What is it?

Bipolar disorder is a chronic mental health condition that causes people to experience extreme, changes in mood and behaviour, from mania to depression. It is called “bipolar” because of the two “poles” of mood, where the mood shifts are extreme, often unprovoked. 

A child who has bipolar disorder experiences both manic phases (periods of abnormally high energy and activity) and depressive phases (periods of intense sadness, tiredness, or irritability) that last days or even weeks. These periods are known as mood episodes. Sometimes, a child will experience manic and depressive symptoms at the same time. This is called a mixed mood episode.

What can be done? 

There is no complete cure for bipolar disorder but with early diagnosis and multidimensional treatment, it can generally be controlled, allowing children to return to more normal functioning. 

Psychotherapy

Psychotherapy refers to a wide range of techniques and methods used to help children who are experiencing difficulties with their emotions or behaviour. Different types of therapies can help children and their families manage symptoms of bipolar disorder. Family-focused therapy and skill-building and cognitive behavioural approaches, as well as dialectical behaviour therapy (DBT), are evidence-based approaches and supports that can be effective in managing bipolar disorder. 

Medications

There are medications that are effective at managing bipolar disorder. Doctors typically prescribe one or more of the following classes of medications to treat bipolar disorder in children and teens:

• mood stabilizers
• anticonvulsant medications
• atypical antipsychotics
• antidepressants

Most children with bipolar disorder need to take medications for a long time, starting with low doses and then increasing gradually as needed. Because the symptoms of bipolar disorder are quite complex, it is not unusual to need more than one medication to manage them. School support is essential in treating children with mental health challenges. It is important for the school to have information about the child’s medications.

What makes some children more vulnerable to bipolar disorder? 

Genetic factors: family history of mental health challenges and brain-based disorders 

Environmental factors such as adverse childhood experiences or toxic stress during childhood

Brain chemistry/development factors: Both genetic and environmental risk factors can alter brain chemistry and development. Scientists believe that the brains of children with bipolar disorder grow and develop differently than those of other children.

Where can I access support?

Talk to the child’s family doctor or pediatrician to help identify if the child’s behaviour is normal for their developmental stage. 

Talk to the child’s guardianship worker to explore what options are available for assessment so their diagnosis and treatment plan can be included in their Care Plan. The guardianship worker will help make appropriate referrals for specialized supports and services that may include working with a counsellor that would be a good fit for the child. 

 Get an assessment through your local Child and Youth Mental Health team. Your local CYMH office offers a range of free and voluntary mental health services and supports for children from 0-18 years of age and their families. These services include assessments, therapy and treatment, education and referrals to specialized programs and resources. There are 100 intake clinics for children, youth and their families at convenient locations throughout BC. 

You can also contact a private psychologist or counsellor through the BC Association of Clinical Counsellors or the BC Psychological Association. You can use website filters to search for a counsellor in your community that specializes in certain mental health challenges.

What is it?

Tourette syndrome is a neurodevelopmental condition characterized by uncontrolled, brief repetitive muscle movements and vocalizations called tics.

What are the symptoms of Tourette syndrome?

The symptoms typically begin at the age of 5. Two types of tics are associated with Tourette syndrome:

1. Motor tics:  sudden, uncontrollable muscle movements such as eye blinking, nose twitching, grimacing, head jerking, clapping, shoulder shrugging or arm/hand movements
2. Vocal tics: throat clearing, coughing, whistling, squeaking, sniffing, humming or repeating sounds or phrases

When a child is under stress, the tics can become more severe, frequent, or extended. The type of tic may also change.

Children who have tics or Tourette may also be diagnosed with anxiety, attention deficit hyperactivity disorder (ADHD) and obsessive-compulsive disorder.

What can be done?

Cognitive behavioural therapy (CBT): CBT is a type of behavioural therapy that teaches a person to recognize behaviour and helps them change how they behave. It can help children with tics learn to identify situations that cause or exacerbate tics and find ways to change them.

Medications are available that can help suppress tics.

What makes some children more vulnerable to Tourette syndrome?

Tourette syndrome is a genetic disorder that happens during fetal development. Environmental factors may contribute to or modulate the severity of symptoms, especially during childhood.

Where can I access support?

Caregivers should always share behavioural observations such as tics with the child’s family doctor or pediatrician. They can further evaluate to determine if the symptom is a tic and if it is caused by a medical condition, medication or drug, or occurring on their own. Tourette syndrome can be diagnosed by family doctors, pediatricians, neurologists, psychiatrists, and psychologists.

Talk to the child’s guardianship worker and share your behavioural observations. Tell them if the tics are causing significant distress, impairment or if you think it is related to other mental health concerns. Explore what options are available for assessment so their diagnosis and treatment plan can be included in their Care Plan. The guardianship worker will help make appropriate referrals for specialized supports and services.

What is it? 

Self-harm is the act of physically hurting oneself without the intent of committing suicide. It is a sign of neurochemical imbalance in the brain and emotional distress, signalling that a child has a lack of healthy emotional regulation skills. Children typically engage in self-harming behaviour to cope with big feelings and/or to express their pain.

What are the signs of self-harm in children? 

Self-harm is not a diagnosis in and of itself but children who engage in self-harm are most often diagnosed with neurodevelopmental challenges such as mood disorders, eating disorders and behavioural disorders.  Some signs of self-harm in children under the age of 6 include hitting their head against the wall, severely biting their skin or cutting the skin with sharp tools.

When is it time to seek professional help? 

You need to seek professional help if the child is injuring themselves and showing signs of physical illness that is affecting their sleep and eating habits as well as their school and family life. If you’ve tried to discourage the behaviour using different strategies and nothing has changed or it’s gotten worse.

What makes some children more vulnerable to self-harming thoughts and behaviours? 

Risk factors for self-harming behaviour include: 

• Trauma, adverse childhood experiences and toxic stress
•  Co-occurring mental health disorders
• Family history of mental health challenges and brain-based disorders 
• Witnessing someone exhibiting the same self-harming behaviour

What can be done? 

Cognitive behavioural therapy (CBT) is a type of behavioural therapy that teaches a person to recognize behaviour and helps them change how they behave. 

Dialectical behavioural therapy (DBT) is a type of therapy that teaches children how to regulate their emotions and respond to emotional distress through skills training.

Interpersonal therapy (IPT) is a brief treatment that focuses on how interpersonal factors affect a child’s emotional state.

Family-based therapy focuses on helping the family act in more positive and supportive ways through education.

Where can I access support?

In an emergency, call 911 or go to the nearest emergency care facility. 

If not an immediate emergency, call 811 to speak with a registered nurse. 

Talk to the child’s family doctor or pediatrician to help identify if the child’s behaviour is normal for their developmental stage. 

Talk to the child’s guardianship worker and share your behavioural observations. Explore what options are available for assessment so their diagnosis and treatment plan can be included in their Care Plan. The guardianship worker will help make appropriate referrals for specialized supports and services.

Get an assessment through your local Child and Youth Mental Health team. Your local CYMH office offers a range of free and voluntary mental health services and supports for children from 0-18 years of age and their families. These services include assessments, therapy and treatment, education and referrals to specialized programs and resources. There are 100 intake clinics for children, youth and their families at convenient locations throughout BC. 

You can also contact a private psychologist or counsellor through the BC Association of Clinical Counsellors or the BC Psychological Association. You can use website filters to search for a counsellor in your community that specializes in certain mental health challenges.

What is it?

Post Traumatic Stress Disorder (PTSD) is a disorder that can develop after experiencing or witnessing an intense event. Trauma occurs when a stressful event overwhelms the child’s natural ability to cope. These events cause a “fight, flight, or freeze” response, resulting in changes in the body—such as an increase in heart rate—as well as changes in how the brain perceives and responds to the world. 

Examples of traumatic events include: 

• Psychological, physical or sexual abuse
• Neglect
• Family or community violence
• Serious accidents or life-threatening illness 
• Natural disasters 
•  Loss or separation from a loved one 
• Forced displacement or war experiences 
• Serious and untreated parental mental illness 
• Discrimination
• Persistent extreme poverty

What are the symptoms of PTSD?

Symptoms of PTSD in young children may include:

• reliving or avoiding reminders of the traumatic event 
• feeling alienated 
• delays in reaching physical, language or other developmental milestones
• hypervigilance
• irritability or fussiness
• being difficult to calm
• frequent tantrums
• clingy behaviour
• difficulty paying attention

Learn about the symptoms and strategies for PTSD in children and youth in this video:

When is it time to seek professional help? 

It may be time to seek professional help if the traumatic stress reaction is so intense that it affects the child’s ability to function at school or home and if the symptoms become worse over time.

What can be done? 

Trauma-focused cognitive-behavioural therapy (TF-CBT) is an evidence-based treatment approach for children with PTSD. TF-CBT provides children, parents and caregivers with stress management skills before a direct discussion and processing traumatic experiences. It typically focuses on enhancing safety, psychoeducation and parenting skills, relaxation skills, affective regulation skills, and cognitive coping skills.

Eye movement desensitization and reprocessing (EMDR) is a psychotherapy treatment that uses eye movements to reduce negative physical and mental responses to traumatic memories. 

Play therapy helps children build coping skills, enhance their capacity for self-regulation, and promote positive self-esteem. Play therapists structure activities to target emotions, cognitions, and behaviours rooted in trauma.  

Medications such as antidepressant and anti-anxiety medications (e.g. Selective serotonin reuptake inhibitors or SSRIs) can help some children deal with symptoms of PTSD as well as other brain-based disorders that contribute to the severity of PTSD symptoms such as depression, anxiety, and behavioural disorders.

What makes some children more vulnerable to PTSD? 

Younger children are more vulnerable to PTSD because they have not fully developed cognitive and emotional skills to process a traumatic event. Even infants and toddlers who are too young to remember or talk about the stressful event retain lasting memories of traumatic events that can affect their well-being into adulthood.

Where can I access support?

Talk to the child’s family doctor or pediatrician to help identify if the child’s behaviour is normal for their developmental stage. 

Talk to the child’s guardianship worker and share your behavioural observations. Explore what options are available for assessment so their diagnosis and treatment plan can be included in their Care Plan. The guardianship worker will help make appropriate referrals for specialized supports and services.

Get an assessment through your local Child and Youth Mental Health team. Your local CYMH office offers a range of free and voluntary mental health services and supports for children from 0-18 years of age and their families. These services include assessments, therapy and treatment, education and referrals to specialized programs and resources. There are 100 intake clinics for children, youth and their families at convenient locations throughout BC. 

You can also contact a private psychologist or counsellor through the BC Association of Clinical Counsellors or the BC Psychological Association. You can use website filters to search for a counsellor in your community that specializes in certain mental health challenges.