Bipolar Disorder in Children: Signs, Symptoms, Treatment

Written by Natasha Tracy

There is medical debate about whether bipolar disorder should be diagnosed in children as currently, there are no specific symptoms for bipolar disorder in children, only for adult bipolar disorder. Moreover, many clinicians believe bipolar disorder cannot be diagnosed in pediatric patients, as evidenced by the fact the proposed update to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V)¹ still does not contain any symptoms for bipolar in children or teens.

However, research suggests 20% - 30% of adults with bipolar disorder type 1 first showed symptoms before the age of 20. Additionally, 20% of youths diagnosed with depression later go on to experience a manic episode.²

Symptoms of Bipolar in Children

Bipolar disorder in children and teens is difficult to recognize because it does not precisely fit the symptom criteria established for adults, and its symptoms can resemble or co-occur with those of other common childhood-onset mental disorders. In addition, symptoms of childhood bipolar may be initially mistaken for normal emotions and behaviors of children and adolescents. But unlike normal bipolar symptoms and mood changes, bipolar disorder significantly impairs functioning in school, with peers and at home with family.

There appears to be an equal number of male and female children with bipolar disorder but males are more frequently referred for treatment.

In their book The Bipolar Child: The Definitive and Reassuring Guide to Childhood's Most Misunderstood Disorder, Demitri and Janice Papolos suggest the following symptoms of bipolar disorder in children:

Very common in childhood bipolar:

• Separation Anxiety
• Rages and Explosive Temper Tantrums (lasting up to several hours)
• Marked Irritability
• Oppositional Behavior
• Frequent Mood Swings
• Distractibility
• Hyperactivity
• Impulsivity
• Restlessness/ Fidgetiness
• Silliness, Goofiness, Giddiness
• Racing Thoughts
• Aggressive Behavior
• Grandiosity
• Carbohydrate Cravings
• Risk-Taking Behaviors
• Depressed Mood
• Lethargy
• Low Self-Esteem
• Difficulty Getting Up in the Morning
• Social Anxiety
• Oversensitivity to Emotional or Environmental Triggers

Common symptoms in bipolar children:

• Bed-Wetting (especially in boys)
• Night Terrors
• Rapid or Pressured Speech
• Obsessional Behavior
• Excessive Daydreaming
• Compulsive Behavior
• Motor & Vocal Tics
• Learning Disabilities
• Poor Short-Term Memory
• Lack of Organization
• Fascination with Gore or Morbid Topics
• Hypersexuality
• Manipulative Behavior
• Bossiness
• Lying
• Suicidal Thoughts
• Destruction of Property
• Paranoia
• Hallucinations & Delusions