Understanding Pediatric Bipolar Behavior
Understanding the “Hyper-Reactive” Response of the Bipolar Child
Bipolar disorder usually begins during adolescence, but can sometimes begin in early childhood. According to research by the Child and Adolescent Bipolar foundation, "at least three quarters of a million American children and teenagers struggle with bipolar disorder".
Symptoms of bipolar children may present differently than adults. These children may experience extreme emotional fluctuations many times in one day. Rather than exhibiting symptoms of depression (common in adults), children may appear withdrawn, sad, and irritable. On the opposite end of the emotional spectrum (known as mania in adults), children may seem excited, elated, almost “hyperactive” in their behavior.
There is no treatment or cure for bipolar disorder. It is a lifetime, chronic condition. In fact, there is literature that states “the lifetime mortality rate for bipolar disorder (from suicide) is higher than some childhood cancers” (Child and Adolescent Bipolar Foundation). Because of this, focus needs to be on providing these children with a stable and supportive network of adults who can help them manage their behavior.
Understanding Hyper-Reactive Behavior
Although challenging, the disorder can be managed through the careful administration of medication, the right adult support in the school and in the home, and behavior modification. Adults working with bipolar children can significantly help these children cope if they have a better understanding of the behavior.
The best way to describe the behavior of a bipolar child is that the child is “hyper-reactive” to life’s situations. This child is capable of having extreme reactions to ordinary situations. For example, a situation that might cause a child without bipolar to be upset (poor grade on a test) could cause an amplified reaction in a child with bipolar.
The same extreme reaction is possible for every emotion – anger, fear, anxiety, depression, happiness, surprise, nervousness, disappointment, anticipation, disgust, and aggression to name just a few. Think of all of these emotions on a continuum and place the bipolar child’s reaction on the extreme end.
Another important factor to keep in mind is that the amplified reaction occurs immediately. There typically is not a recognizable progression of emotion from one end of the continuum to the other. It is an immediate escalation of emotion; many times without an opportunity to slow down the progression.
Understanding the concept of “hyper-reactive” will go a long way to assisting adults in understanding why a child reacts the way he/she does. This will also help adults working with bipolar children to anticipate the responses of the child ahead of time, and prepare a plan to help deescalate a potentially emotionally charged situation.
Anticipating the Bipolar Response to Help Manage the Behavior
Anticipating the response of a bipolar child is a key factor in managing the behavior. Anticipating the response means that the adult should already be planning two or three responses ahead of the child (moving into proximity, responding with verbal cues, and providing some type of distraction to remove the focus off of the emotional trigger) before the child has a chance to react to a situation.
These proactive movements can help deescalate a potential problem before the child even has a chance to amplify her/her emotions. Anticipating the response and proactively responding to prevent a problem is the best way to avoid situations that can quickly get out of control.
Taking steps to prevent an emotional outburst is a much better approach to controlling behavior than trying to gain control of a child after he/she has already lost control. Understanding the nature of "hyper-reactive" behavior will help adults anticipate potential problems and proactively take steps to prevent them.
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