What can children and adolescents with bipolar disorder expect from treatment?

There is no cure for bipolar disorder, but it can be treated effectively over the long term. You and your child's doctor should keep track of your child's symptoms and treatment effects to decide whether changes to the treatment plan are needed. One way to do this is by creating a mood or daily life chart, where you and the doctor can track your child's moods, treatments, sleep patterns, and life events. The chart can help you track and treat the illness more effectively. Be sure to work closely with your child's treatment providers. Talk openly and frequently with them about treatment choices.

Sometimes a child may switch from one type of bipolar disorder to another. This calls for a change in treatment. In the NIMH-funded Course and Outcome of Bipolar Illness in Youth (COBY) study, researchers found that roughly 30 percent children with BP-NOS later switched to bipolar I or II. Also, roughly 20 percent of children who started out with a diagnosis of bipolar II switched to bipolar I.⁴⁰ Because different medications may be more helpful for one type of symptom than another (manic or depressive), your child may need to change medications or try different treatments if his or her symptoms change.

The COBY study also showed that treatment helped around 70 percent of children with bipolar disorder recover from their most recent episode (either manic or depressive) over the course of about a year and half. However, within the next year or so, symptoms returned in half of the children who recovered. Children with bipolar I or II tended to recover faster than those with BP-NOS, but their symptoms returned more frequently as well.

If your child has other psychiatric illnesses, such as an anxiety disorder, eating disorder, or substance abuse disorder, he or she may be more likely to experience a relapse—especially of depressive symptoms.⁴¹ Scientists are unsure how these co-existing illnesses increase the chance of relapse.

As we work to find ways to better understand and treat the disorder in children, NIMH is also spearheading the Research Domain Criteria (RDoC) Project, which in an ongoing effort to map our current understanding of the brain circuitry that is involved in behavioral and cognitive functioning. By essentially breaking down mental disorders into their component pieces—RDoC aims to add to the knowledge we have gained from more traditional research approaches that focus solely on understanding mental disorders based on symptoms. The hope is that by changing the way we approach mental disorders, RDoC will help us open the door to new targets of preventive and treatment interventions.

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