Red Flags: Symptoms of Bipolar Disorder in Children

Bipolar Child Basics

By Kimberly Read & Marcia Purse,

Updated: June 18, 2006 Health's Disease and Condition content is reviewed by Steven Gans, MD

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by Kimberly Read


Randy is an endearing five year-old boy with an engaging smile. And yet, he has a history of tempestuous behavior that has followed him since infancy. He is bright, articulate, a fast learner - and as unpredictable as a tornado. From the time he cut his first tooth, he began biting - often drawing blood. At one and a half years old, Randy was dismissed from pre-school for aggressive behavior. He consistently scores high marks for academics, but has a string of "needs improvement" comments in all areas of behavior. He is loving, cuddling, wanting to be held one minute; screaming and raging with veins bulging from his neck the next.

Randy's parents are exasperated. They have attended many a parenting class, read a plethora of books, and tried every means of discipline suggested by family, friends, teachers and doctors.

Some say, "Randy is just all boy. He will grow out of it." Others suggest, "Randy has Attention Deficit Disorder. Ask your doctor for Ritalin." A few point their fingers at the parents: "You need to take a firm hand with Randy. A good spanking is what that boy needs."

Many whisper, "Can you believe that boy Randy? I would never allow a child of mine to behave like that."

No one seems willing to consider the idea that Randy may have early-onset Bipolar Disorder. His mother has struggled with depression most of her life. His father has Bipolar Disorder. Randy is a prime candidate for a mood disorder.

A study conducted by Demitri Papolos, MD, and Janice Papolos indicates that over 80% of children who have Bipolar Disorder come from families with a history of mood disorders and/or alcoholism on both sides of the family. And yet, even when a strong family history of this is present, professionals rarely consider early-onset Bipolar Disorder. Many children who actually have Bipolar Disorder have been diagnosed with ADHD. Why? Because the official guidelines for diagnosing Bipolar Disorder found in the American Psychiatric Association's Diagnostic and Statistical Manual, Fourth Edition (DSM-IV) outline criteria based on classic adult symptoms. When the last edition of the DSM was published, very little was known about how Bipolar Disorder presents itself in children.

A great deal more is now known about Bipolar Disorder in children. Demitri and Janice Papolos have written a well-researched book entitled The Bipolar Child: The Definitive and Reassuring Guide to Childhood's Most Misunderstood Disorder. I was thrilled to review such a wonderful book. We applaud Demitri and Janice for providing this much needed, insightful resource! Below is an excerpt from their work (reprinted with permission), which lists those symptoms common to children who have early-onset Bipolar Disorder.

Very Common

  • Separation Anxiety
  • Rages & Explosive Temper Tantrums (lasting up to several hours)
  • Marked Irritability
  • Oppositional Behavior
  • Frequent Mood Swings
  • Distractibility
  • Hyperactivity
  • Impulsivity
  • Restlessness/ Fidgetiness
  • Silliness, Goofiness, Giddiness
  • Racing Thoughts
  • Aggressive Behavior
  • Grandiosity
  • Carbohydrate Cravings
  • Risk-Taking Behaviors
  • Depressed Mood
  • Lethargy
  • Low Self-Esteem
  • Difficulty Getting Up in the Morning
  • Social Anxiety
  • Oversensitivity to Emotional or Environmental Triggers
  • Bed-Wetting (especially in boys)
  • Night Terrors
  • Rapid or Pressured Speech
  • Obsessional Behavior
  • Excessive Daydreaming
  • Compulsive Behavior
  • Motor & Vocal Tics
  • Learning Disabilities
  • Poor Short-Term Memory
  • Lack of Organization
  • Fascination with Gore or Morbid Topics
  • Hypersexuality
  • Manipulative Behavior
  • Bossiness
  • Lying
  • Suicidal Thoughts
  • Destruction of Property
  • Paranoia
  • Hallucinations & Delusions
Less Common
  • Migraine Headaches
  • Bingeing
  • Self-Mutilating Behaviors
  • Cruelty to Animals