While bipolar disorder in children isn’t common, it’s still possible. Children who show more emotional disruption and disorderly behaviors may become a concern to parents. With that, you may be curious about bipolar signs in children.

Since it’s rare for children to develop bipolar disorder, signs of the condition in children are fairly vague. Not to mention, they can apply to several other mental illnesses, such as depression.

What is Bipolar Disorder?

Bipolar disorder is a condition that causes severe mood swings involving emotional highs (mania or hypomania) and lows (depression). Since these are contradicting emotions, a person with bipolar can go from euphoria and full energy to hopelessness and loss of interest in previously enjoyed activities within weeks. ¹

Currently, mental health professionals recognize three types of bipolar disorder:

• Bipolar I Disorder – Defined by manic episodes that last for at least seven days. They may become so severe, they require hospitalization. Episodes of depression will last at least two weeks and can overlap with episodes of mania.

• Bipolar II Disorder – Defined by hypomanic and depressive episodes. Hypomanic episodes are not as severe as the manic episodes found in bipolar I.

• Cyclothymic Disorder (Cyclothymia) – When hypomanic and depressive episodes last for at least two years. ²

Typically, bipolar disorder is diagnosed in late adolescence (teen years) or early adulthood. However, symptoms can appear in children and older adults. ³ Not to mention, some women may notice symptoms upon pregnancy or following childbirth.

Bipolar Symptoms

Symptoms of bipolar disorder are divided into three categories. These are as follows:

Mania Symptoms

Symptoms of mania include:

• Feeling very “up,” “high,” “jumpy,” irritable, or touchy
• Loss of appetite
• Notions that you’re critical, talented, or powerful
• Participating in risky behavior (i.e. drugs or alcohol, gambling, reckless sex)
• Racing thoughts
• Reduced need for sleep
• Talking very fast
• Thinking you can do a lot at once

Hypomania Symptoms

Symptoms of hypomania are the same as manic episodes. However, they aren’t as intense as those of manic symptoms.

Depression Symptoms

Symptoms of depression include:

• Difficulty sleeping (i.e. waking up too late, sleeping too much)
• Feelings of sadness, emptiness, and hopelessness
• Inability to do simple tasks
• Increased appetite (weight gain)
• Loss of interest in things you once enjoyed
• Restlessness
• Talking very slow
• Trouble with concentration and decision-making
• Suicidal ideation

8 Bipolar Signs in Children

Since bipolar is rare in children, finding the right signs and symptoms can be difficult. However, there are a few things you should keep an eye out for if you believe your child struggles with bipolar disorder:

1.) Manic Episodes

Just like adults with bipolar disorder, children will experience manic episodes that are defined by emotional highs. However, a child may also present their symptoms a bit differently:

• Increased energy and lack of need for sleep (going days without feeling tired)
• Rapid thoughts and conversations (talks about multiple things at once)
• Repeated risky behavior (seen more in teenagers – drug use, sexual promiscuity, etc.)
• Unrealistic self-esteem (i.e. having superhero powers)

Since children tend to be more active than adults, their overabundance of energy may initially be overlooked. Furthermore, it may also be mistaken for attention-deficit/hyperactivity disorder (ADHD).

2.) Depressive Episodes

Signs of a depressive episode may be less obvious than those of manic episodes. Typically, a child with bipolar disorder can experience: ⁴

• Decreased appetite (changes in eating habits)
• Difficulty concentrating
• Fatigue
• Loss of interest in activities they once enjoyed
• Low energy

A child may reveal their depression by talking about physical illnesses, such as stomach aches and headaches. These discussions shouldn’t be overlooked as children can also experience thoughts of suicide. ⁵

3.) Family Genetics

If a child struggles with bipolar disorder, it’s likely someone else in the family also has the condition. For this reason, a family medical history should be taken into consideration when diagnosing bipolar disorder. There’s a chance your child may struggle with another condition. ⁶

Still, it’s important to note that a family history of bipolar disorder is not absolute when it comes to diagnosis. Furthermore, the risk of bipolar increases when genetics are closer to the child (i.e. a parent or sibling rather than an aunt or cousin).

4.) Grandiose Behavior

While it’s not the most common symptom of bipolar in children, grandiose behavior is a key sign your child struggles with this condition, especially in the initial phases of diagnosis. There are a few aspects of this behavior a parent should keep an eye out for: ⁷

• Acting as though they are superior to others
• Giddiness and goofiness at inappropriate times (i.e. bedtime)
• Overwhelming happiness (especially over things that aren’t important)

Since grandiose behavior is less common, it shouldn’t alone determine bipolar disorder.

5.) Rage and Anger

In children with bipolar disorder, anger is one of the most common symptoms. While all children get angry from time to time, those with bipolar tend to show very intense levels of anger. ⁸

These levels can become violent and may put the child or others at risk. For example, a child might reveal their anger by attacking someone else or destroying their toys.

Unfortunately, children with bipolar anger are usually unable to control their emotions. With that, anger can become more and more severe and last for hours at a time. Furthermore, a parent’s response to the anger may only exaggerate it.

6.) Mood Swings

As discussed, mood swings going from highs to lows are a common trait of bipolar disorder. However, in children, these mood swings tend to be more rapid. Sometimes happening multiple times within a day. ⁹

Parents tend to see these fluctuations in their child’s mood, energy, and overall routine. If you’ve noticed a pattern in your child, it’s important to address it as it can lead to difficulties in other aspects of life, from school to friendships.

7.) Changes in Behavior at School

In teenagers and children, you may notice a behavior change reflected in their school life. This can include:

• Drop in grades
• Engaging in risky sexual behavior
• Quitting a sports team or other extracurricular activities
• Talking about death (usually with classmates)
• Using drugs or alcohol

If you or the school administration has noticed any changes in behavior, it’s important to talk with your child and their teacher or guidance counselor. These discussions can help you set the right treatment path for your child’s recovery.

8.) Development of Similar Conditions

As previously discussed, your child may show signs of bipolar disorder but actually struggle with another mental illness. Both manic and depressive symptoms can overlap with other symptoms and for this reason, it’s important to see a mental health professional before you come to any conclusions. ¹⁰

Healthcare providers will look for “bipolar markers” to determine whether or not your child struggles with bipolar disorder. For example, a psychiatrist may observe if your teenager engages in risky sexual behavior which is unique to bipolar disorder. ¹¹

Furthermore, it’s important to rule out other health conditions. Since bipolar disorder is rare in children, you should check with your child’s doctor to confirm they don’t struggle with a physical condition.

Final Word

Bipolar disorder can be a detrimental condition. However, with the right tools and professional help, your child can overcome it.

It’s important to note that our outline of bipolar signs in children isn’t a determining factor of the disorder. Instead, you must have your child inspected by a mental health professional.

If your child is diagnosed with bipolar disorder, there are several resources for parents to give their children the best shot at beating this condition. Furthermore, it’s important your child consistently follows a psychiatrist’s advice.

References

¹ Jain A, Mitra P. Bipolar Disorder. 2023 Feb 20. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 32644424.

² Bielecki JE, Gupta V. Cyclothymic Disorder. 2023 Jul 17. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 32491800.

³ Carlson GA, Pataki C. Bipolar Disorder Among Children and Adolescents. Focus (Am Psychiatr Publ). 2016 Jan;14(1):15-19. doi: 10.1176/appi.focus.20150038. Epub 2015 Dec 24. PMID: 31975789; PMCID: PMC6524432.

⁴ Selph SS, McDonagh MS. Depression in Children and Adolescents: Evaluation and Treatment. Am Fam Physician. 2019 Nov 15;100(10):609-617. PMID: 31730312.

⁵ Stoep AV, McCauley E, Flynn C, Stone A. Thoughts of death and suicide in early adolescence. Suicide Life Threat Behav. 2009 Dec;39(6):599-613. doi: 10.1521/suli.2009.39.6.599. PMID: 20121323; PMCID: PMC2819538.

⁶ Kerner B. Genetics of bipolar disorder. Appl Clin Genet. 2014 Feb 12;7:33-42. doi: 10.2147/TACG.S39297. PMID: 24683306; PMCID: PMC3966627.

⁷ Katz LY, Fleisher WP. Child and adolescent bipolar disorder. Paediatr Child Health. 2001 Sep;6(7):439-43. doi: 10.1093/pch/6.7.439. PMID: 20107551; PMCID: PMC2807757.

⁸ Patino LR, DelBello MP. Irritability, Anger, and Aggression in the Context of Pediatric Bipolar Disorder. Child Adolesc Psychiatr Clin N Am. 2021 Jul;30(3):561-571. doi: 10.1016/j.chc.2021.04.007. PMID: 34053686.

⁹ Zarei M, Bidaki R, Hakim-Shooshtari M. Early onset bipolar disorder in a 5.5 years- old child. Iran J Psychiatry Behav Sci. 2011 Fall;5(2):143-5. PMID: 24644461; PMCID: PMC3939957.

¹⁰ Singh T, Rajput M. Misdiagnosis of bipolar disorder. Psychiatry (Edgmont). 2006 Oct;3(10):57-63. PMID: 20877548; PMCID: PMC2945875.

¹¹ Krantz M, Goldstein T, Rooks B, Merranko J, Liao F, Gill MK, Diler R, Hafeman D, Ryan N, Goldstein B, Yen S, Hower H, Hunt J, Keller M, Strober M, Axelson D, Birmaher B. Sexual Risk Behavior Among Youth With Bipolar Disorder: Identifying Demographic and Clinical Risk Factors. J Am Acad Child Adolesc Psychiatry. 2018 Feb;57(2):118-124. doi: 10.1016/j.jaac.2017.11.015. Epub 2017 Nov 26. PMID: 29413144; PMCID: PMC5806213.