Diagnosing bipolar disorder in children and teens is controversial. Most people with the disorder don’t show signs or symptoms until their mid-twenties, so diagnosing someone younger may be preemptive. Adolescents with bipolar disorder also don’t show symptoms in the same way as adults. They tend to express more irritability and heightened mood. Episodes may not last long enough to be considered true mania or even be recognizable as episodes. The diagnosis of a severe mental illness is also something people carry throughout their lives and a mistaken diagnosis can be harmful. However, it’s vital to diagnose those with bipolar disorder correctly and as soon as possible. One reason is that teens and young children are more vulnerable to suicide than others.

Children who have endured family struggles, mistreatment, abuse, exposure to violence, substance use and sexual abuse are up to three times more likely to develop bipolar disorder at a young age than the general population. These are children that need to be monitored closely for any signs that they may be developing a mental illness. If home life is a negative environment, it may be up to adults outside the home, like educators, to watch out for those who are vulnerable.

A research team, led by Flórido Sampaio das Neves Peixoto of ABC School of Medicine in Santo André, Brazil, sought to find trends in suicidal ideation and attempts of young people with bipolar disorder. They looked at 463 articles to determine signs of the disorder in children and risk factors that may lead to thoughts of suicide and suicide attempts or completions.

They found the following factors present in cases of the 20% of youth with bipolar disorder who attempt suicide.

1 Depressed mood
Depression in teens and children is similar to that in adults. There are many symptoms of depression including:

  • Sadness/hopelessness
  • Irritability/hostility
  • Crying
  • Withdrawing from family and friends
  • Lower performance in school
  • Changes in eating or sleeping habits
  • Lack of motivation
  • Fatigue
  • Difficulty concentrating

Being watchful for these symptoms is imperative. Depression greatly increases the likelihood of thoughts of suicide and suicide attempts.

2 Attention deficit
A combination of bipolar disorder and ADHD is common in children at a rate of 60-98%. Symptoms can range from being hyperactive and impulsive to frequent daydreaming and forgetfulness. The researchers from the study found that youths with ADHD and bipolar disorder are more than twice as likely to have thoughts of suicide than those without symptoms.

3 Impulsiveness
The brain does not fully develop until young adulthood, and in those with bipolar disorder there are physical differences in the brain that cause functional impairment. Therefore, the brains of children are still developing in regard to decision making, attention, memory and general cognition and those with bipolar disorder are at a greater disadvantage. They have a limited ability to judge consequences or see beyond the current situation. Combine this with the impulsiveness seen in bipolar disorder and it puts young people at a higher risk of rash decisions like suicide attempts.

4 Substance use
People with bipolar disorder are prone to also have substance use problems at a rate of over 50%. Substance use disorders are not limited to adults, as 16% of youths with bipolar disorder also experience abuse or dependence on drugs or alcohol. Substance use worsens the course of bipolar disorder and may make it harder on children, who then see suicide as an option.

5 Family history of bipolar disorder
Chances of inheriting bipolar disorder are fairly high, more so than other illnesses like major depressive disorder. When a child has a parent with bipolar disorder, the chances for suicidal ideation are 57%. Home life for children who have bipolar disorder and also have a parent who has bipolar disorder may also be more chaotic. Fragile family relationships can also increase the chances of thoughts of suicide or suicide attempts.

 

Children with bipolar disorder are three times as likely to develop suicidal ideation that youths without the disorder. It’s important to recognize these risk factors and be on the lookout for behaviors that indicate someone is in crisis. Doing so can save lives.

 

If you are considering suicide there are steps you can take to help.

  • Call a crisis hotline. They are there 24/7 for support.
  • For the U.S., call or chat online with the National Suicide Prevention Lifeline: 1-800-273-8255
  • Internationally, find a number here: Suicide.org
  • For LGBTQ youth, call The Trevor Project: 1-800-4-U-TREVOR
  • For veterans, call or chat online with the Veterans Crisis Line: 1-800-273-8255
  • Go to the ER. Most are equipped to handle psychological emergencies.
  • Call your doctor. They can give more personal direction and adjust your meds if necessary.
  • Tell someone. If you are unable to get help for yourself, ask someone to do it for you, even if you think they don’t care.

 

 

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Image credit: Logan Prochaska