Being a parent in and of itself can bring many rewards and many challenges. Bipolar disorder, also known as manic depression, is a medical disorder that impairs the brain’s ability to sustain a calm, steady mood. Adults and children with bipolar disorder experience a variety of intense emotional states, including but not limited to elation, narcissism, grandiosity, explosiveness, irritability, periods of extreme sadness and low energy that they cannot easily control.

Those suffering from bipolar disorder can experience moods that may shift abruptly many times per day, or they may persist for weeks, months, or even years. Mood changes may not be attributable to external stimuli or a direct response to an event or issue. The responses can seem inappropriate to actual circumstances and stresses. Bipolar disorder like many significant mental health disorders is a complex illness that tends to worsen over time if left untreated or if improperly treated.

Without effective treatment, children and other young people with bipolar disorder are at risk for substance abuse, school failure, risky or impulsive acts, escalating deviant behaviors, accidents, incarceration, and suicide. Although there is no cure, the symptoms can be managed with proper treatment, understanding, as well as lifestyle and environmental modifications. For reasons that are not readily understood, bipolar disorder is occurring with growing frequency in both young children and adolescents.

Bipolar disorder may look quite different in young people than it does in adults. Children with bipolar disorder often have mood swings that shift rapidly over hours or even minutes, while adults’ mood swings typically shift over days to weeks. Whereas adults with bipolar disorder generally have discrete periods of depression and discrete periods of mania, children with bipolar disorder are more likely to have moods that are not distinct. Therefore, many mood changes in children are attributed to “normal” developmental temperament changes.

A child or adolescent with bipolar disorder can behave quite differently at home than at school or in the doctor’s office. Because the child appears different in different settings, diagnosing bipolar disorder sometimes invites disagreement between parents, schools, and clinicians.

Louis, Jane, and Evan

Louis and Jane have been married for 8 years, they have a 5-year son named Evan. For the past several months Louis and Jane have been struggling with how to address the changes in Evan’s behavior. Evan has been really irritable, fighting with his friends, destroying toys, sleeping/eating disturbances, refusing to participate in class activities, or doing his homework. Evan’s behavior has also created problems in Louis and Jane’s marriage, Louis believes Evan should be spanked in response to his negative behavior, Jane believes Evan’s behavior is an attempt to gain more attention.

Louis attempts to avoid further conflict with Jane by working later and later each day, as he no longer wishes to dwell on Evan’s behavior. Louis does not agree with the manner in which Jane chooses to handle Evan’s behavior, he is beginning to harbor resentment. Jane is feeling overwhelmed, abandoned, and alone, she feels as if she is a single parent in raising Evan. Evan for his part hates seeing his parents unhappy, he misses the time when they used to do most things together, watch movies and laugh. He wants to stop being “bad”, he wants everything to go back to the way things were, but can’t understand why his mind “is acting up”. The seams in this family is beginning to come undone, the marital relationship is becoming fragmented, is there something the couple or family can do manage Evan’s behavior?