The manic phase of pediatric bipolar disorder is often misdiagnosed as ADHD due to the hyperactive and agitated part of mania. The depressed phase of the disease is sometimes written off as anxiety, extreme sensitivity, irritability or aggressive behavior. Doctors often use adult bipolar diagnosis criteria to diagnose children, which may work for teenagers, but is difficult to apply to toddlers and young children.Here are some common behaviors in children diagnosed with bipolar disorder, as compiled by the Child and Adolescent Bipolar Foundation. Note that many of these behaviors mimic other psychiatric disorders, which makes diagnosis even harder:
expansive or irritable mood
extreme sadness or lack of interest in play
rapidly changing moods
explosive, lengthy, destructive rages
separation anxiety
defiance of authority· hyperactivity, agitation and distractibility
sleeping too little or too much
bed wetting and night terrors
strong and frequent cravings, usually for carbohydrates and sweets
impaired judgment, impulsivity, racing thoughts, and pressure to keep talking
dare-devil behaviors
inappropriate or precocious sexual behavior
delusions and hallucinations· belief in abilities that defy logic (ability to fly, for example)
There is a sad-but-true joke among parents of children with bipolar disorder; you know you have a bipolar child if you have prevented them from jumping out of a moving car at least once. That kind of dangerous impulsivity is a hallmark of the disorder in children.
Bipolar symptoms even show up in infancy. Children with bipolar disorder often were infants who slept badly, were more clingy, and often had uncontrollable rages that were different than the usual childhood tantrums.