Is bipolar disorder in children possible? Or does it only affect adults?
Answer From Paul Croarkin, D.O.
Bipolar disorder is most often identified in young adults, but it can occur in teenagers. It's rare but possible in younger children. It can cause extreme mood swings from emotional highs, called mania or hypomania, to serious depression.
Emotional unrest and behaviors that disrupt others are common in childhood and the teen years. In most cases, these behaviors aren't a sign of a mental health problem that needs to be treated. All kids have rough periods. They'll feel down, irritable, angry, hyperactive or impulsive at times. But if your child's symptoms are severe or ongoing, or they're causing big problems, it may be more than just a phase.
Symptoms of bipolar disorder in children include:
- Serious mood swings that differ from their usual mood swings. These happen often, can last a long time, and greatly affect the way a child acts.
- Being very hyperactive, impulsive and aggressive, which affects how a child acts socially and in other areas of life.
- Racing thoughts, sometimes shown by quickly and often changing subjects when talking.
- Risky and reckless behaviors that are out of character, such as having frequent casual sex with many partners. Other examples include alcohol or drug misuse, or wild spending sprees.
- Being unable to sleep or greatly decreased need for sleep.
- Depressed or irritable mood most of the day, nearly every day, during a depressive bout.
- An inflated view of capabilities that's not based on reality.
- Suicidal thoughts or behaviors. These symptoms occur more often in older children and teens.
- Loss of contact with reality, such as seeing things that aren't there or believing that someone is trying to hurt them.
When a child or teen with bipolar disorder experiences symptoms, it's called an episode. Between these episodes, they can return to their usual behavior and mood.
It is important to remember that these symptoms alone can't determine whether bipolar disorder is present. That's because these symptoms can be related to other problems, such as:
- Attention-deficit/hyperactivity disorder (ADHD).
- Autism spectrum disorder.
- Oppositional defiant disorder.
- Conduct disorder.
- Anxiety disorders.
- Major depression.
- Substance use disorder.
- Earlier experiences that were distressful or painful, often called traumatic experiences.
Identifying a mental health condition can be challenging because these conditions can occur along with bipolar disorder.
Making a diagnosis of bipolar disorder is complicated. It often involves several assessments, sessions and sources of information. There are no laboratory, genetic, medical or brain imaging tests that a health care provider can use to diagnose bipolar disorder.
If your child has serious mood swings, depression or behavior problems, see a mental health provider who specializes in working with children and teens. Mood and behavior issues caused by bipolar disorder or other mental health conditions can lead to major problems. Early treatment can help prevent serious issues and decrease the effects of mental health problems as your child gets older.
April 07, 2023
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See more Expert Answers
- Findling RL, et al. Progress in diagnosis and treatment of bipolar disorder among children and adolescents: An international perspective. Evidence-Based Mental Health. 2018; doi:10.1136/eb-2018-102912.
- Elhosary M, et al. Pediatric Bipolar Disorder — Misinformation with unintended negative consequences for children and adolescents. European Neuropsychopharmacology. 2022. https://www.clinicalkey.com/. Accessed Feb. 22, 2023.
- Croarkin PE (expert opinion). Mayo Clinic. Feb. 24, 2023.
- Patino LR, et al. Irritability, anger, and aggression in the context of pediatric bipolar disorder. Child and Adolescent Psychiatric Clinics of North America. 2021; doi:10.1016/j.chc.2021.04.007.
- Birmaher B. Pediatric bipolar disorder: Assessment and diagnosis. https://www.uptodate.com/contents/search. Accessed Feb. 22, 2023.
- Birmaher B. Pediatric bipolar disorder: Epidemiology and pathogenesis. https://www.uptodate.com/contents/search. Accessed Feb. 22, 2023.
- Cichon L, et al. Clinical picture and treatment of bipolar affective disorder in children and adolescents. Psychiatria Polska. 2022; doi: 10.12740/PP/OnlineFirst/92740.
- Bipolar and related disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5-TR. 5th ed. American Psychiatric Association; 2022; doi.org/10.1176/appi.books.9780890425787.x03_Bipolar_and_Related_Disorders.