Child Bipolar: Guide to Causes, Diagnosis & How To Treat

20 May Child Bipolar: Guide to Causes, Diagnosis & How To Treat

When we think about childhood, we often picture fun play, lots of energy, and innocent curiosity.

However, some children and their families face a different reality: bipolar disorder.

This is often seen as an “adult” illness, but it can also affect children in a big way.

Bipolar disorder can change a child’s mood, energy, and how well they can do everyday things. It can be scary and confusing for parents, leaving them with many questions and worries.

According to Dr. Vivek Pratap Singh (best child psychiatrist in patna), Bipolar Disorder is a condition associated with the mental state of a person or mood, energy, and actions. While it is said to appear only in adult life, it can appear in childhood as well.

Pediatric bipolar disorder can be defined as prolonged mood states co-occurring with extreme changes in mood or one of mania, hypomania, and depressive episodes.

With early intervention and treatment, a child will learn to manage his/her symptoms and live as functional a life as possible.

In this blog, we’ll explore the bipolar disorder in children signs, causes, and treatment options, shedding light on a topic that’s often misunderstood and overlooked.

Definition of Bipolar Disorder

Bipolar disorder is defined as psychological illness that causes abnormal deviations in mood, energy, and behavior.

Such mood variations or fluctuations are real, in contrast to the normal emotional shifting every human happens to experience, which can last days, weeks, or even months.

Such changing moods can affect the functioning of the child at home, in school, and socially with peers.

This disorder is most frequently misdiagnosed in children, as symptoms overlap with Attention Deficit Hyperactivity Disorder (ADHD) or depressive disorders.

The early recognition and the correct management promise the better outcome for children with the disease.

Explanation of Mood episodes

Bipolar disorder shows up as changes in how a child feels, thinks, and acts.

In simple terms, mood episodes include the following:

1: Manic Episodes

This episode is characterized by abnormally increased energy, restlessness, and impulsivity.

The child may speak very fast and switch topics a lot, thinking he is more important than he really is, at least for a little while.

Children sleep too little sometimes and feel very much energy.

Impulsive behavior may lead to unsafe events like reckless driving, going for spending skates, or creating non-realistic targets.

Sometimes, they do show a lot of aggression, and, at other times, very disruptive behavior.

2: Hypomanic Episodes

Hypomania is just less functioning mania, wherein the child appears just to be excessively energetic and very cheerful or excited.

Hypomania, in simple words, means diminishing intensity of the excessive symptoms of mania so that it is insufficient to affect proper functioning of the victim in daily chores.

The child becomes more talkative, open-minded, and even becomes self-assured, but that might be sometimes accompanied by irritability.

Hypomanic episodes can still make life more difficult at school and in social situations, thus leading to numerous difficulties in relationships.

3: Depressive Episodes

Such episodes are marked by extreme sadness, hopelessness, and low energy levels.

The child is going to cease taking interest in any activities, social friendly behavior, or play with friends and family members.

They may find it difficult to concentrate, experience changes in appetite, or have difficulty sleeping.

Some children may express feelings of worthless, self-harming thoughts, or actual suicidal ideation.

They’re longer than days to weeks and, in turn, have much less functioning ability when compared to episodes formed in depression.

Bipolar Disorder In Children vs adults

Bipolar disorder can show up in different ways in children and adults, even though they have the same basic problem.

Here’s how bipolar disorder usually appears in children compared to adults:

1: Rapid Mood Changes

Compared to the standards set by adults, the pace of changing moods that children exhibit seems faster. Some shifts may be mania and depression at the same time, all occurring sometime in a day or less.

Admittedly, while in such episodes, we adults would normally be having cycles that last from more than a few weeks up to several months.

Such rapid cycling may ultimately ‘confuse’ children’s accurate diagnosis of the disorder.

2: Irritability Over Euphoria

For most of the adults with bipolar disorder, the manic episode consisted of euphoric highs filled with increased self-esteem.

Mostly, children would demonstrate their general irritability, frustration, and aggressiveness just like someone getting angry instead of roaring in happiness.

Tension would then build with parents, and teachers, and peers.

3: Tantrum Behavior Outburst

Bipolar disorder, frequent, intense, full-blown emotional outburst is more extreme in children than regular tantrums.

These types of outbursts come on quickly, are difficult to control, usually have no clear reasons, and last much longer than regular tantrums.

4: Diagnostic Difficulties in Children

Bipolar symptoms in children can often look like other issues like ADHD, anxiety, or oppositional defiant disorder (ODD).

This can cause doctors to make mistakes in diagnosing and delay the right treatment.

Difficulty in clearly expressing emotions often impede clear evaluation by mental health professionals for most children.

5: Effects to Academic Achievement and Social Life

Sudden mood changes can make it hard for children to focus on their studies, complete tasks, or get along with others.

Children with bipolar disorder may act impulsively or aggressively, which can hurt their friendships.

Teachers and caregivers often see these mood changes as behavior problems instead of mental health issues.

In short, although the basic problem is the same, bipolar disorder in children usually shows stronger irritability, quicker changes in mood, and lasts longer than in adults.

This makes it hard to diagnose early and correctly, but it is very important for giving the right help and support.

How Common Is Bipolar Disorder In Children?

Bipolar disease in children is thought to be less prevalent than in adults, however estimates vary.

The diagnosis of bipolar disorder in younger children has generated a lot of controversy.

Below is a summary of the findings from the research:

Prevalence of Bipolar Disorder In Children

1-3% of children and adolescents have bipolar disorder, as per estimates.

Studies show that more than 50 percent of such adults report their first symptoms of the disorder occurring before age 18.

Children become at a substantially greater risk of having the disease if it is exhibited in a parent or sibling.

Late diagnosis and non-treatment have debilitating effects such as academic failure, alcohol and drug use, or self-harm.

Risk of suicide is a little higher among them having bipolar disorder-in this context, the need for early interventions.

Despite these statistics of bipolar disorder in children, the condition remains challenging to diagnose accurately due to its atypical presentation in younger populations.

Children often exhibit more irritability and rapid mood changes compared to the distinct manic and depressive episodes seen in adults.

As research improves how we diagnose bipolar disorder, we will better understand how common it is in children.

This will help provide better support and treatment for families who are affected.

Bipolar Disorder In Children Symptoms

What are the signs of bipolar in a child? It can be hard to notice a disease in children because their moods change a lot.

However, if these changes are strong, last a long time, or affect their daily life, it might mean they have bipolar disorder.

Let’s take a look at signs of bipolar disorder in children…

1: Frequent Mood Swings That Seem Extremely Unstable

Children with bipolar disorder have extreme mood swings; it switches suddenly and suddenly to very deep sadness.

These might happen within minutes or hours.

As far as emotional situations between children are concerned, these are much more severe.

2: High and Hyper Energy Levels

Bipolar children during a manic phase have a lot of energy and seem very restless.

They cannot seem to stop their activity, always feel like they must keep moving, or talk too much.

Because of hyperactivity, they will not be able to sit still or finish tasks.

3: Irritable or Aggressive Without Reasons

On the contrary, an adult feels euphoric during manic episodes; in children, such an episode turns into irritable outbursts of anger or aggressiveness toward others.

Usually, these can be viewed as tantrums but they are much more intense and drawn out.

4: Trouble Sleeping or Sleep Needs Very Little

Most of the time, these children have difficulty falling asleep or wake up several times during the night.

Days can go by, during which these children receive little sleep, while still displaying a really energetic, active demeanor.

In fact, sleep deprivation can intensify symptoms and increase mood instability.

5: Impulse Control Poor, Risky Excessive Behavior, or Bad Judgment

Children will engage in reckless activities without considering consequences.

These include climbing dangerous heights, running into traffic, and spending large sums of money.

Poor impulse control can lead to problems in school and relationships.

6: Long Interval of Profound Sadness, Hopelessness, or Withdrawal from Social Contacts

Depressive episodes include extreme sadness, lethargy, and lack of interest in previously enjoyed activities.

A child would go into self-isolation, would stop taking interest in various hobbies, or even lack motivation to do something.

Sometimes it can also lead to feelings of worthlessness or self-doubt.

7: Difficulty Concentrating or Completing Tasks

Mood swings make it difficult for children to concentrate.

They may face problems in school, either forgetting assignments or being deflected very easily.

These can be mistaken for attention deficit-hyperactivity disorder (ADHD) sometimes.

8: Increased Talking or Racing Thoughts

Children in a manic episode tend to speak more rapidly, jumping frequently from one topic to another.

Their thoughts may race, which makes it difficult for them to stay on one subject.

They also may interrupt conversations or struggle to listen to others.

Causes and risk factors

Bipolar disorder in children, like in adults, is understood to be a complex condition resulting from an interplay of genetic, biological, and environmental factors.

It’s rarely attributed to a single cause.

1: Genetics

Bipolar disorder is a mental health issue that often runs in families. If a child has a parent or sibling with bipolar disorder, they are more likely to develop it too.

Nonetheless, if one parent has bipolar disorder, the child’s chance of getting it is about 10% to 25%.

If both parents have it, the chance can increase to 10% to 50%.

2: Biological Factors (Brain Chemistry and Structure)

Bipolar disorder is believed to be related to imbalances in brain chemicals known as neurotransmitters.

These include:

• Dopamine: Important for feeling rewarded, motivated, and happy. High levels of dopamine can occur during manic phases, while low levels are linked to depression.
• Serotonin: Affects mood, sleep, hunger, and control over impulses.
• Norepinephrine: Influences how awake, energetic, and focused we feel.

3: Environmental Factors

Triggers for bipolar disorder mainly affect people who are already at risk.

• Stressful events like losing a loved one, abuse, family problems, or major life changes can cause episodes.
• Childhood trauma and neglect can increase the risk and make symptoms worse.
• Using alcohol or drugs, especially as a teenager, can cause mood swings or hide symptoms.
• Recreational drugs and some medications can lead to manic or depressive episodes.
• Poor sleep, irregular routines, and changes in daily schedules are strong triggers.
• Growing up in a stressful family can worsen the illness, but it does not cause it.

Some studies suggest that smoking during pregnancy or birth problems may be linked to bipolar disorder, but more research is needed.

Overall, these factors can trigger episodes, but they do not cause bipolar disorder by themselves.

4: Co-existing illness

Co-existing disorders, such as ADHD, anxiety, or depression raise the risk of a child being diagnosed with bipolar disorder in the future.

The symptoms of these disorders coincide, which is why the diagnosis becomes more complex.

Bipolar disorder in children is thought to happen because of a mix of factors.

These include a genetic tendency that makes them more vulnerable, differences in their brain’s biology, and stress from their surroundings.

Bipolar Disorder In Children Diagnosis

This is a lengthy evaluation and needs to be done by an expert in mental health.

Since symptoms of bipolar disorder can seem similar to those of other disorders, there are various steps to the process.

Psychiatric Assessment

The examination of patterns of mood, behavior, and emotional responses against time would be passed with a doctor or psychiatrist by the child.

They might ask family history, sleeping habits, and emotional provocation.

Observational Reports

Information on how a child behaves, be it in their home or school, is given by the parents, teachers, and caregivers.

All this will go further in determining how intense or frequent the symptoms might be.

Ruling Out Other Conditions

There are symptoms of bipolar that tend to resemble those associated with ADHD, depression, and anxiety.

The thorough evaluation will create the right diagnosis out of the confusion.

Bipolar Disorder In Children Treatments

How to treat Bipolar Disorder In Children? Treating bipolar disorder in kids needs a complete plan that usually includes medicine and therapy.

It also involves teaching the family and school about the disorder.

The aim is to balance mood, lessen symptoms, help with daily activities, and stop future problems.

Here’s an overview of common treatment methods:

Bipolar Disorder In Children Medication

Medication for bipolar disorder in children includes…

• Mood Stabilizers (as lithium and valproate): Keep mood swings in balance and prevent manic and depressive episodes.
• Antipsychotic Medications (like risperidone or aripiprazole): Manage extreme impulsivity and aggression associated with these mood swings.
• Antidepressants: Very occasionally prescribed because they can induce mania in some individuals.

Therapy

• Cognitive Behavioral Therapy (CBT): Assists children to name their feelings and adapt new methods for coping with their states of being.
• Family Therapy: Trains families to support the child with bipolar disorder.
• Psychoeducation: Information on managing mood and symptoms.

Strategies for Lifestyle and Behaviour

• Regular Sleep Pattern: Keeping kids on schedule to have regular sleep helps prevent mood disturbances.
• Nutritional Habit: Limiting sugars, caffeine, or processed foods helps to stabilize mood.
• Regular Exercise: Helps mental wellbeing and reduces stress through physical exertion.
• Stress Management: Mindfulness, meditation, and breathing exercises are some ways to keep emotions stable.

Treating bipolar disorder in children takes a long time. It needs patience, hard work, and teamwork between the child, family, and different health experts.

With the right and steady treatment, children and teens with bipolar disorder can learn to handle their symptoms well and live happy lives.

How To Prevent Bipolar Disorder In Children: Coping Strategies and Support

Here are key coping strategies and support mechanisms for children at risk or showing early signs, and for their families:

1: Parental Support

Stay calm, listen, and validate their feelings.

Clear rules and expectations might make them feel a little secure.

2: Emotional Identification & Labeling

Learning to recognize and name feelings (e.g., “I’m feeling really irritable,” “This is sadness,” “My thoughts are racing“).

This helps them gain a sense of control over intense emotions.

3: School Collaboration

Inform teachers and school counselors about the child’s condition.

Letters can provide the necessary accommodations in Individualized Education Plans (IEPs).

4: Mood Tracking/Journaling

With parental guidance, keeping a simple journal or mood chart to track daily mood shifts, sleep patterns, energy levels, and potential triggers.

This builds self-awareness.

5: Support Groups

Connect with other families facing similar challenges.

Support groups offer emotional relief and practical advice for coping.

6: Identifying Early Warning Signs

Learning to recognize the subtle cues that indicate a mood shift is beginning (e.g., feeling unusually energized, needing less sleep, increased irritability, heightened sadness).

7: Routine and Structure

Set up a predictable schedule, as this would limit stress and emotional difficulty.

Daily routine allows the child to ride through mood changes effectively.

8: Stress Management & Problem-Solving

Learning age-appropriate techniques to identify stressors and develop practical solutions to problems rather than being overwhelmed by them.

This can include breaking down tasks or asking for help.

9: Social Skills & Communication

Developing skills to communicate effectively with family and peers, resolving conflicts constructively, and building positive social connections.

This can reduce isolation and improve relationships.

Conclusion

With early diagnosis, the right treatment, and good family support, children with bipolar disorder can lead successful lives.

Parents and caregivers need to understand the symptoms, causes, and treatment options to provide the best care.

Very important, avail of professional help and lifestyle strategies to effectively cure the situation.

Families who resides in Patna, Bihar and are seeking for help, you can consult Dr. Vivek Pratap Singh a highly qualified child psychiatrist in patna.

With over 10 years of experience in neuropsychiatry and child psychiatry, Dr. Singh is affiliated with the PMCH Psychiatry Department and practices at Pratap’s Neuro & Child Psychiatry Clinic in Kankarbagh, Patna.

He offers affordable, evidence-based treatments, including behavioral therapy and parent counseling, tailored to each child’s unique needs.

Is My Child Bipolar Quiz

1: How to calm down a bipolar child?

Calming mechanisms like deep breathing and mindfulness can be applied.

Allow self-regulation in a quiet place.

An organized, consistent routine would help reduce anxiety.

Do not engage in arguments or escalation of conflicts.

2: What is commonly mistaken for bipolar?

ADHD, depression, and anxiety disorders have similar symptoms to each other.

Conduct disorder and oppositional defiant disorder can also be very confusing with bipolar disorder.

Normal mood swings during childhood development often seem similar to bipolar conditions.

The best way to assess is with a mental health evaluation by a psychiatrist so that a person is accurately diagnosed.

3: What is the first red flag of bipolar disorder?

• Excessive mood swings, apart from normal behavior of childhood.
• Strongly feels angry enough to go along with burst outs of anger or hyperactivity.
• Jumping between extroversion and interest to extreme lethargy or grave sadness.
• Episodes of mood severely interfere with day-to-day activities and relationships.

4: At What Age Does Bipolar Disorder Start?

Research suggest that bipolar disorder starts in early adulthood or adolescence, between ages 15 and 25.

However, in the case of children, this mental disorder can develop at the age of 6, known as pediatric or early-onset bipolar disorder.

Although, it’s less common and hard to diagnose because of its overlapping symptoms with other conditions like ADHD.

In some rare cases, bipolar disorder symptoms may appear even earlier, but is usually delayed until consistent patterns are observed, often by adolescence.

5: How To Teach A Child With Bipolar Disorder?

At first you need to create a structured, supportive environment with consistent routines and a safe space for self-regulation.

Secondly, change lessons to include short tasks, adjustable deadlines, and different learning methods to help with mood changes.

Collaborate with school counsellors, teachers, parents and a psychiatrist for tailored strategies.

Use positive coping techniques to foster emotional and academic growth.

6: What Is The Hallmark Symptom Of Bipolar Disorder In Children?

The hallmark symptom of bipolar disorder in children is very strong irritability, which often shows as sudden and extreme mood changes.

Unlike adults, children can quickly switch between feeling very happy and very sad, with irritability being more noticeable than happiness.

This can cause them to become aggressive or have strong emotional reactions, making it hard for them to get through daily activities.