Bipolar disorder in children, also known as pediatric bipolar disorder, is a form of bipolar disorder that occurs in children and teenagers. In the latest version of the Diagnostic & Statistical Manual of Mental Disorders (DSM-5), it is not referred to as “bipolar disorder,” but rather as disruptive mood dysregulation disorder. These are one and the same disorder.
Unlike most adults who have bipolar disorder, 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.
The criteria for childhood bipolar disorder are similar to that of adult bipolar disorder, requiring a child or adolescent to meet at least four or more of the following:
- severe temper outbursts that are verbal or aggressive behavior toward others or things
- the temper outburts occur 3 or more times per week and are inconsistent with the child or teen’s age level
- 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 can be characteristic of normal childhood development. For example, separation anxiety, by itself, is a normal fear of being separated from one or both of the parents (such as when attending the first day of first grade or if the parents want to go out for a date 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.
As mentioned, childhood bipolar disorder is now referred as disruptive mood dysregulation disorder by mental health professionals and insurance companies. Treatments for this disorder parallel the treatments used in adult bipolar disorder, and typically will include both medication and psychotherapy.
In addition, some professionals may not recognize the symptoms of this disorder and misdiagnose the child or teen with attention deficit disorder or depression. It helps to see a mental health professional who has direct experience in the diagnosis and treatment of childhood bipolar disorder (disruptive mood dysregulation disorder), to ensure your child or teen receives the best treatment possible.