Our 10-year old son was recently diagnosed with bipolar disorder.  One of my aunts had this illness, so I’m somewhat familiar with it. But my question is whether or not the symptoms of bipolar disorder look the same in children as they do in adults?

Bipolar disorder (manic-depressive illness) affects close to 1 million children and adolescents in the United States at any given time. Abrupt swings of mood and energy that occur multiple times within a day, intense outbursts of temper, poor frustration tolerance, and oppositional defiant behaviors are commonplace in juvenile-onset bipolar disorder. These children veer from irritable, easily annoyed, angry mood states to silly, goofy, giddy elation, and then just as easily descend into low energy periods of intense boredom, depression and social withdrawal, fraught with self-recriminations and suicidal thoughts.

Recent studies have found that from the time of initial manifestation of symptoms, it takes an average of ten years before a diagnosis is made. Bipolar disorder was once thought to be rare in children. Now researchers are discovering that not only can bipolar disorder begin very early in life, it is much more common than ever imagined. Yet the illness is often misdiagnosed or overlooked. Why?

Bipolar disorder manifests itself differently in children than in adults, and in children there is an overlap of symptoms with other childhood psychiatric disorders. As a result, these children may be given any number of psychiatric labels: Attention Deficit/Hyperactivity Disorder (AD/HD), Depression, Oppositional Defiant Disorder, Obsessive Compulsive Disorder, or Separation Anxiety Disorder. Adults seem to experience abnormally intense moods for weeks or months at a time, but children appear to experience such rapid shifts of mood that they commonly cycle many times within the day. This cycling pattern is called ultra-ultra rapid or ultradian cycling and it is most often associated with low arousal states in the mornings (these children find it almost impossible to get up in the morning) followed by afternoons and evenings of increased energy. It is not uncommon for the first episode of early-onset disorder to be a depressive one. But as clinical investigators have followed the course of the disorder in children, they have reported a significant rate of transition from depression into bipolar mood states. 

Editor’s note:  Information for this article taken from the Juvenile Bipolar Research Foundation at www.bpchildresearch.org. 

Education Department
Mental Health Association of Greater St. Louis
314-773-1399

Want to see other Open Mind columns?  Click here for archive index.