The Symptoms of Early-Onset Bipolar Disorder

See a list of symptoms and find out which diagnoses may be masking bipolar disorder in young children.

By Irene S. Levine | PhD from The Child and Adolescent Bipolar Foundation

Bipolar disorder involves marked changes in mood and energy. The Diagnostic and Statistical Manual IV (DSM-IV), requires that, for a diagnosis of bipolar disorder, adult criteria must be met. Although there is no professional consensus on diagnosis, behaviors reported by parents may include:

  • an expansive or irritable mood
  • extreme sadness or lack of interest in play
  • rapidly changing moods
  • 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
  • daredevil behaviors (such as jumping out of moving cars or off roofs)
  • inappropriate or precocious sexual behavior
  • delusions and hallucinations
  • grandiose belief in own abilities that defy the laws of logic (ability to fly, for example)

Research suggests that there may be a strong genetic component to bipolar disorder, so a history of mood disorders or substance abuse in the family can be an important clue. Certain behaviors by a child should raise an immediate red flag:

  • destructive rages that continue past the age of four
  • talk of wanting to die or kill themselves
  • trying to jump out of a moving car

Diagnoses That Can Mask or May Occur Along With Bipolar Disorder:

  • depression
  • conduct disorder (CD)
  • oppositional-defiant disorder (ODD)
  • attention-deficit hyperactivity disorder (ADHD)
  • panic disorder
  • generalized anxiety disorder (GAD)
  • obsessive-compulsive disorder (OCD)
  • Tourette’s syndrome (TS)
  • intermittent explosive disorder
  • reactive attachment disorder (RAD)

In Adolescents, Bipolar Disorder Is Often Misdiagnosed as:

  • borderline personality disorder
  • post-traumatic stress disorder (PTSD)
  • schizophrenia

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