Bipolar Disorder In Children

Many children, and especially adolescents in puberty, experience mood swings. But when these feelings interfere with a child’s ability to function in daily life, bipolar disorder could be the cause. Bipolar disorder, also known as manic-depression, is a mood disorder marked by extreme changes in mood, energy levels, and behavior.

In this article

What are the signs and symptoms?

Manic symptoms

Depressive symptoms

What should parents and caregivers do?

MHA resources

What are the signs and symptoms?

Symptoms can begin in early childhood but usually start in adolescence or adulthood. Children with bipolar disorder are likely to have a family history of the condition.

Until recently, young people were rarely diagnosed with this condition. Yet up to one-third of children and teens diagnosed with depression in the United States may actually be experiencing the early onset of bipolar disorder. Doctors now recognize and treat bipolar disorder in young people, but it is still under-recognized.

Children with bipolar disorder usually alternate rapidly between extremely high moods (mania) and low moods (depression). These mood shifts can produce irritability with periods of wellness between episodes. However, the young person may also feel both extremes at the same time.

Parents who have children with bipolar disorder often describe them as unpredictable. They may alternate between aggressive, silly, or withdrawn. Children with bipolar disorder are at a greater risk for anxiety disorders and attention-deficit hyperactivity disorder. These “co-occurring” conditions complicate the diagnosis of bipolar disorder and contribute to the lack of recognition of the condition in children.

Not all children with bipolar disorder have all symptoms. If a child you know is struggling with any combination of the symptoms listed below for more than two weeks, talk with a doctor or mental health professional.

Manic symptoms

• Severe changes in mood—from unusually happy or silly, to irritable, angry, or aggressive.
• Unrealistic highs in self-esteem. May feel indestructible.
• Great increase in energy level. Sleeps little without being tired.
• Excessive involvement in multiple projects and activities. May move from one thing to the next and become easily distracted.
• Increase in talking. Talks too much, too fast, changes topics quickly, and cannot be interrupted. This may be accompanied by racing thoughts or feeling pressure to keep talking.
• Risk-taking behavior such as using drugs and alcohol, attempting daredevil stunts, being sexually active, or having unprotected sex.

Depressive symptoms

• Frequent sadness or crying.
• Withdrawal from friends and family.
• Decreased energy level, lack of enthusiasm or motivation.
• Feelings of worthlessness or excessive guilt.
• Extreme sensitivity to rejection or failure.
• Major changes in habits such as over-sleeping or over-eating.
• Frequent physical complaints such as headaches and stomachaches.
• Recurring thoughts of death, suicide, or self-destructive behavior.

Many teens with bipolar disorder use alcohol and drugs as a way to cope. If a substance use disorder develops, it is essential to treat both the mental health condition and the substance use disorder at the same time.

What should parents and caregivers do?

Bipolar disorder is treatable. Early identification, diagnosis, and treatment will help children reach their full potential.

Children who show signs of bipolar disorder should be evaluated by a mental health professional who specializes in treating children. The evaluation may include consultation with a child psychiatrist, psychological testing, and medical tests to rule out a physical condition that could explain the child’s symptoms.

A comprehensive treatment plan typically includes therapy and, in most cases, medication. This plan should be developed with the family and, whenever possible, the child.

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MHA resources

Mental health resources for caregivers

Supporting young minds

Blog: Accepting my bipolar brain

Infographic: Life with bipolar

Youth mental health 

If you or a friend are struggling with your mental health, take an anonymous, free, and private mental health test. It only takes a few minutes, and after you are finished, you will be given information about the next steps you can take based on the results.

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