Bipolar disorder in children looks like extreme, rapid mood swings, often with severe irritability and aggression (unlike classic adult euphoria), alongside depressive symptoms like sadness, low energy, and loss of interest, disrupting sleep, school, and social life, and can mimic ADHD due to hyperactivity and focus issues, but with cyclical episodes rather than constant symptoms. Key signs include intense tantrums, inability to sleep, racing thoughts, impulsive or risky behaviors, and feelings of worthlessness or grandiosity, which are far beyond normal childhood ups and downs.
Symptoms of bipolar disorder in children include:
Age at onset of type-I bipolar disorder (BPD) typically averages 12-24 years, is older among patients with type-II BPD, and oldest in unipolar major depressive disorder 1,2,3. Reported onset ages probably vary by ascertainment methods, and possibly among different countries and cultures 1,2,3,4,5,6.
The first red flag of bipolar disorder often appears as significant changes in sleep patterns (insomnia or oversleeping), dramatic shifts in mood (intense irritability, euphoria, or deep sadness), and increased energy or agitation, often accompanied by racing thoughts, impulsivity (like risky spending), or severe fatigue and loss of interest during depressive phases, with these shifts differing greatly from typical mood swings and often impacting daily functioning.
Childhood trauma
Some experts believe that experiencing a lot of emotional distress as a child can cause bipolar disorder to develop. This could be because childhood trauma and distress can have a big effect on your ability to manage your emotions. This can include experiences like: Neglect.
Bipolar disorder has been diagnosed in children as young as 5. When young children experience symptoms, this is called early-onset bipolar disorder.
Common early warning signs for hypomania and mania
Symptoms of bipolar disorder
The Big Five personality comprises independent traits of neuroticism, extraversion, openness to experience, agreeableness and conscientiousness (McCrae and John 1992) and forms the basis of several personality inventories (Costa and McCrae 1992).
Without effective treatment, bipolar disorder can cause episodes of mania, depression, or both. Symptoms of a manic episode can include intense excitement, excessive energy, anxiety, or racing thoughts. A depressive episode can cause sadness, hopelessness, or low energy.
Stressful life events, trauma and significant life changes can trigger or worsen the symptoms of bipolar disorder. Creating a stable and supportive environment can help manage these triggers.
How is bipolar disorder treated in children?
Differential Diagnosis
The most common comorbid conditions with child-onset bipolar disorder, according to several studies, are attention deficit/hyperactivity disorder (ADHD) and conduct disorder (CD). Anxiety disorders, substance abuse, and personality disorders can also occur comorbidly, Weller noted.
The Takeaway. A poor diet can contribute to bipolar mood episodes, and certain food choices may help manage them. People with bipolar disorder should avoid or limit caffeine, alcohol, sugar, salt, and saturated fats.
What are the symptoms of bipolar disorder in a teen?
People with bipolar disorder often experience periods of extremely “up,” elated, irritable, or energized behavior (known as manic episodes) and very “down,” sad, indifferent, or hopeless periods (known as depressive episodes).
Those with borderline personality disorder may have an unstable sense of self. Both conditions are marked by shifts in mood and can involve being impulsive. A 2021 literature review found that antisocial personality disorder was more common among people with bipolar disorder, in particular bipolar I disorder.
Mood episodes in bipolar disorder include intense emotions and significant changes in sleep habits, activity levels, thoughts, or behaviors. Children and teens with bipolar disorder may have manic episodes, depressive episodes, or “mixed” episodes. A mixed episode has both manic and depressive symptoms.
Your routine could include: Day-to-day activities, such as the time you eat meals and go to sleep. Making time for relaxation, mindfulness, hobbies and social plans. Taking any medication at the same time each day.
While the manic episodes of bipolar I disorder can be severe and dangerous, people with bipolar II disorder can be depressed for longer periods of time. Bipolar disorder can start at any age, but usually it's diagnosed in the teenage years or early 20s.
30 Things Not To Say To Those With Bipolar Disorder
Mood-stabilizing medicines help control manic or hypomanic episodes. They also may help depressive bouts. Examples include lithium (Lithobid), valproic acid, divalproex sodium (Depakote, Depakote ER), carbamazepine (Tegretol, Tegretol XR, Equetro, others) and lamotrigine (Lamictal).
How many hours should a bipolar person sleep? People should try to sleep at least 7 hours per night, regardless of whether they have a condition such as bipolar disorder.