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

From The Child and Adolescent Bipolar Foundation

• Facts About Depression
• Learn the facts about depression, and what you can do to treat it.
• 
• Bipolar Disorder: Where to Find Help
• Websites and books for families managing bipolar disorder.
• 
• A Candid Look at Bipolar Disorder
• Something was fueling Michael's disturbing behavior. His parents needed answers.
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• Antidepressants, Stimulants, and Your Child
• A cautionary note for parents and physicians on the use of antidepressants and stimulants.
• 
• Early-Onset Bipolar Disorder: An Epidemic?
• Overdiagnosed? Underdiagnosed? Experts weigh in on the unprecedented surge of bipolar diagnoses in youth.
• 
• The Child and Adolescent Bipolar Foundation
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