Bipolar Depression In Children And How The Treatment Differs

Updated August 30, 2022by BetterHelp Editorial Team

Bipolar depression is, at its very core, a brain illness. Also known as manic depression, it's characterized by extremes in mood and behavior. Those with bipolar disorder may have extreme highs and lows when it comes to their energy, their mood and a whole lot more. Though typically diagnosed in their teenage to young adult years, it is possible for this disorder to be diagnosed in younger children and for treatment to begin much more quickly. Treatment is extremely important however, and early diagnosis can help with this.

Are You Worried Your Child May Have Bipolar Depression?

What is it?

First, what is bipolar disorder? Well, as we mentioned, it's a type of depression that is characterized by extreme highs and lows. Many people know about depression and the sadness and hopelessness that goes with it. But bipolar disorder is a little bit different from this. With bipolar disorder, there are these extreme lows of depression but also some extreme highs where the individual may feel happy, energized and a whole lot more. Unfortunately, both the highs and the lows can result in trouble for the child as they can each cause different types of problematic and even dangerous behavior.

Symptoms of Bipolar Depression in Children

It's extremely important to watch for signs and symptoms of bipolar disorder in children because they may not be able to articulate what they are feeling, as well as a teenager or adult. They may not understand what's happening to them and this may cause them to have even more extreme reactions to those highs and lows or to feel frightened or confused. Treatment can be started quickly and can definitely help with the effects of the bipolar disorder, as well as the side effects for the child.

Symptoms of a Manic Episode

  • Feeling or acting extremely silly in a way that is out of character or doesn't fit their age
  • Extremely short temper or irritability
  • Talking more quickly than normal or jumping between topics quickly
  • Doing risky activities without thought or concern for the risk
  • Difficulty staying focused more than normal
  • Difficulty sleeping but being more energized

Symptoms of a Depressive Episode

  • Feeling or acting extremely sad
  • Changes in eating that have nothing to do with growth (eating more or less)
  • Feelings of guilt or worthlessness (which may be difficult for smaller children to articulate)
  • Little energy and little to no interest in previously enjoyed activities
  • Sleeping excessively or not sleeping at all
  • Aches and pains that don't go away even with treatment
  • Thinking about death or suicide

The Diagnosis Process

It's important to understand that your child, whatever their age may be, is going through a lot of changes in their life as they 'come into their own.' They will start to act a little different as they get older, make new friends, learn their likes and dislikes and more, but the symptoms of manic and depressive episodes we're describing are entirely different from this. They will seem far more extreme than a child who is simply testing the boundaries or trying out a new way of thinking or acting.

Are You Worried Your Child May Have Bipolar Depression?

The younger the child is, however, the more difficult it is to accurately diagnose bipolar depression because of these things. Also, bipolar disorder may be incorrectly diagnosed as ADD or ADHD or even anxiety disorders. It may also occur in conjunction with these disorders, all of which must be treated properly in order for your child to better get a handle on their emotions, thoughts and feelings and be able to still have a healthy and happy childhood and future.

The unfortunate thing is that, there is no way to diagnose bipolar disorder through a test or scan. It would be great if we could simply give the individual a brain scan and determine if they have bipolar disorder or draw their blood and run a test. Unfortunately, the only way to diagnose the disorder is for them to start experiencing it and to then talk to them about it. A doctor will sit down with your child and ask them questions about their mood, their feelings and a whole lot more. They will also sit down with you to find out more about your observations.

Treatment After the Diagnosis

So what happens when your child is diagnosed with bipolar disorder? Well, there are a few things that are going to happen. For one thing, your child will need to take medications and for another, they will need therapy.


Medication will help to balance out the emotions that your child is experiencing and will help them with mitigating the extremes of the highs and lows. Unfortunately, this will not 'cure' them of bipolar disorder and it will not work entirely by itself either. Keep in mind that the best thing you can do for your child is give them the lowest dose possible of the lowest number of medications possible.

Medication is also going to change over time for your child. Bipolar disorder is slightly different in everyone, and especially with young children, which means that one child with bipolar disorder may need different medications than another. One may have different reactions with certain medications or may respond more quickly with a lower dose of x medication rather than a higher dose of y medication. Finding the perfect balance and dose of medication will take some trial and error, but without that process, it's difficult to come up with the ideal balance for your child and the best possible way to help them through the process.


On top of that, you'll want to make sure that your child is speaking with a psychiatrist who is knowledgeable about bipolar disorder and specifically about bipolar disorder in children and teens. Treatment and the discussions necessary to help them through their diagnosis is going to be different than you will find with older teens and adults, so having someone knowledgeable about their specific situation is extremely important and could mean the difference between quicker changes and difficulty accepting or understanding what's happening.

Encourage your child to be open and honest with their therapist. Remind them that what they say in therapy is entirely private between them and the therapist, which means that they don't have to hide any of their thoughts or feelings. A small child may not understand what they are experiencing or how to articulate it, but you should encourage them to talk about it anyway, in any manner they can. A little bit older child may try to hide some of their thoughts and feelings because they don't want to make you (the parent) feel bad. Make sure they understand also how important it is to be completely honest and share everything. You will never know about it anyway so there's no reason not to.

The Future With Bipolar Disorder

Unfortunately, bipolar disorder is a lifelong, chronic disorder. That means even with treatment and long periods of complacency, it is most definitely possible for the disorder to sneak up on you again. This is one reason it is so important to get your child into treatment as early as possible and to talk with them about the possibility of new occurrences. You want to make sure they know what they're watching for and that they let you know immediately if they start experiencing anything strange. That way you can help them get treatment again whenever it's necessary.

Make sure to impress upon your child how important it's going to be for them to watch for signs and symptoms throughout their life as well. Speaking with a counselor at least occasionally for their entire life may not be a bad idea as a counselor or psychiatrist will be able to help them recognize the signs early. They may also need to take medications for the rest of their life to help counteract some of the more severe side effects of their depression. Knowing what's going on and how these medications and one-on-one sessions are helping them makes it more likely that your child will continue to do so into their older and adult years.

If left untreated, bipolar disorder can definitely lead to future problems for a young adult or adult. As your child gets into their teenage years the manic and depressive episodes and the risky behaviors that go along with each could get them into trouble either with friends and family, a job or even their life. It's important to work with your child to make sure they continue taking any medications they need and that medications are changed as necessary to get the best possible results for them and their future.

Getting Help

Finding someone to talk with your child is actually easier than you might think. Whether you want to take them to an actual clinic and have them talk to someone or if you want them to talk to someone through the internet from your own home, you can easily find someone ready to talk. is one great way that you can get an experience psychiatrist for your child and make sure that they're going to be better off than ever before.

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