
Although the effects of bipolar disorder can be overwhelming, it can be effectively treated with
medication, counselling, and brain stimulation therapies. This will depend on the symptoms,
age, general health, and severity of the condition. During the course of the treatment, a team
of dedicated healthcare professionals can be counted on to provide support.
This may include a:
Medical doctor specialising in mental health conditions (i.e. a psychiatrist)
Psychologist
Social worker
Occupational therapist
Case manager
Pharmacist
Nurse
If you are concerned that your child may be experiencing extreme emotional fluctuations, you can speak with a teacher or school counsellor. They will be able to help your child access counselling or therapy.
Healthcare professionals may prescribe certain medications to help treat bipolar disorder. We may incorrectly assume that our child can skip their medication when experiencing mania to prolong their elevated moods. However, it is important that they follow their full medication plan prescribed by their healthcare professionals. This helps us to properly treat and manage their symptoms.
Medications
- 1 or more medications may be used to help balance extreme emotions
- These may include mood stabilisers, antipsychotic medications, antidepressants, or anti-anxiety medications
- These medications are not known to be addictive
Duration
- Medications may be prescribed for 6 months or longer, depending on the pattern and severity of the disorder
- While it may take 1-2 weeks or longer for changes to occur, improvements may be noticed earlier such as in our child’s quality of sleep
- Even after feeling better, long-term medication therapy may be required to prevent more episodes from recurring
- Based on our child’s needs, the healthcare professionals will help adjust medications accordingly
Side effects
- Just as with other medications, it’s normal to experience some mild side effects
- These may include nausea, stomach discomfort, dizziness, drowsiness, dry mouth, and constipation
- Normally, the effects will go away on its own over time and there is no need to worry
Other points to note
- The healthcare professionals will advise on any diet adjustments (though there is usually no need for it)
It is normal if our child feels nervous or overwhelmed by the medications or its side effects. During such times, we can help by providing them with reassurance and support.
However, as parents or caregivers, it is important to ensure that our child follows the prescribed medication plan (even when not manic or depressed) in order to properly treat and manage their bipolar disorder.
If you have any concerns, you can reach out to the healthcare professionals for support. If you would like to stop medication therapy for your child, you should discuss with the healthcare professionals so that they may advise you on the best course of action.
In addition to medications, healthcare professionals may recommend counselling, psychological therapy, family therapy, or working with our child’s school. This can help to provide support, information, and guidance for us and our child. It can also help our child better manage their emotions and reduce the probability of these mood episodes recurring in the future.
During therapy sessions professionals will show us how to:
- Identify triggers for episodes
- Develop healthy coping strategies
- Take medications as prescribed
- Solve interpersonal problems
- Maintain regular daily routines
- Enhance communication skills
- Manage negative emotions effectively
Therapy sessions may be conducted individually (one-on-one) or in groups.
In individual therapy, our child can acquire valuable skills to effectively manage their symptoms. For instance, they can learn helpful techniques such as relaxation techniques.
In parallel, family therapy equips parents or caregivers with the skills to provide support and assist children in managing their symptoms. For instance, we can play an important role in ensuring that our child takes their medications as prescribed and be more aware of their triggers and changes in mood.
Through these therapies, our child will also learn how to better manage their symptoms while we learn how to better support them.
If our child’s bipolar disorder does not respond well to medications, or they are unable to tolerate prescribed medications due to side effects, healthcare professionals may recommend a course of brain stimulation therapy. This may come in the form of electroconvulsive therapy (ECT) or transcranial magnetic stimulation (TMS).
In ECT, a person’s brain is treated with small controlled electrical currents over a brief period. It is a safe and effective treatment for both manic and depressive episodes.
On the other hand, in TMS, the neural circuits in the brain are stimulated using magnetic fields to help regulate mood during depressive episodes. TMS is only used for youth aged 18 years old and above.
How can we help our child manage it?
As parents or caregivers, there are several ways we can support our child as they manage bipolar disorder.
Help them cope with
stress and triggers
Be supportive and patient
Keep track of and accompany
them to appointments
Support them in their treatment plan
Pay attention to their signs and symptoms
Be aware of suicidal symptoms
Join a support network
Self-care matters
Taking care of our child as they manage bipolar disorder can take a toll on our physical and mental well-being. It’s ok to take some time to recharge ourselves as well, especially if we’re also juggling personal life demands.
Practising and prioritising self-care will put us in a ready state to provide our child with the support they will need. So don’t feel guilty if we need to rest or attend to our own needs as it will help us take better care of them in the long run.
Learn more tips on coping with stress and managing our emotions to keep our body and mind healthy.
