What is Juvenile Bipolar Disorder?

Question: What is Juvenile Bipolar Disorder?


Answer: Unfortunately, there’s still a fair amount of controversy over whether or not children can be diagnosed with bipolar disorder. Many people assume (or have been taught) that kids can’t have bipolar disorder because their symptoms don’t match the ones that are listed in the DSM for bipolar I or bipolar II. But those criteria were written to describe adult symptoms not childhood symptoms. 


While there are some children who will exhibit adult symptoms such as clearly defined episodes of mania, grandiosity, or depression that last for days or weeks at a time, most children don’t follow this pattern. Most children with bipolar experience very frequent mood changes, which occur multiple times a day, and which never last long enough to meet the adult criteria. Additionally, their manic episodes might be hard to identify because they seem irritable and angry rather than excited and happy. Other times manic episodes, because they can be so short in duration, appear to be evidence of the distractibility and hyperactivity associated with ADHD. 


But kids with bipolar disorder are usually very bright, creative, kind, and loving when they are stable, and they suffer tremendously as a result of their symptoms. They are often very ill and require treatment that works. Their symptoms are typically include:

    • Abrupt swings of mood and energy that occur multiple times within a day; 
    • Rapid switches from irritable, easily annoyed, angry mood states to silly, goofy, giddy elation; 
    • Intense outbursts of temper; 
    • Poor frustration tolerance;
    • Oppositional defiant behaviors; 
    • Periods of low energy and intense boredom;
    • Depression and social withdrawal;
    • Low self-esteem; and 
    • Suicidal thoughts. 


Unfortunately, as a result the related confusion kids with bipolar disorder are often left undiagnosed, or just as bad, misdiagnosed with multiple other diagnoses such as ADHD, DMDD, ODD, or GAD*. These misdiagnoses often result in treatment with antidepressant ‘SSRI’ medications or stimulants which can worsen their symptoms. 


Many mental health providers won’t even consider giving a child a diagnosis of bipolar disorder even when the symptoms are present because either they incorrectly believe they have to wait until the child is in their mid-to-late teens before making the diagnosis, or because they consider bipolar “too serious” a diagnosis to give a child because it is a life-long condition which requires significant medication management with mood stabilizers. These circumstances often lead to delays in treatment, and on average it can take 10 years for a child with bipolar disorder to be properly diagnosed. 


If you think you or your child may be suffering from childhood onset bipolar disorder and need help understanding how to differentiate bipolar disorder from other mental health diagnoses CMHRC is here to help. Consider engaging the CMHRC Diagnostic Consultation Service where you can speak with a professional who can provide clarity regarding the diagnosis and can answer your questions. Schedule a consultation today



*Attention Deficit Hyperactivity Disorder; Disruptive Mood Dysregulation Disorder; Oppositional Defiant Disorder; Generalized Anxiety Disorder.


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