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Sifting Through the Symptoms of Bipolar Disorder in Children

Parents with children who are expressing behavioral problems can be confusing to their parents. When sorting out the issues and determining whether or not your child has actual bipolar disorder can be a very difficult process. There are so many possibilities that you will want to rule out.

First, let’s look at other possibilities that you will want to rule out, and then we will look at what bipolar might look like in a child. If your child’s behavioral problems are both extreme and continue for a period beyond what would be normal for an adjustment problem, then you will want to get professional advice from both medical doctors and mental health professionals. We cannot make diagnoses here, of course, but the following information might help you explore things a bit, and you can present your ideas and intuitions in a way that is helpful to your doctors. So, first, a look at what bipolar is not:

  • Adjustment Disorders Emotional
  • Disturbance
  • Normal mood swings
  • Frustration expressed as acting out
  • Autism
  • ADHD/ADD
  • Conduct Disorder

The main indicator that you child might have actual bipolar, is unusually intense emotional sates that last for identifiable periods of time. We are looking for states of extreme “highs” or mania, and state of extreme “lows, or depression. In some cases, a child might experience a “high” that is not quite manic, along with the severe depressive states. These can be measured because it is so very clear when the child is experiencing a “mood episode” in contrast from when the child experiences the normal and often intense, but not unusually intense, mood fluctuations.

An “episode” consists of extreme highs and lows that occur concurrently with extreme changes in energy, activity, sleep and behavior. It can be difficult for a parent to distinguish between normal and unusual mood swings in a child, because children are by nature “moody”. The key is to notice if your child’s “episodes” are dramatically different from his or her usual mood. With that said, you will look for extreme episodes of joy or overexcitement, and extreme sadness, feelings of hopelessness and depression. Sometimes a child will have both at the same time. This is called a mixed episode. And a child might also express an episode with extreme disruptiveness, irritableness, and may be explosive.

One of the reasons why it is so difficult to accurately diagnose children is because the expression of explosiveness, and behavioral disturbances can also be found in some of the other diagnoses as mentioned above. So, the key is to look for the dramatic change in mood, which is to such a degree that you can even measure and episode. And this has to occur enough times for you to rule out emotional disturbance, and frustration that results in the difficulties of working through ADD or ADHD, or the severe difficulty adjusting to one’s life circumstances expressed as conduct disorder. Always look at the environmental factors and the events in a child’s life that may have affected them emotionally before jumping to the diagnosis of bipolar. It is better to be objective and consider if a move away from people he or she was attached to, or a divorce, or a serious medical illness, or the loss or separation from someone that your child was attached to might be at the core of his or her behavioral problems first. These kinds of adjustment problems can be expressed as conduct disorders, and it can look as if your child is having extreme mood swings. Treat the emotional issues first.

Bipolar includes a chemical imbalance in the brain. We want to be treating the correct problem. If after treating emotional issues and creating a stable environment for your child, you still see definite severe and identifiable mood swings, you might very well consider bipolar as a possibility, and you will want to share this with your child psychologist and psychiatrist. Symptoms of bipolar disorder are very different from normal mood changes and changes in energy- look for and extreme mood that lasts for a week or so. Sometimes, we can be fooled because the child only experiences hypomania, as mentioned previously. This is not the same as full blown mania, but there will be an episode of depression. When a child experiences mania, his or her actual ability to function normally will be affected; this is also true for the severe depression. However, when a child experiences hypomania, they may be extremely expansive and energetic, and even hyper focused on creative projects, but they will be able to function adequately. So, again, we are not talking about normal mood swings, which to most parents can even seem like they are “severe”. We are talking about mania and depression that is so extreme that it affects the child’s normal ability to function.

If you suspect that your child does indeed have bipolar disorder, you are not alone. There is support. A good place to begin to explore your situation as a parent who is suspecting your child to have bipolar, is this page on NIMH where you can print out a free hard copy of a very informative and helpful pamphlet titled Bipolar Disorder in Children and Adolescents: http://www.nimh.nih.gov/health/publications/bipolar-disorder-in-children-and-adolescents/index.shtml