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Question: What can parents do to help reduce frequency of manic episodes in adolescents?

Ellen Frank, Ph.D.: Build as much structure as possible into the child’s life and the home routine. Do your best to set and stick to regular bedtimes and regular mealtimes, and keep a lot of organizational structure in the home. Each adolescent should go to bed as early as needed to be able to get up and go to school when it’s time. People of all ages with bipolar disorder are more likely to be night owls and less likely to be ready to go first thing in the morning. Parents may want to try to negotiate a later start time with the school if possible. Parents should also try, without being too intrusive, to make sure their teenage children are taking medication as directed, while still giving them freedom to take responsibility for their own illness and treatment.

During an episode of mania, it’s helpful to try to keep the level of stimulation in the house as low as possible. For example, the adolescent can have contact with others, but not 15 friends in the house at once. An emphasis on structure and as little stimulation as possible can help to de-escalate the mania.