Bipolar disorder

Does he or she sometimes get overly silly or excited? Is your child very sad at other times? Do these extreme changes affect how your child’s behavior at home or school? These symptoms may signal bipolar disorder in some children and teenagers.

What is bipolar disorder?

Bipolar disorder, sometimes called manic-depressive illness, is a serious mental illness. Children with bipolar disorder have unusual mood changes. Sometimes they feel very happy or “up,” and are much more active than usual. And sometimes they feel very sad and “down,” and are much less active than usual.

Bipolar disorder goes beyond the day’s ordinary ups and downs and is becoming a serious medical condition and important health concern in this country. This condition is characterized by periodic episodes of extreme elation, happiness, elevated mood or irritability (also called mania) countered by periodic symptoms of major depression.

Watch for these symptoms

Pediatric bipolar disorder is a debilitating mental illness that causes significant problems for the child and his or her family. It’s important to know its possible symptoms, so you can seek help for your child. Children with bipolar disorder may express it in slightly different ways, but most children will experience a combination of the following symptoms:

  • Rapid, wide mood swings. Their mood may vary from overly happy to very sad several times in a day and seemingly without warning.
  • Irritability. Regardless of their current mood, they almost always are irritable and “touchy,” with the smallest things affecting their emotional state.
  • Euphoria. They may be excessively silly and giddy — to such an extent that it is annoying or odd to people around them.
  • Decreased need for sleep. They may have an apparent inability or lack of desire to sleep very much. Even when they don’t get a good night’s sleep, though, they might still have plenty of energy during the day.
  • Increased energy or activities. They often are excessively hyperactive, despite not seeming to need much sleep. This hyperactivity sometimes may be uncontrollable or even result in the child engaging in dangerous behaviors.
  • Rapid speech. Their speech can become extremely fast and expansive. They may go off on tangents frequently, making it difficult to follow what they’re trying to say.
  • Inflated self-esteem. They may sometimes truly believe they are bigger, stronger, smarter or better than others, perhaps even to an irrational extent.

Treatment offers hope

The good news is that children with bipolar disorder can successfully be treated, and significant improvements can be made in their behavior and development. However, it is important that the illness be accurately diagnosed as early as possible and treated appropriately. If bipolar disorder is inaccurately diagnosed or treated, symptoms could possibly worsen or the child could experience unnecessary barriers to his or her social, emotional and cognitive development.

If your child is experiencing symptoms of bipolar disorder, seek psychiatric consultation or ask your primary care physician how to find psychiatric support.

Jennifer Niskala Apps, PhD, is a pediatric neuropsychologist with the Children's Hospital of Wisconsin Child and Adolescent Psychiatry and Behavioral Medicine Program. Dr. Apps also is an associate professor of Psychiatry and Behavioral Medicine at the Medical College of Wisconsin.