Bipolar disorder is a chronic brain disorder marked by bouts of extreme and impairing changes in mood, energy, thinking, and behavior. Symptoms may emerge gradually or suddenly during childhood, adolescence, or adulthood.

Bipolar disorder does not affect every child in the same way. The frequency, intensity, and duration of a child’s symptoms and the child’s response to treatment vary dramatically. It is important to treat bipolar disorder early rather than assume that it will go away on its own. Knowing the symptoms your child could experience will help to determine how to proceed with treatment options.

Bipolar disorder is defined by periods of mania or hypomania. That means a distinct period of abnormally elevated, expansive, or irritable mood accompanied by symptoms such as

  • inflated self-esteem or grandiosity,
  • decreased need for sleep,
  • being more talkative than usual or feeling pressure to keep talking,
  • racing thoughts,
  • being easily distracted,
  • feeling or acting driven to do things, and
  • doing risky or impulsive things regardless of the consequences.

Bipolar is characterized by the experience of an episode of mania which could feature the symptoms listed above. The mania episode must last persistently for at least 4 days to be considered for a diagnosis. Symptoms above in flux could be related to attention-deficit/hyperactivity disorder (ADHD) alternatively.

One episode of mania makes an official diagnosis of bipolar disorder, however, most children and adolescents also experience depression. Periods of depression are usually more common and last longer than periods of mania or hypomania.

Bipolar I or Bipolar II?

  • Bipolar I (or Type I bipolar disorder) is defined by at least one full episode of mania (lasting at least 7 days or resulting in hospitalization). Officially, an episode of mania with no history of depression constitutes a diagnosis of Bipolar I, but most people with Bipolar I have had episodes of significant depression.
  • Bipolar II (or Type II bipolar disorder) is defined by episodes of both depression and hypomania (lasting at least 4 days). Most people living with Bipolar II have repeated episodes of depression.

Diagnostic rules for bipolar disorder also describe two related conditions

  • Bipolar NOS (or Bipolar Disorder Not Otherwise Specified) is defined by a pattern of “bipolar features”—periods with symptoms of depression and mania that are not severe enough or long enough to make a diagnosis of full bipolar disorder.
  • Cyclothymic Disorder (or Cyclothymia) is defined by repeated periods of depression and elevated mood—when those periods are not severe enough to make an official diagnosis of mania/hypomania or a major depressive episode. This is a long-term condition, so the diagnosis would not be applied to problems present for less than a year.

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