Bipolar Disorder Symptoms in Children

In recent years, the number of children and adolescents diagnosed with bipolar disorder has increased tremendously. While still rare, studies have shown that around 7% of children seen at psychiatric facilities meet the research criteria for the disorder.

Diagnosis

Diagnosing bipolar in children is difficult, however, as not all young patients meet the textbook definition of bipolar disorder. Many have mood swings or other mood dysregulation, but don't meet the DSM-IV TR criteria for bipolar disorder because they don't have distinct episodes lasting the required amount of time, have rapid cycling of moods, or have chronic irritability that does not quite meet the definition of mania. Experts have not yet agreed on whether the criteria for pediatric bipolar disorder should be different than the traditional adult criteria.

Mania Symptoms

Some of the common symptoms of mania in children are hyperactivity, irritability, and distractibility, which can make bipolar difficult to distinguish from attention deficit hyperactivity disorder (ADHD). Symptoms unique to mania to look for include elation (such as hysterical giggling without reason), grandiose behaviors (like telling their teacher how to teach or thinking they can do superhuman things), flight of ideas (jumping rapidly from topic to topic), decreased need for sleep, and hypersexuality (such as acting flirtatious in an age-inappropriate way or using explicit sexual language).

Depression Symptoms

Children with bipolar disorder often cycle quickly from high to low, with multiple cycles in one day. Low or depressed behaviors may include extreme sadness, lack of interest in play, and suicidal thoughts or talk. Severely depressed children are at risk for suicide, just like depressed adults, and their mood should be taken seriously. They may have distinct (even if short) episodes of depression, or they may have mixed episodes with the energy associated with mania and the low mood of depression.

Children experiencing the above symptoms, or any symptoms that are worrisome, should be seen by a doctor for an evaluation and diagnosis (if warranted).

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