A mother talking with a doctor about her child’s pediatric bipolar symptoms.

Spotting Pediatric Bipolar Symptoms in Your Child

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Your child’s mood can be unpredictable. Sometimes, they’re full of energy and giddy to the point of being reckless — then suddenly, they’re sad and withdrawn. It’s only natural for these mood swings to cause you to worry.

While those changes can be completely normal, they can also represent several mental health conditions including pediatric bipolar symptoms. If you’re a parent or caregiver concerned about your child’s symptoms, it’s important to familiarize yourself with the different ways mental health disorders present themselves.

What Is Pediatric Bipolar Disorder?

Once referred to as manic depression or manic-depressive disorder, bipolar disorder is a mental illness characterized by extreme mood swings and changes in behavior

To be diagnosed with bipolar disorder, a person must experience alternating mood episodes, including both manic/hypomanic episodes and depressive episodes.

Manic episodes are periods of high energy and elevated mood, while hypomania is a milder form of mania. Depressive episodes are the opposite, characterized by lowered energy and activity levels and a depressed mood.

Between mood episodes, you may also notice emotional dysregulation. This means that when something good happens, they may feel overjoyed, but when something bad happens, they may experience significant depression — often more intensely than others would.

Types of Bipolar Disorder

Several types of bipolar disorder differ in the severity of manic and depressive episodes.

Bipolar I

Bipolar I involves at least one period of mania along with depressive episodes.

Bipolar II

Bipolar II is similar to bipolar I. The intensity of depressive episodes may be the same, but hypomania is present rather than mania. People with bipolar II may develop bipolar I over time.

Cyclothymic Disorder

Cyclothymic disorder, or cyclothymia, is a rarer form of bipolar where the highs and lows are less severe and shorter in duration.

Mixed Bipolar

Bipolar with mixed features, previously referred to as mixed episodes, involves experiencing both manic and depressive symptoms simultaneously, rather than cycling through distinct episodes of mania and depression

Rapid Cycling Bipolar Disorder

Bipolar disorders I or II can present with rapid cycling. This is defined by at least four episodes of mania, hypomania, or depressive episodes within a year. Mood swings can also occur more quickly, sometimes over a few days or even hours.

Seasonal Bipolar Disorder

Seasonal bipolar disorder is defined by depressive symptoms in the winter and manic or hypomanic episodes in the spring or summer. Around 25% of people with bipolar disorder have this kind of mood disorder.

How Common Is Bipolar Disorder in Children?

Many believe that bipolar disorder only develops in late teens or adulthood, but that’s not true. Children and young people can develop bipolar disorder at any age.

The exact prevalence is not known and has been debated for some time, as different studies produce varying results. Conservative studies place the rate of bipolar I in children at 0.5% to 1%, and 6.6% when including all types of bipolar disorders.

To put it into perspective, the prevalence of attention-deficit/hyperactivity disorder (ADHD) in children is 11.3% So, while bipolar disorder is less common than other mental health and conduct disorders that affect children, it isn’t as rare as you might think.

Risk Factors and Symptoms of Bipolar Disorder

A child’s risk for developing bipolar disorder can be influenced by several factors, including a family history of bipolar disorder, particularly if an immediate family member has the diagnosis. Major life changes, such as the death of a loved one, can also play a significant role. Substance abuse and any major change in their life are other factors that can contribute to the onset or worsening of symptoms.

According to the DSM 5, both mania and episodes of major depression need to be present to receive a diagnosis of bipolar disorder.

Manic Symptoms

    • Elevated or irritable mood
    • High energy levels
    • Inflated self-esteem
    • Feelings of grandiosity
    • More talkative than normal
    • Quicker pace of speech
    • Racing thoughts
    • Decreased need for sleep
    • Risk-taking behaviors
    • Easily distracted
    • Psychosis with hallucinations and delusions.

For a diagnosis of bipolar I disorder, the above behaviors must persist consistently for at least one week and be severe enough to significantly impact daily life.

Hypomanic Symptoms

Hypomania shares similar symptoms to a manic episode, but is less severe and lasts a shorter duration. A hypomanic episode also causes an observably elevated mood and a change in behaviors, but it is not severe enough to impact daily life. There are also no symptoms of psychosis.

Depressive Symptoms

    • Low energy levels and mood
    • Feelings of sadness and worthlessness
    • Lowered self-esteem
    • Withdrawing from social situations
    • No longer enjoying hobbies
    • Difficulty sleeping or oversleeping
    • Trouble concentrating

How to Treat Bipolar Disorder

Mental health professionals prescribe treatment plans for bipolar disorder using a mix of medication, psychotherapy, and calming strategies.

Typically, mood stabilizers are used to treat bipolar disorder. Antidepressants can sometimes be used, but this is not always the most effective treatment; manic episodes can be a side effect of taking antidepressants for those on the bipolar spectrum.

Support groups and other interventions may be a part of the treatment of bipolar disorder, as well. A mental health professional can help you select the right treatment options for your child if they are struggling.

Similarities to Other Mental Health Conditions

It can be difficult to diagnose childhood bipolar disorder because it tends to be less common than other conditions. It also shares symptoms with other disorders that are more common in young children and adolescents.

Even in adults, bipolar disorder, especially bipolar disorder II, is often misdiagnosed as depression since depressive episodes are a part of the condition. This misdiagnosis may also happen when younger children and teens are struggling with bipolar disorder, especially if they have less disruptive hypomania.

Irritability is also a common symptom when it comes to bipolar diagnoses, ADHD, anxiety disorders, oppositional defiant disorder, and other conduct disorders. Anxiety disorder and bipolar disorder can both cause stomach aches, as well.

The primary way to diagnose bipolar disorder is by the extreme changes in moods and behaviors. However, emotional dysregulation and mood swings can also be symptoms of ADHD.

Diagnosis Requires Professional Care

Without a qualified mental health care provider, you can’t be sure what mental health condition your child is struggling with. Even with a professional’s help, it can be hard to get an accurate diagnosis. You need someone who specializes in child psychiatry.

At Meridian HealthCare, our therapists are experienced in providing high-quality care to young children and adolescents who are struggling with their mental health. If you’re worried your child is showing pediatric bipolar symptoms, reach out. We can help you find out what is causing the symptoms and develop an appropriate treatment plan.