Does your child go through extreme changes in mood and behavior? Does your child get much more excited or much more irritable than other kids? Do you notice that your child goes through cycles of extreme highs and lows more often than other children? Do these mood changes affect how your child acts at school or at home?

Some children and teens with these symptoms may have bipolar disorder, a brain disorder that causes unusual shifts in mood, energy, activity levels, and day-to-day functioning. With treatment, children and teens with bipolar disorder can get better over time.

Bipolar disorder is a mental disorder that causes people to experience noticeable, sometimes extreme, changes in mood and behavior. Sometimes children with bipolar disorder feel very happy or “up” and are much more energetic and active than usual. In a recent study, people with bipolar disorder were twice as likely to have a problem with gambling compared to those without bipolar disorder. There are several ways to avoid and control. Bipolar Disorder 7 Reasons Bipolar Disorder Makes It Hard to Hold Down a Full-Time Job For many people (including myself) who received a mental health diagnosis as a young adult, the idea of reaching adulthood and thriving can feel a little (OK, a lot) overwhelming.

What is bipolar disorder?

Bipolar disorder is a mental disorder that causes people to experience noticeable, sometimes extreme, changes in mood and behavior. Sometimes children with bipolar disorder feel very happy or “up” and are much more energetic and active than usual. This is called a manic episode. Sometimes children with bipolar disorder feel very sad or “down” and are much less active than usual. This is called a depressive episode.

Bipolar disorder, which used to be called manic-depressive illness or manic depression, is not the same as the normal ups and downs every child goes through. The mood changes in bipolar disorder are more extreme, often unprovoked, and accompanied by changes in sleep, energy level, and the ability to think clearly. Bipolar symptoms can make it hard for young people to perform well in school or to get along with friends and family members. Some children and teens with bipolar disorder may try to hurt themselves or attempt suicide.

Most people are diagnosed with bipolar disorder in adolescence or adulthood, but the symptoms can appear earlier in childhood. Bipolar disorder is often episodic, but it usually lasts a lifetime.

Signs and symptoms of bipolar disorder may overlap with symptoms of other disorders that are common in young people, such as attention-deficit/hyperactivity disorder (ADHD), conduct problems, major depression, and anxiety disorders. Diagnosing bipolar disorder can be complicated and requires a careful and thorough evaluation by a trained, experienced mental health professional.

With treatment, children and teens with bipolar disorder can manage their symptoms and lead successful lives.

What causes bipolar disorder?

The exact causes of bipolar disorder are unknown, but several factors may contribute to the illness.

For example, researchers are beginning to uncover genetic mechanisms that are linked to bipolar disorder and other mental disorders. Research shows that people’s chance of having bipolar disorder is higher if they have a close family member with the illness, which may be because they have the same genetic variations. However, just because one family member has bipolar disorder, it does not mean that other members of the family will have it. Many genes are involved in the disorder, and no single gene causes it.

Research also suggests that adversity, trauma, and stressful life events may increase the chances of developing bipolar disorder in people with a genetic risk of having the illness.

Some research studies have found differences in brain structure and function between people who have bipolar disorder and those who do not. Researchers are studying the disorder to learn more about its causes and effective treatments.

What are the symptoms of bipolar disorder?

Mood episodes in bipolar disorder include intense emotions along with significant changes in sleep habits, activity levels, thoughts, or behaviors. A person with bipolar disorder may have manic episodes, depressive episodes, or “mixed” episodes. A mixed episode has both manic and depressive symptoms. These mood episodes cause symptoms that often last for several days or weeks. During an episode, the symptoms last every day for most of the day.

These mood and activity changes are very different from the child’s usual behavior and from the behavior of healthy children and teens.

Children and teens having a manic episode may:

• Show intense happiness or silliness for long periods of time.
• Have a very short temper or seem extremely irritable.
• Talk fast about a lot of different things.
• Have trouble sleeping but not feel tired.
• Have trouble staying focused, and experience racing thoughts.
• Seem overly interested or involved in pleasurable but risky activities.
• Do risky or reckless things that show poor judgment.

Children and teens having a depressive episode may:

• Feel frequent and unprovoked sadness.
• Show increased irritability, anger, or hostility.
• Complain a lot about pain, such as stomachaches and headaches.
• Have a noticeable increase in amount of sleep.
• Have difficulty concentrating.
• Feel hopeless and worthless.
• Have difficulty communicating or maintaining relationships.
• Eat too much or too little.
• Have little energy and no interest in activities they usually enjoy.
• Think about death, or have thoughts of suicide.

Can children and teens with bipolar disorder have other problems?

Young people with bipolar disorder can have several problems at the same time. These include:

• Misuse of alcohol and drugs. Young people with bipolar disorder are at risk of misusing alcohol or drugs.
• Attention-deficit/hyperactivity disorder (ADHD). Children and teens who have both bipolar disorder and ADHD may have trouble staying focused.
• Anxiety disorders. Children and teens with bipolar disorder also may have an anxiety disorder.

Sometimes extreme behaviors go along with mood episodes. During manic episodes, young people with bipolar disorder may take extreme risks that they wouldn’t usually take or that could cause them harm or injury. During depressive episodes, some young people with bipolar disorder may think about running away from home or have thoughts of suicide.

If your child shows signs of suicidal thinking, take these signs seriously and call your child’s health care provider.

If you think your child is in crisis and needs immediate help, call 911. You also can call the National Suicide Prevention Lifeline (Lifeline) at 1‑800‑273‑TALK (8255), or text the Crisis Text Line (text HELLO to 741741). The deaf and hard of hearing can contact the Lifeline via TTY at 1-800-799-4889. These services are confidential, free, and available 24/7.

How is bipolar disorder diagnosed?

A health care provider will ask questions about your child’s mood, sleeping patterns, energy levels, and behavior. There are no blood tests or brain scans that can diagnose bipolar disorder. However, the health care provider may use tests to see if something other than bipolar disorder is causing your child’s symptoms. Sometimes health care providers need to know about medical conditions in the family, such as depression or substance use.

Other disorders have symptoms like those of bipolar disorder, including ADHD, disruptive mood regulation disorder, oppositional defiant disorder, conduct disorder, and anxiety disorders. It also can be challenging to distinguish bipolar disorder from depression that occurs without mania, which is referred to as “major depression.” A health care provider who specializes in working with children and teens can make a careful and complete evaluation of your child’s symptoms to provide the right diagnosis.

How is bipolar disorder treated?

Children and teens can work with their health care provider to develop a treatment plan that will help them manage their symptoms and improve their quality of life. It is important to follow the treatment plan, even when your child is not currently experiencing a mood episode. Steady, dependable treatment works better than treatment that starts and stops.

Treatment options include:

• Medication. Several types of medication can help treat symptoms of bipolar disorder. Children respond to medications in different ways, so the right type of medication depends on the child. This means children may need to try different types of medication to see which one works best for them. Some children may need more than one type of medication because their symptoms are complex. Children should take the fewest number of medications and the smallest doses possible to help their symptoms. A good way to remember this is “start low, go slow.” Medications can cause side effects. Always tell your child’s health care provider about any problems with side effects. Do not stop giving your child medication without speaking to a health care provider. Stopping medication suddenly can be dangerous and can make bipolar symptoms worse.
• Psychosocial Therapy. Different kinds of psychosocial therapy can help children and their families manage the symptoms of bipolar disorder. Therapies that are based on scientific research—including cognitive behavioral approaches and family-focused therapy—can provide support, education, and guidance to youth and their families. These therapies teach skills that can help people manage bipolar disorder, including skills for maintaining routines, enhancing emotion regulation, and improving social interactions.

What can children and teens expect from treatment?

With treatment, children and teens with bipolar disorder can get better over time. Treatment is more effective when health care providers, parents, and young people work together.

Sometimes a child’s symptoms may change, or disappear and then come back. When this happens, your child’s health care provider may recommend changes to the treatment plan. Treatment can take time, but sticking with the treatment plan can help young people manage their symptoms and reduce the likelihood of future episodes.

Your child’s health care provider may recommend keeping a daily life chart or mood chart to track your child’s moods, behaviors, and sleep patterns. This may make it easier to track the illness and see whether treatment is working.

How can I help my child or teen?

Help begins with the right diagnosis and treatment. Talk to your family health care provider about any symptoms you notice.

If your child has bipolar disorder, here are some basic things you can do:

• Be patient.
• Encourage your child to talk, and listen to your child carefully.
• Pay attention to your child’s moods, and be alert to any major changes.
• Understand triggers, and learn strategies for managing intense emotions and irritability.
• Help your child have fun.
• Remember that treatment takes time: sticking with the treatment plan can help your child get better and stay better.
• Help your child understand that treatment can make life better.

How does bipolar disorder affect caregivers and families?

Caring for a child or teenager with bipolar disorder can be stressful for parents and families. Coping with a child’s mood episodes and other problems—such as short tempers and risky behaviors—can challenge any caregiver.

It is important that caregivers take care of themselves, too. Find someone you can talk to or consult your health care provider about support groups. Finding support and strategies for managing stress can help you and your child.

Where do I go for help?

If you’re not sure where to get help, your doctor, pediatrician, or other family health care provider is a good place to start. A health care provider can refer you to a qualified mental health professional, such as a psychiatrist or psychologist, who has experience treating bipolar disorder and can evaluate your child’s symptoms.

You can learn more about getting help and finding a health care provider on the National Institute of Mental Health website. Hospital health care providers can help in an emergency. The Substance Abuse and Mental Health Services Administration (SAMHSA) has an online tool to help you find mental health services in your area.

I know someone who is in crisis. What do I do?

If you know someone who might be thinking about hurting themselves or someone else, get help quickly.

• Do not leave the person alone.
• Call 911 or go to the nearest hospital emergency room.
• Call the toll-free National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or the toll-free TTY number at 1-800-799-4TTY (4889). You also can text the Crisis Text Line (text HELLO to 741741) or go to the National Suicide Prevention Lifeline website.

What should I know about clinical trials?

Clinical trials are research studies that look at new ways to prevent, detect, or treat diseases and conditions. Although individuals may benefit from being part of a clinical trial, participants should be aware that the primary purpose of a clinical trial is to gain new scientific knowledge so that others may be better helped in the future.

Researchers at NIMH and around the country conduct clinical trials with patients and healthy volunteers. Talk to your health care provider about clinical trials, their benefits and risks, and whether one is right for you. For more information, visit the NIMH Clinical Trials webpage.

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
National Institutes of Health
NIH Publication No. 20-MH-8081
Revised 2020

Dr Tom Richardson, Principal Clinical Psychologist, Solent NHS Trust and Visiting Academic, University of Southampton

In the world of mental health I wear many hats. I’m a clinical psychologist. I’m an academic. And I’m a service-user, I have a diagnosis of bipolar disorder myself.

Symptoms Of Gambling Disorder

So my latest research, on the links between bipolar disorder and spending, is something very close to my heart.

The background

Bipolar disorder is a mental health problem characterised by episodes of depression and hypomania or mania. When people are hypomanic or manic, they may have symptoms such as grandiosity, elevated mood, decreased need for sleep and an increase in ‘goal directed activity’ – that is, activities focused on very specific projects or ambitions.

Bipolar Disorder Gambling Problem Solving

It has been shown that people with bipolar can be impulsive, especially when manic. Indeed a potential symptom, according to the diagnostic criteria for the condition, is ‘excessive involvement in pleasurable activities with high potential for painful consequence’ (for example, engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments). Those with bipolar disorder are also at higher risk of gambling and compulsive spending, and caregivers often report that this causes them stress.

Bipolar Disorder Gambling Problem Definition

However, despite excessive spending being included in the diagnostic criteria and many screening questionnaires for the condition, there is very little research on it in bipolar disorder. Research has shown that those with depression are more than twice as likely to be in debt, and research with students suggests a vicious cycle between financial difficulties and mental health problems. However there is little research on the impact of debt on mental health in bipolar disorder specifically.

Themes in the current study

A study I conducted in Portsmouth, which is in press in the journal Clinical Psychology Forum, asked 44 people with bipolar disorder how they saw their finances as related to their mental health and found a number of themes:

1. Overspending, and within this impulse shopping and excessive generosity: for example giving all money to charity when high
2. Anxiety and depression, and within this suicidality: for example feeling depressed when people realise how much debt they are in
3. Regret/Guilt: for example regretting overspending when manic
4. Poor planning/avoidant coping: for example ignoring bills
5. Vicious cycle: For example realising in that they are debt and feeling depressed, and then comfort spending to cope
6. Poor employment: For example having to take pay cuts due to mental health problems
7. Comfort spending: For example buying things to feel better when down

The relationship over time

A simultaneous study I conducted in Portsmouth (both papers of which are being written up, so results are preliminary) gave 54 clients with bipolar disorder questionnaires about finances, compulsive shopping, mood and psychological variables such as mindfulness. 40 clients also completed these again at a second time point four months later.

This found that, across one time point (baseline results not controlled for):

• Greater impulsivity led to greater financial difficulties over time
• Poorer perceived financial wellness lowered self-esteem over time
• Being in greater financial difficulty at the beginning of the study increased the likelihood of later hypomanic thoughts around a need to achieve and being goal focused

After baseline scores were controlled for:

• Poorer perceived financial wellness increased anxiety and stress over time
• How clients saw their finances subjectively was more important than objective measures such as the number of loans.
• Compulsive shopping got worse over time with higher symptoms of depression anxiety and stress, as well as lower mindfulness, higher dependency on others and a greater focus on achieving specific goals. Dependency and anxiety were also increased by compulsive spending suggesting a vicious cycle.

What Is Gambling Disorder

A preliminary psychological model

From these findings, a preliminary psychological model is being developed to try and map the complex relationships between finances and mental health in bipolar disorder.

Essentially, we find a potential cycle between financial difficulties, worry about finances, anxiety, depression and suicidality, and compulsive spending. Financial difficulties lead to anxiety and low self-esteem as people worry about their finances. This low-self esteem can also lead to depression. Anxiety and depression can then cause people to comfort spend. These mental health problems can also worsen financial difficulties, as people avoid financial management, struggle with financial planning and struggle to find and maintain stable employment. Low mood and anxiety can also lead to higher spending, creating another pathway to financial difficulties. When people are depressed they can be less mindful or aware, which makes them more vulnerable to compulsive shopping, buying things in an attempt to feel better. When people have low self-esteem they can also feel more dependent on others, and need to feel approved by those close to them, in some cases offering gifts to try and win this approval. In both cases,this spending can create a vicious cycle when fuelling guilt and regret, which exacerbates anxiety. Financial difficulties can also trigger hypomanic symptoms and thoughts around a need to achieve – the ideas about how to achieve can sometimes include ideas about how to get themselves out of their financial hole. In some cases, this might mean a plan to try and spend money to make money, which fuels compulsive shopping and ultimately ends up increasing financial difficulties.

Not everyone with bipolar disorder will experience financial difficulties or changes in spending behaviour, and where these are experienced they will not always follow these routes. For some the goal focus might be key, for others avoiding their finances when anxious might be important. But understanding how these issues are connected will make it easier to ensure people receive the right support.

Conclusions

This study suggested that:

• Finances affect mental health and vice versa in people with bipolar disorder: there is a vicious cycle.
• Compulsive spending is a key factor: This is not always random, there are potential themes and it is goal-focused, that is, directed towards specific ideas and projects that a person may fixate on
• Many psychological mechanisms are important and psychological therapies such as CBT and mindfulness might help break the link
• Future research is needed to help test the model and develop interventions to help.

Bipolar And Gambling Addiction