What is bipolar disorder in children and teens?

When children older than age 6 or teens have bipolar disorder, they have mood swings with extreme ups and downs. When they are up, they have brief, intense outbursts or feel irritable or extremely happy (mania) several times almost every day. They have a lot of energy and a high activity level. When they are down, they feel depressed and sad.

In the past, experts thought bipolar disorder was the same in children and adults. But symptoms in children and teens are different from those in adults, and they need different treatment.

What causes bipolar disorder?

Experts don’t fully understand what causes bipolar disorder.

It seems to run in families. Your child has a greater risk of having it if a close family member such as a parent, grandparent, brother, or sister has it. Parents may wonder what they did to cause their child to have bipolar disorder. But there is nothing a parent can do to cause or prevent it.

What are the symptoms?

Children and teens with bipolar disorder have mood swings with extreme ups (mania) and downs (depression). These intense moods quickly change from one extreme to another without a clear reason. Some children may briefly return to a normal mood between extremes. Many children change continuously between mania and depression, sometimes several times in the same day. Sometimes children with bipolar disorder have symptoms of both mania and depression at the same time.

Times of mania or depression may be less obvious in children and teens than in adults.

  • During a time of mania, children and teens may:
    • Feel irritable and throw violent temper tantrums.
    • Seem extremely happy and have high energy levels.
    • Touch their genitals, use sexual language, and approach others in a sexual way.
    • Not sleep much and go about the house late at night looking for things to do.
    • Talk very fast.
  • During a time of depression, children and teens may:
    • Say they feel empty, sad, bored, or down.
    • Complain of headaches, muscle aches, stomachaches, or fatigue.
    • Often spend time alone and may easily feel rejected or criticized.
    • Move very slowly.

How is bipolar disorder diagnosed in children and teens?

This disorder can be hard to diagnose in children and teens. The symptoms can look a lot like the symptoms of other problems, such as attention deficit hyperactivity disorder (ADHD), alcohol and drug abuse problems, or conduct disorder. Bipolar disorder can often occur along with these problems.

If your doctor thinks your child or teen may have bipolar disorder, he or she may ask questions about your child’s feelings and behavior. Your doctor may also give you and your child written tests to find out how severe the mania or depression is. The doctor may do other tests (such as a blood test) to rule out other health problems. He or she may ask if your family has any history of mental illness or problems with drugs or alcohol. Any of these problems can be linked to bipolar disorder.

Why is early diagnosis of bipolar disorder important?

Children with this disorder are more likely to have other problems. These include alcohol and drug abuse, trouble in school, running away from home, fighting, and even suicide. Treating the disorder as early as possible may keep your child from having these problems.

Watch for the warning signs of suicide, which change with age. Warning signs of suicide in children and teens may include thinking too much about death or suicide. Watch also for things that can trigger a suicide attempt such as a recent breakup of a relationship or the loss of a parent or close family member through death or divorce.

How is it treated?

The mood changes that come with bipolar disorder can be a challenge. But with the right treatment, they can be managed well. Treatment usually includes both medicine (such as mood stabilizers) and counseling.

An important part of treatment is making sure your child takes his or her medicine. Children and teens with this disorder sometimes stop taking their medicines when they feel better. But without medicine their symptoms usually come back.

Medicines for bipolar disorder in adults have been well studied. But not much research has been completed about how the medicines work and if they are safe for children and teens.

Accepting that your child has bipolar disorder can be hard. The disorder can be a serious, lifelong problem. Your child will need long-term treatment and will need to be watched carefully. By working with your child’s doctor, you can find a treatment that works for your child.