Some of the most persistent problems that children and adolescents with bipolar disorders have involve types of thinking that are irrational and difficult for others to understand. When young people learn to recognize and name these "thought errors," it can help them avoid making a scene, getting embarrassed, and getting in trouble. Once you can label and dissect an irrational thought, you take away some of its power. The longer these patterns are allowed to continue, however, the more likely they are to become ingrained, lifelong habits. These habits of thought contribute to development of the hard-to-treat personality disorders that often bedevil bipolar adults.

Problematic thought styles include:

• Catastrophizing. Seeing only the worst possible outcome in everything. For example, your child might think that because he failed his algebra test he will get an F for the semester, everyone will know he's stupid, the teacher will hate him, you will ground him, and moreover, he'll never get into college, and on and on. No matter what soothing words or solutions you try to apply, he'll insist that there's no remedy.
• Minimization. Another side of catastrophizing, this involves minimizing your own good qualities, or refusing to see the good (or bad) qualities of other people or situations. People who minimize may be accused of wearing rose-colored glasses, or of wearing blinders that allow them to see only the worst. If a person fails to meet the minimizer's high expectations in one way--for example, by being dishonest on a single occasion--the minimizer will suddenly write the person off forever, refusing to see any good characteristics that may exist.
• Grandiosity. Having an exaggerated sense of self-importance or ability. For example, your child may fancy herself the all-time expert at soccer, and act as though everyone else should see and worship her fabulous skill as well. She may think she can run the classroom better than her "stupid" teacher, or feel that she should be equal in power to her parents or other adults.
• Personalization. A particularly unfortunate type of grandiosity that presumes you are the center of the universe, causing events for good or ill that truly have little or nothing to do with you. A child might believe his mean thoughts made his mother ill, for example.
• Magical thinking. Most common in children and adults with obsessive-compulsive disorder, but seen in people with bipolar disorders as well. Magical thinkers come to believe that by doing some sort of ritual they can avoid harm to themselves or others. The ritual may or may not be connected with the perceived harm, and sufferers tend to keep their rituals secret. Children are not always sure what harm the ritual is fending off; they may simply report knowing that "something bad will happen" if they don't touch each slat of the fence or make sure their footsteps end on an even number. Others may come to feel that ritual behavior will bring about some positive event.
• Leaps in logic. Making seemingly logic-based statements, even though the process that led to the idea was missing obvious steps. Jumping to conclusions, often negative ones. One type of logical leap is assuming that you know what someone else is thinking. For instance, a teenager might assume that everyone at school hates her, or that anyone who is whispering is talking about her. Another common error is assuming that other people will naturally know what you are thinking, leading to great misunderstandings when they don't seem to grasp what you're talking about or doing.
• "All or nothing" thinking. Being unable to see shades of gray in everyday life can lead to major misperceptions and even despair. A person who thinks only in black-and-white terms can't comprehend small successes. He's either an abject failure or a complete success, never simply on his way to doing better.
• Paranoia. In its extreme forms, paranoia slides into the realm of delusion. Many bipolar people experience less severe forms of paranoia because of personalizing events, catastrophizing, or making leaps in logic. A teen with mildly paranoid thoughts might feel that everyone at school is watching and judging him, when in fact he's barely on their radar screen.
• Delusional thinking. Most of the other thought styles mentioned above are mildly delusional. Seriously delusional thinking has even less basis in reality, and can include holding persistently strange beliefs. For example, your child may insist that he was kidnapped by aliens, and really believe that it is true.

Not only are these thought styles in error, they're intensely uncomfortable to the person who uses them--or should we say suffers from them, because no one would deliberately choose to have these anxiety-producing thoughts. When these thoughts emerge in words and deeds, the damage can be even worse. Expressing such ideas alienates friends and family, and can lead to teasing, ostracism, and severe misunderstandings.

Young children in particular don't have much of a frame of reference when it comes to thinking styles. They may well assume that everyone thinks this way! Older children and teens are usually more self-aware. Unless they're in an acute depressed, hypomanic, mixed, or manic episode, they may try hard to keep their "weird" thoughts under wraps. That's an exhausting use of mental energy, and makes the sufferer feel terribly alienated.

The same chemical imbalances that cause bipolar disorder are at the root of these thought errors, although they also have a basis in life experiences. When you have been taunted, teased, bullied, and ridiculed on a regular basis, for example, personalization and paranoia are not that farfetched. You may have been scapegoated so often that you start to feel like you really are the cause of all problems.

The rigidity that these problematic thought patterns have in common may also come from life experiences, at least in part. Many clinicians suspect that because people with bipolar disorders often deal with illogical waves of emotion and activity, they try to impose strict structures on their thoughts and beliefs to compensate. It's easy to get carried away with this, though, especially for children who don't have a lifetime of "normal" thinking to compare these thought patterns to.

Because these thought styles have at least some chemical basis, medication helps in many cases. Another good approach (especially when it's used in conjunction with medication) is cognitive therapy, a type of talk therapy geared precisely toward helping people identify erroneous thinking and mistaken beliefs about themselves and the world.

First, you have to listen to what's being said--really listen. You might even want to take notes. Don't interrupt or make a value judgment on the thoughts your child is expressing while you're in active listening mode.

Next, ask questions about the thoughts expressed. See if you can help your child express the logic (or discover the lack of it) behind his statements. It can be hard to do, but try to avoid evaluating his words yourself. What you're trying to do is not so much to tell him the "right" way to think, but to help him discover his own thought errors, and to help him learn ways to correct or avoid these mistakes in the future.

Knowing the formal rules of logic can be extraordinarily helpful to someone with bipolar disorder. These are taught in speech classes and sometimes in writing classes, and can also be learned from books. They'll help your child know when others are trying to fool her, and also give her some clues for recognizing when her own brain is playing illogical tricks.

Kids with a visual bent may benefit from diagramming their thoughts using boxes and lines, or using computer programming-style "if-then" statements. This technique can help people see how flexible most situations and problems are, with many possible choices, solutions, and end results. "Choose your own adventure" books that let readers drive the story by making choices for the characters are another vehicle for explaining this concept. You can also ask "what do you think made him do that?" and "what if?" questions about the thoughts and choices of characters in their favorite books or movies.

Truly delusional thinking can become entrenched, sometimes very quickly. Keeping the lines of communication open should help you spot this kind of trouble before it occurs, although many people with delusional thoughts are very secretive about them. Because delusions are a type of psychosis (a loss of connection with objective reality), medication is almost always used to help break the pattern. When delusions are potentially harmful to the patient or others, full or partial hospitalization may be called for until medication can take effect.