Bipolar Disorder In Children

Have you observed that your child experiences too intense moods? Do you have extreme changes in behavior? Do you have very sad periods and are suddenly very enthusiastic and exaggerated at times? If these types of behaviors occur permanently over time and are part of the daily routine, your child may suffer from bipolar disorder.

However, not all sudden and intense changes in mood in children mean that this disorder exists. This can only be confirmed by a mental health specialist after proper evaluation. However, most cases are diagnosed in older children and adolescents, although it can occur at any age. Let’s go deeper.

What is bipolar disorder in children?

Bipolar disorder affects children’s mood and energy, causing sudden changes in their emotional states. 

Sometimes they feel very happy, excessively content and do not stop from one place to another. It is a period of exaltation out of the ordinary. This state is called mania. Other times they feel too sad, with a state of discomfort that influences their level of activity and energy and is known as depression.

“Children with bipolar disorder experience unusual changes in their mood.”

Unlike bipolar disorder in adults, in children both manic and depressive symptoms occur on the same day or may appear simultaneously. Therefore, bipolar disorder in children can be more severe at this stage than in adolescence or adulthood.

Now, it is important to be clear that bipolar disorder is not the same as the normal ups and downs of behavior and mood that any child can experience. In fact, children with it often find it difficult to complete their homework or socialize with their peers and family.


The essential feature of a manic episode is a period defined by an abnormally and persistently elevated, expansive, or irritable mood. It is also characterized by an abnormal or persistent increase in activity or energy.

The mood in a manic episode is often described as euphoric, overly cheerful, high, or “feeling above the world.” In children, joy, “foolishness” and “nonsense” are normal in the context of special circumstances. However, if these symptoms are recurring, inappropriate for the context, and go beyond what is expected for the child’s developmental level, then we must pay attention.

High levels of activity and grandeur

During the manic episode, the child may engage in many new and underhanded games. Even sometimes during ungodly hours of the day. In addition, he has a high self-esteem that ranges from uncritical self-confidence to a marked grandeur that can reach delusional dimensions.

Children usually overestimate their abilities and are convinced, for example, that they are the best in a sport or the smartest in the class.

The child’s belief in his greatness is still present despite clear evidence to the contrary. Also, the child could attempt a feat that is clearly dangerous.

Less need for sleep

One of the most common features of mania is a decreased need for sleep. This is different from insomnia. In insomnia, the person wants to sleep or feels the need to sleep but cannot, while when there is an episode of mania, the person sleeps little or wakes up several hours earlier than usual, feeling rested and full of energy.

A decreased need for sleep often signals the onset of a manic episode.

The Depression

Depression refers to a set of related symptoms that come and go together. This set is usually made up of sadness, irritability, loss of interest, fatigue, feelings of inferiority and guilt, psychomotor slowdown, insomnia, suicidal thoughts, poor appetite, weight loss and difficulty concentrating.

It is important to remember that children often feel sad, listless, irritable, tired, or guilty. The joint appearance of these normal behaviors must be differentiated from the presence of a depression syndrome.

“Children often feel sad, listless, irritable, tired, or guilty.”

Thus, for example, it is necessary to differentiate a normal state of lack of motivation and complaints of boredom when carrying out certain activities, from the depressive symptom of persistent and generalized disinterest in all kinds of activities.

It is also necessary to differentiate the little desire to eat and the tendency to perpetuate meals, from the pronounced loss of appetite that constitutes a depressive symptom. Or differentiate the typical tiredness product of long school and extracurricular days, from continuous depressive fatigue.

Symptoms of bipolar disorder in children

Children with a manic episode may feel excessively happy, suddenly express their temper, speak quickly about many different topics, have difficulty staying asleep but feeling rested, have trouble concentrating, engage in dangerous behaviors, etc.

Children who suffer from a depressive episode may feel too sad, have somatic complaints such as headaches or stomach aches, sleep too little or too much, feel inferior to others or guilty … They may also have very little energy and lack of interest in fun games and until you think of death or suicide.

What Causes Bipolar Disorder in Children?

As with many other disorders and illnesses, there is no single cause to explain the origin of bipolar disorder in children. Thus, there are several factors that can cause it.

Genetics play an important role in the development of bipolar disorder in children,  since it is inherited, so children with a history in their family are more likely to develop it. On the other hand, it has also been hypothesized that there is some abnormality in the structure or function of the brain. One thing to ponder is that bipolar disorder is more common in rich countries than in poor countries.

“There are several factors that can cause a child to develop bipolar disorder.”

If your child suffers from bipolar disorder, you should know that the treatment is similar to that of adults. Treatment can help control symptoms and works best when it is continuous and not interrupted. Medications are often helpful for mood stability.

With proper treatment, children with bipolar disorder should get better over time. However, it is usually normal that you have to try several times before finding the ideal treatment for each person.


Comeche Moreno, Mª Isabel. Behavior therapy manual in childhood. Dykynson-Psychology. Madrid, 2012.

American Psychiatry Association (2014). Diagnostic and Statistical Manual of Mental Disorders (DSM-5), 5th Ed. Madrid: Editorial Médica Panamericana.

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