Bipolar Disorder

In order to diagnose BPB in children and adolescents, a Mania or Hypomania episode must definitely be present. Mania/hypomania findings can be summarized as abnormally and persistently elevated or irritable mood, increased self-confidence and grandiosity, claiming unrealistic abilities in children, decreased need for sleep (feeling energetic despite 3-4 hours of sleep), increased talkativeness, flight of ideas, distractibility, increase in goal-directed activity, and excessive participation in risky behaviors.

Depressive symptoms include depressive mood or irritability lasting two weeks or longer, anhedonia, inability to enjoy activities, changes in sleep and appetite, loss of energy and feeling tired, worthlessness, excessive feelings of guilt, inability to concentrate, and suicidal thoughts. To make the diagnosis, at least one manic or hypomanic period must be present. For a manic period, symptoms must last at least 7 days; for a hypomanic period, at least 4 days. Diagnosing in children can be difficult. Because many of the symptoms can also be seen in other psychiatric conditions such as ADHD, oppositional defiant disorder, major depression, disruptive mood dysregulation disorder, borderline personality pattern, and trauma-related disorders.

Risk factors include the presence of BPB diagnosis in family members, prenatal and perinatal complications, early childhood trauma and abuse, serious life stressors, sleep-wake disorders, and substance use.

After the diagnosis of BPB is made, the first choice in acute treatment in children and adolescents is medications called atypical antipsychotics (risperidone, aripiprazole, olanzapine, quetiapine). The second-line medication groups that can be given are Valproate and Lithium. Psychoeducation, teaching communication skills, problem-solving skills training, ensuring sleep hygiene, mood monitoring, behavioral activation, and creating social routines are other necessary interventions to be carried out during the treatment process.

Protective factors for BPB can be summarized as having a regular sleep-wake rhythm, early diagnosis and treatment arrangement, providing good psychoeducation, teaching stress management skills, avoiding substance use, having appropriate social support systems such as school and friend circles, and teaching regular physical activity and healthy lifestyle.