Bipolar Disorder looks different in children than it does in adults. Learn more about what bipolar disorder symptoms look like in children.

Bipolar disorder involves marked changes in mood and energy. In most adults with the illness, persistent states of extreme elation or agitation accompanied by high energy are called mania. Persistent states of extreme sadness or irritability accompanied by low energy are called depression.

However, the illness looks different in children than it does in adults. Children usually have an ongoing, continuous mood disturbance that is a mix of mania and depression. This rapid and severe cycling between moods produces chronic irritability and few clear periods of wellness between episodes.

Symptoms of bipolar disorder in children may include:

• An expansive or irritable mood
• Depression
• Rapidly changing moods lasting a few hours to a few days
• Explosive, lengthy, and often destructive rages
• Separation anxiety
• Defiance of authority
• Hyperactivity, agitation, and distractibility
• Sleeping little or, alternatively, sleeping too much
• Bed-wetting and night terrors
• Strong and frequent cravings, often for carbohydrates and sweets
• Excessive involvement in multiple projects and activities
• Impaired judgment, impulsivity, racing thoughts, and pressure to keep talking
• Dare-devil behaviors
• Inappropriate or precocious sexual behavior
• Delusions and hallucinations
• Grandiose belief in own abilities that defy the laws of logic (ability to fly, for example)

Symptoms of bipolar disorder can emerge as early as infancy. Mothers often report that children later diagnosed with the disorder were extremely difficult to settle and slept erratically. They seemed extraordinarily clingy, and from a very young age often had uncontrollable, seizure-like tantrums or rages out of proportion to any event. The word "no" often triggered these rages.

Several ongoing studies are further exploring characteristics of affected children. Researchers are studying, with promising results, the effectiveness and safety of adult treatments in children.

What are the symptoms of bipolar disorder in adolescents?

In adolescents, bipolar disorder may resemble any of the following classical adult presentations of the illness.

Bipolar I. In this form of the disorder, the adolescent experiences alternating episodes of intense and sometimes psychotic mania and depression.

Symptoms of mania include:

• Severe changes in mood, either extremely irritable or overly silly and elated
• Overly-inflated self-esteem; grandiosity
• Increased energy
• Decreased need for sleep, ability to go with very little or no sleep for days without tiring
• Increased talking, talks too much, too fast; changes topics too quickly; cannot be interrupted
• Distractibility, attention moves constantly from one thing to the next
• Hypersexuality, increased sexual thoughts, feelings, or behaviors; use of explicit sexual language
• Increased goal-directed activity or physical agitation
• Disregard of risk, excessive involvement in risky behaviors or activities
• In severe casess, the child may experience hallucinations

Symptoms of depression include:

• Persistent sad or irritable mood or crying spells
• Loss of interest in activities once enjoyed
• Significant change in appetite or body weight
• Difficulty sleeping or oversleeping
• Physical agitation or slowing
• Loss of energy
• Feelings of worthlessness or inappropriate guilt
• Difficulty concentrating and possible drop in school grades
• Recurrent thoughts of death or suicide

Any talk about wanting to die, or asking why they were born or wishing they were never born must be taken very seriously as even quite young children can hang themselves in the shower, shoot themselves or complete suicide by other means.