Originally thought to be primarily an adult disorder, childhood bipolar disorder diagnosis is becoming more common. Although researchers are still learning about childhood bipolar disorder, the Medical University of South Carolina (2002) reports that 1 to 2 percent of the world’s adult population is bipolar.
Early onset â€” or juvenile â€” bipolar disorder presents very similarly to ADHD (attention deficit hyperactivity disorder). Early onset bipolar disorder may also be mistaken for childhood depression. As a matter of fact, the Depression and Bipolar Support Alliance (2006) estimates that one-third of American children diagnosed with depression have juvenile bipolar disorder.
According to a study performed at John’s Hopkins University (2003), average ages of onset of bipolar disorder and depression have decreased by an average of 10 years with each successive generation since World War II.
Bipolar Disorders: Children and Adults
Bipolar disorder in children is difficult to detect, as symptoms differ in preteens, teenagers and adults. Teens and adults display cycles of manic episodes (high energy, irritability and high activity), followed by episodes of depression (low energy, social withdrawal, etc.)
Bipolar disorder in children, however, rarely exhibits clearly defined episodes of mania and depression. Symptoms of bipolar disorder in children often include rapid cycles through mania and depression, sometimes several times a day, leaving children chronically irritable and upset.
Causes of Bipolar Disorder in Children
Although environmental factors and events can trigger juvenile bipolar disorder, the root cause appears to be genetic. The disorder may skip a generation or cause different symptoms from one generation to another.
Family histories of depression, substance abuse, alcoholism and bipolar disorder increase the risk of childhood depression. According to the Pittsburgh Bipolar Offspring Study conducted by University of Pittsburgh School of Medicine (2009), a child with one bipolar parent has a 15 to 30 percent chance of developing the disorder. If both parents have a history of manic depression, this risk increases to 50 to 70 percent.
Symptoms of Bipolar Disorder in Children
Symptoms of bipolar disorder in children may be detected as early as infancy. Parents may describe these babies as having difficulty sleeping and settling, and as young children, they often display pronounced separation anxiety.
Children with bipolar disorder are emotionally erratic. Periods of intense, inappropriate euphoria and happiness are quickly followed by episodes of anger, crying and irritation.
Intense temper tantrums and uncontrollable rages are common, including screaming, destruction and head banging. Asserting authority and the word “no” may trigger these symptoms of bipolar. Rage symptoms rarely occur out of the house or around strangers, making it difficult to convince others that a problem exists.
No single child exhibits all possible symptoms of bipolar disorder. In addition to the symptoms discussed above, children with bipolar disorder may experience:
- ADHD symptoms
- Food cravings
- Impaired judgment
- Night terrors, a more extreme nightmare in which a child awakes screaming, sweating and or breathing fast and has no recollection of what happened.
- Reckless, dangerous behavior
- Too little sleep
- Too much sleep.
Children with bipolar disorder may also exhibit inappropriate sexual behavior. Some patients have “grandiose” beliefs, such as believing they can fly or that they are too smart to go to school. In severe cases, childhood bipolar disorder can cause severe delusions or hallucinations.
Medical Diagnosis: ADHD or Juvenile Bipolar Disorder?
Many factors complicate a diagnosis of bipolar disorder in children. First of all, current diagnostic criteria for bipolar disorder apply only to adults: No definitive criteria exist as of yet for children.
In addition, symptoms of childhood bipolar disorder closely resemble those of attention deficit hyperactivity disorder. The Bipolar Child (1999) reports that approximately 80 percent of children with bipolar disorder have all the symptoms of ADHD. Distinguishing between these two conditions is important; stimulant medications used to treat ADHD can increase mania symptoms and aggression associated with bipolar disorder.
Depression and Bipolar Support Alliance. (2006). Bipolar disorder statistics. Retrieved August 2, 2010, from http://www.dbsalliance.org/site/PageServer?pagename=about_statistics_bipolar.
McInnis, M. G., McMahon, F. J., Chase, G. A., Simpson, S. G., Ross, C. A.