All types of bipolar disorder consist of 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 and how quickly mood cycles occur.

• With bipolar I disorder, moods swing between mania and depression, sometimes with periods of normal mood between extremes. Some children with type I bipolar disorder have episodes of mania and are hardly ever depressed.
• With bipolar II disorder, depression is more prominent than mania, and manic episodes may be less common and less severe.

Children and young adolescents with bipolar disorder tend to have rapid-cycling or mixed-cycling types of bipolar disorder-meaning that the cycles between depression and mania occur quickly (rapid cycling), sometimes within the same day, or that symptoms of both mania and depression occur at the same time (mixed cycling).

Following are some common symptoms of bipolar disorder in children and adolescents. A combination of depressive and manic mood swings must occur for at least 1 week before bipolar disorder is diagnosed.^{2, 3}

Symptoms of depression

• Continuous sad or irritable mood
• Loss of interest in activities the child once enjoyed, 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 or agitated body movements or restlessness
• No energy or loss of energy
• Inappropriate feelings of guilt or worthlessness
• Difficulty concentrating
• Recurrent thoughts or talk of death or suicide

The warning signs of suicide change with age. Warning signs of suicide in children and teens may include losing interest in their usual activities or becoming fascinated with death or suicide.

Manic symptoms

• Severe changes in mood from being extremely irritable or sad 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 or no 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

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).

Bipolar disorder frequently occurs along with other conditions (such as conduct disorder), and each condition needs appropriate evaluation and treatment.

Untreated bipolar disorder can lead to suicide. The warning signs of suicide change with age. Warning signs of suicide in children and teens may include preoccupation with death or suicide or a recent breakup of a relationship.