Bipolar disorder causes cycles of mania (or hypomania, a less severe form of mania) and depression. The different types of bipolar disorder are based on whether a person has more severe symptoms of mania or depression.
- With bipolar I disorder, moods swing between mania and depression, sometimes with periods of normal mood between extremes. All children with this disorder have episodes of mania, but episodes of depression vary. For example, some children do experience depression, and others rarely are depressed.
- With bipolar II disorder, depression is more severe than mania. And manic episodes may last for fewer days and be less intense.
- With cyclothymia, the high and low mood swings are not as severe as the mania and depression seen in bipolar I or bipolar II disorders.
- Bipolar, NOS (not otherwise specified), is diagnosed when symptoms of mania and depression are not frequent or severe enough for the above diagnoses.
- Rapid-cycling means that there have been at least four shifts between depression and mania over the past 12 months. These shifts occur quickly, sometimes within the same day. Often the shifts happen without a return to a normal mood in between the extremes.
- Mixed-cycling (also known as mixed-features) means that symptoms of both mania and depression occur at the same time.
- Continuous sad or irritable mood
- Loss of interest in activities that the child enjoyed in the past, such as hobbies, sports, games, or friends
- Significant changes in appetite or body weight (weight loss or gain)
- Sleeping too much or too little or having trouble falling asleep
- Slowed body movements or restlessness
- No energy, or loss of energy
- Inappropriate feelings of guilt or worthlessness
- Problems concentrating
- Recurrent thoughts or talk of death or suicide
- Headaches, muscle aches, or stomachaches
- Severe changes in mood from being extremely irritable to overly silly and elated
- Too much energy, such as the ability to keep going without tiring while the child's peers are tiring
- Decreased need for sleep, such as going for days with very little sleep and not being tired
- Talking too much or too fast, changing topics too quickly, and not allowing interruptions
- Increased distraction and constantly moving from one thing to another
- Grandiosity, such as inflated self-esteem or a belief in unrealistic abilities or powers
- Increased sexual thoughts, feelings, activity, and use of sexual language (hypersexuality)
- Increased obsession with reaching goals or becoming involved in too many activities
- Risky, wild, thrill-seeking behavior
During severe episodes of mania, your child may suffer from symptoms of psychosis, such as having hallucinations or delusions of grandeur (for example, telling people that a rock band is coming to his or her birthday party).
People sometimes confuse bipolar disorder in children with other conditions with similar symptoms, such as attention deficit hyperactivity disorder (ADHD). Although there is some evidence of a link between ADHD and bipolar disorder, the conditions have distinct features that you can usually identify.
In young children, the symptoms of mania are more than just being a bother to adults and other children now and then. For example, many children can be silly and giggly to a point that it bothers their parents sometimes. This is not considered to be a sign of mania. But if a child is silly and giggly for several hours, several times almost every day, and this is interrupting the family's usual routine, then it may be a symptom of mania.