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The Definition & Diagnosis of Pediatric Bipolar Disorder

written by: Roohi Khan • edited by: Emma Lloyd • updated: 7/25/2010

A lack of consensus among experts makes the diagnosis of pediatric bipolar disorder a difficult one. However, as a parent there are certain behaviors that can help you identify whether your child has this psychiatric illness. Read this article to find out more about bipolar disorder in children.

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    Definition of Bipolar Disorder

    Bipolar disorder in children and adolescents is termed pediatric bipolar disorder. Manic depression or bipolar disorder is a chronic brain disorder characterized by episodes of extreme changes in mood, energy, thinking, and behavior. People with bipolar disorder may fluctuate between periods of intense mania and major depression or quickly switch from mania to depression and back, often as quickly as within a single hour. The incidence of this chronic brain disorder, which is quite common in adults, is on the rise in children. However, the diagnosis of bipolar disorder in children is not as easy as in adults.

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    Bipolar Disorder in Children

    The frequency, intensity, duration, and treatment of bipolar disorder in children may vary from one child to the other. Researches have identified this brain disorder as a neuro-developmental one. This is because different parts of the brain mature at different times and different rate. The brain keeps on maturing till around the age of 25. As the child grows up, the disorder may affect the size, shape, and function of different areas and networks of the brain and the symptoms and diagnosis of the illness may keep changing.

    In many children, the disorder is often accompanied by symptoms of other psychiatric disorders. This is why it is often misdiagnosed as ADHD, depression, borderline personality disorder, obsessive-compulsive disorder, or post-traumatic stress disorder among many others.

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    Symptoms and Diagnosis of Bipolar Disorder in Children

    There are some children who satisfy all the criteria of bipolar disorder. However, there are others who don't fulfill all the criteria. They may not have episodes of a specific duration or they may have chronic irritability and clear mood swings, but no mania. Researchers have yet to reach a consensus on the specific criteria for diagnosing this psychiatric illness in children.

    However, there are certain behaviors that have been found in most cases and a diagnosis of child bipolar disorder is usually made if the child exhibits more than a few of these behaviors. Following are the behaviors:

    • Severe depression which keeps recurring
    • Intense and lengthy rage episodes
    • Lack of interest in playing
    • Extreme sadness
    • Severe anxiety of being separated from the parents
    • The child may talk about hurting or killing others or themselves
    • Dangerous behaviors with a potential to cause serious injury
    • The child may believe that he or she can do things that defy logic such as believing that they can fly
    • The child may exhibit sexual behaviors inappropriate for his or her age
    • Exhibiting impulsive aggression
    • Delusions and hallucinations
    • Extreme hostility towards other
    • He/she is constantly irritable
    • They may draw images or tell stories that are extremely violent
    • There may be disturbances in sleep such as violent nightmares or insomnia
    • Their thoughts keep racing and they feel an urge to keep talking incessantly
    • The child mentions hearing voices asking them to perform destructive actions
    • They have a compulsive craving for certain foods or objects
    • Too much involvement in too many activities
    • Compulsive creativity
    • Ordering or teaching adults about how they should be doing things
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    Treatment of bipolar disorder in children

    Due to the difficulty in diagnosis, this disorder is considered to have more severe repercussions in children than in adults. Teens with this disorder often attempt suicides and get involved in substance abuse and illegal activities that gets them suspended from school. However, effective treatment can be provided by educating the child and the family about the illness and prescribing medications such as lithium for mood stabilization. Psychotherapy can also improve the child's understanding of his or her behavior and help them handle life stressors more effectively.

    There is no doubt that the diagnosis of pediatric bipolar disorder is a difficult one and can often be misdiagnosed leading to delayed treatment. However, an evaluation by an expert psychiatrist specializing in children and adolescents can identify bipolar disorder in children and help provide timely treatment.

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    References

    Child & Adolescent Bipolar Foundation: About Pediatric Bipolar Disorder

    http://www.bpkids.org/learn/library/about-pediatric-bipolar-disorder

    American Academy of Child Adolescent Psychiatry: Bipolar Disorder In Children And Teens

    http://www.aacap.org/cs/root/facts_for_families/bipolar_disorder_in_children_and_teens

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