Bipolar Disorder

What Bipolar Disorder Looks Like in Children

Learn the most common symptoms of bipolar disorder in children, as well as warning signs that may present at home and at school.

A child with symptoms of bipolar disorder swings at the park

Before the 1990s, it was widely believed that only adults could have bipolar disorder. Doctors asserted that children couldn’t experience the dramatic mood swings of mania and depression; any symptoms they did demonstrate were usually credited to another condition, or deemed the product of normal child development.

However, epidemiological studies conducted in 1990 and beyond started to indicate that many adults with bipolar disorder — in some cases, up to 20 percent — were already showing symptoms in childhood. Suddenly, the condition that was once assumed nonexistent in children was found to be much more common than anyone would have guessed. Training on pediatric bipolar disorder still lags behind other conditions and the diagnosis is still controversial, but the facts remain — some children show symptoms of the disorder as early as age 6, and approximately 0.5 percent of children in the U.S. are thought to be living with pediatric bipolar disorder. Having a child with bipolar disorder can be heart-wrenching for parents, who often struggle to understand and cope with the intense rages and deep depressions that can overtake their child for seemingly no reason. And even after a diagnosis is made, families aren’t “out of the woods” for quite some time — many parents agonize about putting their child on the strong medications necessary to treat bipolar disorder; and even after they do, some symptoms may still remain.

However torturous pediatric bipolar disorder is for parents, it is often more traumatic for the children themselves, who grow up feeling “bad”; sometimes, a child with undiagnosed bipolar disorder will make dangerous choices or hurt herself. If you suspect your child is cycling between mania and depression, don’t hesitate to bring it up to your doctor — she’ll be able to either put your mind at ease or provide you with a diagnosis and set up a treatment plan that can help your child live a normal, happy life.

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Symptoms of Pediatric Bipolar at Home

Part of the controversy surrounding pediatric bipolar disorder is that many of the diagnostic criteria were designed with adults in mind. What, many experts wonder, does bipolar disorder actually look like in a child? Every child’s symptoms are different, but during a manic phase, you may see signs like:

  • Acts hyper, exuberantly happy, or incredibly silly, in a way that is unusual for his normal personality or inappropriate for children his age; your teen may be unable to go 10 minutes without dissolving into a fit of giggles, for instance
  • Talks so quickly that you can’t understand her, or switches topics mid-sentence (seemingly without noticing)
  • Gets “hyperfocused” on a single subject or project that seems to come out of nowhere
  • Gets extremely upset when obstacles arise or he is told “no”; demands you buy him multiple toys, for instance, and becomes combative when you don’t comply
  • Highly imaginative; comes up with complex storylines for his toys and acts them out excitedly
  • Becomes angry quickly and violently over small slights; throws her books around the room because you answered the phone while she was talking, for instance
  • Doesn’t seem to feel tired, and is uninterested in napping, resting, or going to bed at night; gets up frequently during the night
  • Becomes preoccupied with sex or sexual thoughts; talks about sex at inappropriate times
  • Acts on sexual desires in public, dangerous, or age-inappropriate ways; masturbates excessively or engages in risky sex at a young age
  • May see or hear things that aren’t there

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During a depressive phase, you might see symptoms like:

  • Feels very sad; might be unusually weepy
  • Complains about stomachaches and headaches frequently; often asks to miss school because of the pain
  • Sleeps too much; parents are unable to rouse a teen from bed before 2 PM on a weekend, for example — no matter what she has planned
  • Eats too little or too much; might gain or lose weight very rapidly
  • Little interest in regular activities; says he doesn’t want to go to soccer practice three days in a row, for example
  • Talks about being a “bad” child, or wonders aloud if everyone hates her
  • Preoccupied with death; talks about suicide or, for very young children, how it would be better for everyone if he “went away forever” or “was never born”

Symptoms of Pediatric Bipolar at School

Bipolar disorder will sometimes look a little different at school, where your child is around peers and adults to whom she is not related. During a manic phase, symptoms at school might include:

  • Appears at times to be a “social butterfly”; makes new friends easily and charms adults with a “precocious” personality
  • At other times, becomes overly bossy with friends; gets irrationally upset over slight disagreements or friends not taking orders
  • Disobeys teachers and other authority figures; acts “out of control” and excessively hyperactive
  • Behaves inappropriately — removes clothing in the classroom or sings loudly during the Pledge of Allegiance, for example
  • Unable to sleep during naptime or settle down to quietly read
  • Unable to make transitions; becomes upset or violent when unwelcome change occurs
  • Difficulty focusing on schoolwork; often seems unable to sit still
  • Jumps between acting “goofy” — even when other students aren’t playing along — to angry and aggressive, often with seemingly no provocation
  • Acts in ways that are dangerously impulsive; throws himself off the jungle gym, climbs the highest tree, or tries to “escape” from school, for instance

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During a depressive phase, you might see signs at school like:

  • Uninterested in friends or regular playtime activities; may sit alone during recess instead of joining in the fun
  • May become suddenly antisocial or develop a fear of classmates; suddenly starts clinging to parent’s leg when being dropped off, for instance
  • Believes that nobody likes him
  • Complains about aches and pains to the teacher frequently; often asks to be excused to the nurse’s office or picked up by a parent
  • Becomes fixated on death, often bringing it up to other students or to the teacher
  • Unable to focus on schoolwork; often seems “zoned out”

It’s important to remember that, for most children, the cycling between mania and depression occurs at a much more rapid pace than it would for adults. While it’s common for cycles to happen over the course of weeks, months, or years for adults, in extreme cases, your child may cycle between these different symptoms several times in one day.

Updated on February 12, 2020

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