What generally happens when bipolar kids hit puberty?
David Miklowitz: “As you go up the age ladder, the symptoms tend to resemble those in adults more and more. When the kid becomes a teenager, the episodes are characterized by mixed symptoms, rapid cycling, psychosis, and severe irritability. … The big issue in adolescence is that all kids strive for independence. They try to define themselves separately from their parents. If they have a psychiatric illness, that tends to derail them socially—they fall behind their peers. Other kids shun them or make up rumors, and they get isolated. Some of them aren’t really ready for the developmental tasks of adolescence. By age 18 many kids feel ready to take on the world, but a lot of these kids don’t. The other big worry is that adolescence is often the first time that kids go off their medications. They get to be 12 or 13 and say, ‘I don’t really have to do this.” It can become a weapon against their parents. I worked with a kid who started leaving lithium tablets all over the house—on the ta
