Childhood bipolar disorder, also known as pediatric bipolar disorder, is a form of bipolar disorder that occurs in children. While its existence is still a matter of some academic debate and disagreement, there is a growing body of evidence that suggests that bipolar disorder can exist in children.
Unlike most adults who have bipolar disorder, however, children who have pediatric bipolar disorder are characterized by abrupt mood swings, periods of hyperactivity followed by lethargy, intense temper tantrums, frustration and defiant behavior. This rapid and severe cycling between moods may produce a type of chronic irritability with few clear periods of peace between episodes.
Because the current diagnostic manual of mental disorders doesn’t recognize childhood bipolar disorder, there is no official symptom criteria. However, researchers have used criteria similar to that of adult bipolar disorder, requiring a child or teen to meet at least four or more of the following:
- an expansive or irritable mood
- extreme sadness or lack of interest in play
- rapidly changing moods lasting a few hours to a few days
- explosive, lengthy, and often destructive rages
- separation anxiety
- defiance of authority
- hyperactivity, agitation, and distractibility
- sleeping little or, alternatively, sleeping too much
- bed wetting and night terrors
- strong and frequent cravings, often for carbohydrates and sweets
- excessive involvement in multiple projects and activities
- impaired judgment, impulsivity, racing thoughts, and pressure to keep talking
- dare-devil behaviors (such as jumping out of moving cars or off roofs)
- inappropriate or precocious sexual behavior
- grandiose belief in own abilities that defy the laws of logic (ability to fly, for example)
Keep in mind that many of these behaviors, in and of themselves, are not indicative of a possible disorder and are characteristic of normal childhood development. For instance, separation anxiety, by itself, is a normal fear of being separated from one or both of the parents (for instance, attending the first day of first grade or if the parents want to go out for a night).
Childhood bipolar disorder is characterized by many of these symptoms, taken together, and marked by rapid mood swings and hyperactivity. These symptoms must also cause significant distress in the child or teen, occur in more than just one setting (e.g., at school and at home), and last for at least 2 weeks.
Because the existing diagnostic manual doesn’t recognize pediatric bipolar disorder, and there is still debate within the professional community about the validity of this diagnosis, insurance companies may not reimburse for treatment of this disorder. In addition, some professionals may not recognize the disorder and misdiagnose the child or teen with attention deficit disorder or depression.