Does Your Child Have Bipolar Disorder? Symptoms In Children And Teens

Are you concerned that your child or teen may have bipolar disorder? You’ve come to the right place. In this article, we will introduce you to bipolar disorder, highlight the first signs and key  symptoms to watch for in children and teens, and explain how you can offer support. 

Ready? Let’s dive in.

What is Bipolar Disorder?

Bipolar disorder is characterized by extreme, unprovoked mood swings that come with sudden changes in behavior, energy, sleeping patterns, and even thinking.

Bipolar disorder consists of two types of episodes: manic and depressive. Manic episodes are marked by extreme highs in mood and energy, while depressive episodes involve extreme lows.

Bipolar disorder typically manifests during adolescence, though symptoms can appear as early as childhood.

Two Types of Bipolar Disorder

Manic Episodes

Manic episodes involve children exhibiting a high level of energy and grandiosity. You can recognize a manic episode when your child’s behavior shifts from their baseline state to an unusually high level of energy.

High Energy

Children experiencing manic episodes may have a decreased need for sleep—not a lack of sleep. They feel as if they no longer need to sleep as much and still have enough energy for the next day.

Kids in a manic episode can be very talkative, often in ways that deviate from their baseline. For example, if they talk too fast, jump from topic to topic excitedly, and do not allow others to interrupt, it may signal a manic episode.

Younger children may express high energy through increased activity and difficulty being redirected. They can also be more prone to tantrums, irritability, and violent outbursts compared to their teenage counterparts.

In teenagers, high energy may manifest in risky behaviors, such as engaging in extreme sports. Additionally, your teenager might display overly sexual behaviors that are unusual for them.

Grandiosity

If your child suddenly expresses unrealistic confidence about achieving overly ambitious goals, this could be a sign of grandiosity. For instance, they might declare they will become a world-famous painter despite having shown no prior interest in the arts. 

You may notice them generating numerous ideas and starting multiple projects, but failing to complete any of them.

Depressive Episodes

As you may have assumed, depressive episodes involve very low moods, a loss of motivation to do anything, and a lack of energy for even mundane tasks, like getting out of bed.

Due to this lack of motivation and the desire to avoid their low moods, you might also notice your child sleeping too much and exhibiting a poor attention span.

During depressive episodes, they may feel intense, unprovoked sadness, and you might find them to be too sensitive, irritable, and prone to crying.

Social Withdrawal and Isolation

During this time, your child may not want to play or go out with friends, pushing away their close companions in ways that are far from their baseline behavior—not just needing some alone time if they are introverts.

Negative Self-Image

Whether they are a teenager or a younger child, negative self-image manifests as feelings of insecurity and unlikability, even among their closest friends.

They might believe they are incompetent at tasks they usually excel at and lose interest in activities they once enjoyed.

These two symptoms manifest in similar ways in both age groups, but let’s look at the rest that differ.

How depressive symptoms vary by age

Younger Kids

Anger Outbursts

Manic episodes may also involve anger outbursts like tantrums. However, since younger kids often have a harder time recognizing and expressing their feelings of sadness than teenagers, their low moods frequently manifest as anger.

You might notice they have a very low tolerance for frustration, lose control of their emotions more often, and display misdirected anger. Sometimes, this aggression can be physical.

Rejection Sensitivity with Emotional Outbursts

While friendly banter is normal between close circles, if your child seems overly sensitive to harmless teasing from close friends, they may be experiencing a depressive episode.

During this time, they may feel victimized by mundane events. For example, if their best friend doesn’t immediately notice them entering the room, they might believe that their friend no longer wants to be friends and is replacing them.

You might hear phrases like, “No one loves me,” during these episodes, as they perceive every minor inconvenience as a sign of rejection from loved ones.

Somatic Complaints

“Mom, I have a headache.”

“I feel a toothache coming on.” 

“My stomach hurts.”

During a depressive episode, your child may frequently complain about various physical pains.

This may occur for two reasons: their inability to properly recognize and express sadness can lead to stress that manifests as physical pain, or they may simply struggle to voice their emotional hurt, instead expressing it as physical discomfort.

Teens

Your teen has a better grip on recognizing their feelings, but they may still struggle with expressing them.

Irritability and Hopelessness

Both younger kids and teens experience increased irritability. However, while younger kids express sadness through anger, teenagers may express it as irritability and hopelessness.

They may lose interest in activities they once enjoyed and feel directionless about their future.

Boredom

This isn't your typical boredom. Depressive episode boredom is characterized by an unwillingness to engage in available opportunities.

This lack of motivation results in a failure to take initiative in anything.

During this phase, they may not know how to handle boredom and feel apathetic about addressing it.

Outward Expressions of Sadness

Teenagers may recognize their feelings of sadness but struggle to articulate them.

As a result, they might express their feelings outwardly through changes in makeup or style. You might notice their makeup becoming less vibrant or their style gravitating toward black and darker clothing.

They may cover more of their skin or hide their faces with their hair. You might also observe a shift in their music preferences, such as a newfound interest in sadder, more emotional genres.

Lack of Motivation in Academics

Their lack of motivation can lead to academic decline. They might skip classes, miss assignments, and show little interest in school.

If they are normally involved in extracurricular activities, they will probably also show a lack of enthusiasm towards those.

Change in Appetite

This symptom may manifest in both children and teens, but is more common in teenagers. There may be significant changes in appetite, whether it is a loss of appetite or binge eating, both at extreme levels.

If you feel that these sudden changes pose a health risk, take your child to a hospital immediately.

Mixed Episodes

As mentioned earlier, bipolar disorder involves cycling through manic and depressive episodes. However, some individuals may experience symptoms of both types simultaneously.

For instance, constant talking may coincide with feelings of sadness and tearfulness. This phenomenon is called rapid cycling, which is more common in younger kids with bipolar disorder.

Diagnosis

If you’re quite sure by now that your kid probably has bipolar disorder, it’s time to get a proper diagnosis. To obtain a diagnosis, consult a mental healthcare provider who specializes in working with children and teens.

They will ask questions about your child’s energy levels, mood, sleeping patterns, eating habits, etc., and conduct a mental health evaluation.

Your doctor may also request medical tests or physical examinations to rule out other health conditions.

Can Bipolar Disorder Be Mistaken for Something Else?

Bipolar disorder includes both manic and depressive episodes, but these episodes may not occur simultaneously.

For example, younger kids may experience several initial episodes that are purely manic, leading to an initial diagnosis of mood disorders before developing into bipolar disorder.

Conversely, since teens are more prone to depression, they may first receive a depression diagnosis before manic episodes manifest, ultimately leading to a proper bipolar diagnosis.

It's not a misdiagnosis; rather, bipolar disorder can present as either ADHD or depression. As treatments begin, bipolar disorder may clarify, resulting in a new diagnosis.

Treatment

Various treatments are available for bipolar disorder, and your child may be recommended one or a combination of the following:

• Psychotherapy
• Medications
• Family-focused therapy
• Other therapeutic approaches
• Lifestyle changes, such as a healthy diet, exercise, and maintaining routines

When to Seek Emergency Help

While you now understand that depressive episodes in bipolar disorder differ from major depressive disorder, the following signs warrant immediate emergency room attention:

• Psychosis (experiencing hallucinations or delusions)
• Paranoia
• Hurting themselves or others
• Suicidal thoughts or attempts

FAQs

What Causes Bipolar Disorder?

Currently, we cannot pinpoint a specific cause, but genetics play a significant role. If one or both parents have bipolar disorder, there is a high chance that their children may inherit the genes that increase their risk.

Should I Be Worried If My Child Exhibits Only a Few Symptoms?

If their behavior significantly differs from their usual baseline, it’s essential to be concerned. Rule out other medical conditions or external factors that might be affecting your child’s behavior.

But of course it’s always best to get them evaluated by a doctor.

Can Bipolar Disorder Be Mistaken for Something Else?

Yes. As mentioned above, several symptoms of bipolar disorder overlap with other psychiatric disorders, such as ADHD and depression.

Manic episodes in bipolar disorder can resemble ADHD symptoms, while depressive episodes are similar to those in children diagnosed with depression. 

The key distinction lies in consistency. Children with ADHD typically show consistent hyperactivity and high energy, while children with depression consistently exhibit low moods and lack of motivation.

In contrast, children with bipolar disorder cycle through extreme moods and behaviors, demonstrating inconsistency.

Will It Continue Into Adulthood?

This varies from case to case. While childhood and teenage bipolar disorder often continues into adulthood, with proper treatment and support, your child can learn to cope and lead a full, healthy life.

Read here to learn more about extreme mood swings.