Children and teens can be diagnosed with depression or bipolar just like adults. However, mood disorders can appear differently in young people than in adults. By knowing the signs and symptoms to watch for, you will know when to guide a young person to get appropriate help. If you do see changes in mood in your young person, it is important to seek help rather than assume it will go away on its own.
Just a mood or something more?
It can be hard to determine if changes in mood for a young person are associated with natural childhood development or something more. Mental health conditions in young people may be overlooked if there is a belief their mood changes are because of hormones. To understand if your young person is struggling with a mental health condition, consider their baseline. Have they normally been talkative but now are withdrawing and feeling less interested in socializing? Have you noticed a change in their eating or sleeping habits? Are they more irritable or seem sad a lot? Dramatic changes in typical behavior or personality can be an indicator there is something more going on.
Depression in young people versus adults
Depression in young people can look different than it does in adults. Symptoms of depression in children and teens include:
- Frequent sadness, or crying, or constant irritability
- Loss of interest in activities that used to be enjoyable
- Feelings of hopelessness, worthlessness, or guilt
- Change in weight or eating (increased or decreased)
- Fatigue or low energy
- Decline in school performance
- Sleep changes (more or less than usual)
- Thoughts of suicide and/or self-destructive behavior
These symptoms are also prevalent in adults; however, some symptoms may appear different in children and teens. Younger children will have a harder time explaining their emotions because they don’t yet have the language for it, so their complaints may be about physical symptoms voiced as “my tummy hurts” or “my head hurts.” If physical complaints cannot be explained by seeing a pediatrician
It is important to remember: the younger the child, the less ability they will have to vocalize what they are feeling, which is why it is important to consider their baseline and observe changes in behavior over time. Irritability is more common and possibly more severe for young people when they are depressed. Depression increases social withdrawal; however, teens may withdraw from their family more than their peers.
Bipolar in young people versus adults
Bipolar disorder is a mental health condition that is marked by intense changes in mood, energy, thinking, and behavior. Symptoms for young people may emerge gradually or suddenly during childhood, adolescence, or adulthood. Bipolar disorder is most frequently diagnosed in the mid-20s. However, onset can occur earlier in childhood or during the teen years. Knowing the symptoms of bipolar disorder can be helpful to understand if your child is experiencing a mental health concern.
Bipolar disorder is defined by periods of mania or hypomania, which are times 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
- Marking risky or impulsive choices regardless of consequences
Individuals experiencing mania will have more than one of the above symptoms for at least 7 straight days. Hypomania is defined as having more than one symptom for at least 4 straight days. One episode of mania can lead to a diagnosis of bipolar, but most periods of mania are followed by a period of depression (note the symptoms above).
It is important to look for both signs of depression and mania or hypomania, as children may have depression symptoms before symptoms of mania. Adults are more likely to show symptoms of mania.
The most notable difference between bipolar in adults versus children is that children may experience the course of their condition more continuously than adults do. Adults tend to have more defined periods of depression and mania or hypomania, whereas children may have longer periods of rapid cycling. (Rapid cycling occurs when someone moves quickly through both the depressed and manic states, sometimes even within the same day.)
Both children and adults can experience rapid cycling moods, but current research finds rapid cycling more common in children with bipolar. Additional research around rapid cycling and children is needed to ensure this is not caused by a possible second diagnosis.