Bipolar disorder causes mood changes and other symptoms. It usually appears during young adulthood, but it can develop earlier, in children and teens.
Research suggests bipolar disorder affects 1–3% of youth — particularly adolescents, as it is somewhat rare in children. It can be difficult to diagnose for a number of reasons.
In this article, find out more about how bipolar disorder can affect children and teens, and what treatments are available.
- hypomania: an elevated mood
- mania: a severely elevated mood
- depression: a low mood
- mixed episodes: high and low moods at the same time or in quick succession
The mood changes may be relatively mild, but some people experience greater extremes.
There can also be times of stability, and the duration of these periods can vary among individuals.
Levels of disruption also differ, depending on the severity of symptoms and the effectiveness of treatment. Many people with bipolar disorder attend school and work with few problems. For others, daily activities can be a challenge.
High and low moods in children with bipolar disorder
In a period of elevated mood, a young person may:
- seem extremely happy or excited
- do silly things
- take greater risks than their peers
- talk a lot and very quickly, possibly changing topics quickly
- experience racing thoughts
- find it hard to concentrate
- seem irritable
- not be sleepy
- be unusually energetic
- feel as if they can do anything, like someone with superpowers
- exhibit hypersexual behavior
During a low mood, a young person may:
- sleep too much or too little
- feel sad, hopeless, or empty
- cry frequently
- believe that they are worthless
- feel angry, irritable, or bored
- find it difficult to concentrate
- seem slow and lacking in energy
- have difficulty communicating with others
- have thoughts of death, such as by suicide
- lose interest in activities that they usually enjoy
- feel unwell, possibly with frequent headaches or stomachaches
These episodes differ in length from person to person. An episode may last a few weeks to several years. Some people experience changes in mood several times per day.
Conditions that may occur alongside bipolar disorder include:
- anxiety disorders
- disruptive behavior disorders
- drug or alcohol use disorders
- attention deficit hyperactivity disorder, or ADHD
These conditions can conflict, worsening symptoms and making treatment more challenging.
The symptoms of these conditions can also resemble those of bipolar disorder, and this may create challenges during diagnosis.
It can be difficult to diagnose bipolar disorder in children. The American Academy of Child and Adolescent Psychiatry recommend observing the child over time.
If a parent or caregiver has concerns that a teen may have bipolar disorder, a child psychiatrist or another mental health professional can help make an assessment.
It can be difficult to identify bipolar disorder in a young person for various reasons. For example, mood changes and occasional insomnia are common features of adolescence.
It can also be hard to distinguish bipolar disorder symptoms from those other conditions.
A person is more likely to develop bipolar disorder if a close family member has it, and researchers continue to uncover a genetic link.
Types of bipolar disorder
There are several categories of bipolar disorder, depending on how the features develop.
Bipolar I: A person has at least one manic episode lasting longer than 1 week and may experience depression. Some people also experience psychosis, in which they feel detached from reality, possibly with hallucinations or delusions.
Bipolar II: A person has at least one major depressive episode and at least one hypomanic episode, but no full manic episode.
Cyclothymic disorder: A person has several episodes of hypomanic and depressive symptoms for at least 2 years, in adults, or 1 year, in children. The episodes are less severe than those of bipolar I or II, but they can still significantly impact daily life.
In another phenomenon, called rapid cycling, a person has four or more episodes within 12 months. This is not an official type of bipolar disorder, but it does share some features with it.
There is effective treatment for bipolar disorder. A doctor may prescribe a combination of medication and therapy, and the person may need to take the medication throughout their life.
Medication can help manage mood changes, by decreasing the frequency and severity of manic and depressive episodes.
It can take time to find the best drug and dosage for each person, as the symptoms vary, and people respond differently to different drugs.
Also, the fact that a child’s body is still developing can affect the way that medication works. The doctor will carefully monitor and adjust the dosage to find the most suitable approach.
Therapy is an integral part of treatment for bipolar disorder. In therapy, a young person can:
- talk through their emotions
- come to understand and manage their behavior and reactions
- learn ways to handle stress, relationships, and self-esteem
- learn about bipolar disorder
- come to understand their own triggers
Factors such as stress and a lack of sleep can trigger a bipolar episode, and learning to cope well with stress, for example, can help reduce these episodes’ occurrence.
A young person with bipolar disorder needs active, ongoing support to help them manage the changes and challenges ahead of them.
The following tips may help:
- Be patient and understanding through the changes in mood.
- Seek and follow through with treatment.
- Encourage communication through questions and active listening.
- Be encouraging about treatments, emphasizing that they can make life better, while also listening to concerns.
- Inform the child or teen’s school about the challenges that they face.
Finding the right treatment can take time. Meanwhile, a supportive home environment can help the child or teen manage their symptoms.
Helping a child or teen with bipolar disorder can be challenging, and parents and caregivers may need support, too.
- learning about bipolar disorder and its symptoms
- improving communication skills
- managing the impact of bipolar disorder on the family
- finding new ways to solve problems
The result may be that family members have new, constructive strategies when bipolar disorder symptoms arise.
It is important for family members and caregivers who experience stress and other challenges to receive medical care and advice. A doctor may also recommend a local or online support group for people caring for those with bipolar disorder.
Experts do not know exactly why bipolar disorder develops. A combination of biological, genetic, and environmental factors may play a role.
According to the National Institute of Mental Health, the following may contribute:
Genetic features: Bipolar disorder is more likely to develop if a close family member has it.
Stress: Adversity, trauma, and stressful events can trigger bipolar disorder in people with a genetic predisposition.
Biological factors: Some research suggests that people with bipolar disorder share key distinctions in brain structure and function.
Bipolar disorder usually appears in young adulthood, but it can develop in teens and, less often, children.
A range of treatments are effective, but it can take time to diagnose bipolar disorder in children and more time to find the best approach to treatment.
In the meantime, medical professionals can help the young person and their family develop strategies for support.