Children diagnosed with bipolar disorder go through extreme fluctuations in mood. These mood episodes may be characterized by either depression or mania. A combined mood episode of both depression and mania, known as a mixed episode, also might be seen. These mood episodes usually last at least a week, and individuals with the disorder cycle between mood states. Children's bipolar symptoms may look somewhat different than adults'.
Types
Mania and depression look considerably different in children. Children experiencing mania may demonstrate extreme mood states. They may show extreme happiness or silliness, or extreme irritability and anger. Irritability may lead to outbursts of temper. Some children may experience a lesser form of mania known as hypomania in which they may seem more active and energetic than usual, but not to an extreme degree that causes impairment. Children experiencing depression may demonstrate sadness or irritability over a two-week period, with changes in behavior as well. Although both mania and depression can manifest as irritability, mania is accompanied by euphoria and increased energy, while depression is accompanied by sluggishness and sadness.
Identification of Mania
During a manic episode, children may appear full of energy, despite getting little sleep. They may have racing thoughts, talking rapidly and changing topics quickly. They may show difficulties with focus and concentration, moving quickly from one activity to the next. They may begin to take part in risky or dangerous behaviors, such as substance use. The child may also show inflated self-esteem, thinking he or she has powers or special gifts.
Identification of Depression
During a depressive episode, children may show sadness through crying or irritability. They may stop participating in activities they used to enjoy, they may have difficulty focusing, or they might exhibit weight loss or gain. Sleep patterns may change, with the child either sleeping too much or very little. Changes in energy level and appearing tired or sluggish are also common. Some children may have suicidal thoughts and ideas. Children may also complain of physical pain, such as stomachaches, headaches or body aches.
Significance
Children with bipolar disorder manifest symptoms differently than adults. When bipolar disorder is diagnosed in children, it tends to be a more severe form. According to the National Institute of Mental Health, children with bipolar disorder are more likely to have mixed episodes--dual experience of depression and mania--and to cycle more quickly between mood states. Children's mood may appear more chronically irritable and unstable, without the definitive changes between depression and mania seen more commonly in adults.
Warnings
Children and teenagers with bipolar disorder are much more likely to attempt suicide than adults with the disorder. The NIMH reports that in one study approximately one-third of children with bipolar disorder had attempted suicide. Because of the drastic oscillation in mood states, it is crucial to monitor suicidal thinking, planning and intent in people with bipolar disorder.
References
- National Institute of Mental Health: What Are Common Symptoms of Bipolar Disorder in Children and Teens
- American Academy of Child and Adolescent Psychiatry: Bipolar Disorder in Children and Teens
- National Institute of Mental Health: How Does Bipolar Disorder Affect Children And Teens Differently Than Adults?
