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Childhood Bipolar Disorder

Bipolar Spectrum Disorder is rare among children. But for parents who may have concerns about their youngster’s behavior, Dr. Ellen Leibenluft talks about possible warning signs. Dr. Leibenluft is Senior Investigator and Chief of the Bipolar Spectrum Disorder Section at the National Institute of Mental Health.

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Dr. Leibenluft: The important thing to remember about bipolar disorder is that it presents in terms of what are called episodes.  

Announcer:  Dr. Ellen Liebenluft is chief of the NIMH section on bipolar spectrum disorders and the mood and anxiety disorders program. Since coming to the institute in 1989, she has focused on the inner workings of the brain - or brain mechanisms - and how they relate to bipolar disorder in children. Her research has also addressed the question of whether children with impairing irritability should be diagnosed with bipolar disorder…

Dr.  Leibenluft: An important thing to remember is that the vast majority of irritability in children is not bipolar disorder. Bipolar disorder is really relatively rare particularly in children. It happens somewhat more commonly in adolescents because that’s when most people who are going to get bipolar disorder are going to develop it.

Announcer: For parents concerned about their child’s behavior there are warning signs that include sharp mood swings- both highs and lows….

Dr. Leibenluft: First of all if it seems to be particularly extreme. Second of all, if there are problematic behaviors such as substance abuse of various kinds, staying out all night - truancy.  And then related to that, of course, if things are not going as well in school. And if a child who had a normal social life all of the sudden- that’s changed very dramatically in terms of the type of activities they are involved with or whether or not they have friends.   

Announcer:  Dr. Leibenluft’s work involves the use of cognitive neuroscience techniques- in essence, the study of interaction between the brain and behavior. Her work has also led to extraordinary advances in neuroimaging…   

Dr. Leibenluft:  And the research is really growing by  leaps and bounds and we know a tremendous amount more than we use to. Having said that, it is not yet ready to be used for diagnosis. At this point it is still basically a research tool and the best diagnosis is made by a clinician who spends a lot of time with the child, a lot of time with the parents, getting a lot of information and carefully considering things.

Announcer:  But for parents who may still have doubts…

Dr. Leibenluft: It never hurts to consult with someone… to talk to the pediatrician, for example, or even to see a mental health professional.  There’s a difference between going and talking to someone to get an assessment versus actually getting involved in longer range treatment. You may go talk with a mental health professional… and they’ll tell you everything is fine.