For information

about children’s

mental health contact

the National

Mental Health

Information Center

toll-free:

1.800.789.2647

(English/Spanish)

1.866.889.2647

(TDD)

Bipolar Disorder

How Can I Find a System of Carefor My Child With BipolarDisorder?Contact the system of care community inthe box on the back of this fact sheet. Ifnone is listed or that system of carecommunity is not in your area, visitwww.mentalhealth.samhsa.gov/cmhs and

click “Child, Adolescent & Family” andthen “Systems of Care” to locate a systemof care close to you. If you prefer to speakto someone in person to locate a systemof care, or if there is not a system of carein your area, contact the National MentalHealth Information Center by calling tollfree 1.800.789.2647 or visiting

www.mentalhealth.samhsa.gov.

SMA-4058 /2005

r Disorder: Systems of Care

Helping Children and Youth With Bipolar Disorder:Systems of CareThis fact sheet provides basic information onbipolar disorder in children and describes anapproach to getting services and supports,called “systems of care,” that helps children,youth, and families thrive at home, in school, inthe community, and throughout life.What Is Bipolar Disorder?Bipolar disorder is a brain disorder that causespersistent, overwhelming, and uncontrollablechanges in moods, activities, thoughts, andbehaviors. A child has a much greater chance ofhaving bipolar disorder if there is a familyhistory of the disorder or depression. Thismeans that parents cannot choose whether ornot their children will have bipolar disorder.Although bipolar disorder affects at least750,000 children in the United States1 , it is often

difficult to recognize and diagnose in children. Ifleft untreated, the disorder puts a child at risk forschool failure, drug abuse, and suicide. That iswhy it is important that you seek the advice of aqualified professional when trying to find out ifyour child has bipolar disorder.Symptoms of bipolar disorder can be mistakenfor other medical/mental health conditions, andchildren with bipolar disorder can have othermental health needs at the same time. Otherdisorders that can occur at the same time asbipolar disorder include, but are not limited to,attention-deficit/hyperactivity disorder,conduct disorder, oppositional defiant disorder,anxiety disorders, autistic spectrum disorders,and drug abuse disorders. The roles that afamily’s culture and language play in how causesand symptoms are perceived and then describedto a mental health care provider are important,too. Misperceptions and misunderstandings canlead to delayed diagnoses, misdiagnoses, or no

diagnoses—which are serious problemswhen a child needs help. That is why it isimportant that supports be in place tobridge differences in language and culture.Once bipolar disorder is properlydiagnosed, treatment can begin to helpchildren and adolescents with bipolardisorder live productive and fulfilling lives.

What Are the Signs of BipolarDisorder?Unlike some health problems where differentpeople experience the same symptoms,children experience bipolar disorderdifferently. Often, children with the illnessexperience mood swings that alternate, orcycle, between periods of “highs” and “lows,”called “mania” and “depression,” withvarying moods in between. These cycles canhappen much more rapidly than in adults,

1This figure represents an estimate by the Child and Adolescent Bipolar Foundation.

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At age 12, Austin appears to be a typical sixthgrader—he likes to play basketball and videogames, and is enrolled in an after-schoolhorseback riding program. He is an honor rollstudent, and his mother describes him ascompassionate, loyal, and a champion for the“underdog.” Austin and his family also managethe challenges of bipolar disorder each day.Austin was diagnosed in first grade withattention-deficit/hyperactivity disorder andseparation anxiety disorder, but Austin’s mother,Kim, recalls a series of incidents that led her toquestion whether her son’s mental health needswere being met. At age 9, Austin set two fireswithin a week. The first time it happened, Kimthought it was an isolated incident that would notbe repeated—Austin said he was lighting candles.The second time Austin set a fire, however, thesituation was very different. While bringinggroceries into the house, Austin set a small fire inthe car. When Kim discovered signs of the fire thenext morning, she says, “I immediately got on thephone and started calling his physician. Thoughtswere flashing through my mind about what couldhave happened.”After Kim received a referral from Austin’sphysician for diagnostic testing and other mentalhealth services, she learned that her son had beenexperiencing hallucinations, which were causinghim to set the fires. She also learned that hisextreme mood swings, as well as his unusual sleeppatterns, were signs of bipolar disorder. As aresult, Austin was hospitalized for 20 days anddiagnosed with bipolar disorder. During this time,Austin was accepted into a system of care througha referral from his school guidance counselor.

Kim says the system of care played an importantrole in helping Austin make the transition from thehospital to his home—even providingtransportation, as Kim’s car was being repairedat the time. System of care staff helped Kim learnmore about her son’s disorder. They also helpedher locate services and supports tailored toAustin’s needs, including counseling, health care,specialized schooling, after-school programs,transportation, and child care.The system of care also empowered Kim to be amore effective advocate for Austin’s needs. Beforejoining the system of care, she says, “I tried to fitthe service to the need, rather than fit the need tothe service. That was a mistake.”Kim also assumed that professionals were bestable to determine how to meet her child’s needs.After working in partnership with the system ofcare, Kim now knows that services and supportsshould be responsive to Austin’s needs and thather and her son’s input into the services andsupports is crucial.Despite the successes her family has had, Kimemphasizes that the journey to wellness is notover. In addition to coping with the symptoms ofbipolar disorder, she and Austin also mustovercome the stigma associated with mentalillnesses. Together, Kim and Austin counter thisstigma by educating others that he, and otherswith mental illnesses, should be known for whothey are rather than the disorders they happen tohave. Despite the ongoing challenges of stigmaand bipolar disorder, Kim believes that thesystem of care has made a huge difference interms of helping her family move forward.

Austin’s Story