Bipolar Depression In Children And How The Treatment Differs

Updated August 24, 2023by BetterHelp Editorial Team

"Bipolar depression," referring to the depressive episodes of bipolar disorder, can be seen in children and typically follows hypomania or mania. Bipolar disorder can be characterized by extreme shifts in mood and behavior, which can impact a person's energy levels, relationships, and daily functioning. Though typically diagnosed in adolescence and young adulthood, bipolar disorder can be diagnosed in children. 

Because bipolar disorder is not as common as other conditions in children, it may be challenging to spot the signs of bipolar disorder early on. However, when starting in childhood, treatment for bipolar disorder may be effective. For this reason, learning to identify concerning symptoms can be crucial.

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What Is Bipolar Disorder?

Bipolar disorder is a mental illness characterized by extreme highs and lows. Some people may know about depressive disorders like major depressive disorder. However, they may not know that bipolar disorder can cause significant depressive episodes in people of any age. 

In addition to depressive episodes, a person with bipolar disorder may experience highs known as mania or hypomania, distinguishing it from depressive disorders. The highs and lows accompanying bipolar disorder can be challenging for an undiagnosed and untreated child, as they can contribute to risky, dangerous, or unhealthy behavior. 

There are three main subtypes of bipolar disorder: bipolar I disorder, bipolar II disorder, and cyclothymic disorder. Bipolar I disorder is categorized by at least one episode of mania lasting a week or more, with or without depression. Bipolar II disorder is categorized by episodes of hypomania and depression. Hypomania is a less severe form of mania that may not accompany paranoia or delusions as mania does. Cyclothymic disorder may be diagnosed when an individual doesn't meet the criteria for the other diagnoses and has cycling moods that are rapid or long-term and cause mild to moderate functioning difficulties. 

Symptoms Of Bipolar Disorder Depression In Children

It can be essential to look for the 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 might. Children may not understand what's happening to them, which can cause them to have more extreme reactions to highs and lows or to feel frightened or confused. 

Parents, guardians, and caretakers can help a child receive support by watching for unusual changes in behavior that may point to a mental health disorder. Symptoms of bipolar disorder can manifest differently in children than in adults, so it may be helpful to familiarize yourself with some of its key signs.

Symptoms of a manic episode in children can involve the following: 

  • Acting silly or high-energy in a way that is out of character or doesn't fit the circumstances 

  • A short temper or irritability

  • Talking more quickly than usual or jumping between topics quickly

  • Partaking in risky activities without thought or concern

  • Difficulty staying focused 

  • Difficulty sleeping due to increased energy 

Symptoms of a depressive episode in children may include the following: 

  • Extreme sadness or a prolonged low mood

  • Changes in eating unrelated to growth 

  • Feelings of guilt or shame

  • Thoughts of worthlessness or hopelessness 

  • 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 with treatment or have no medical cause

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How Can Children Be Diagnosed With Bipolar Disorder? 

Regardless of their age, your child may be going through many transitions in life as they age. They might start acting differently as they age, make new friends, learn their interests, and explore their identity. However, the symptoms of manic and depressive episodes are different. These symptoms may be more extreme than a child who is testing boundaries or trying a new personality. 

However, the younger a child is, the more difficult it may be to diagnose bipolar disorder accurately. In some cases, bipolar disorder may be misdiagnosed as another mental illness, such as generalized anxiety disorder or attention-deficit hyperactivity disorder (ADHD), as these conditions are more common. 

There is no way to diagnose bipolar disorder through blood tests or a scan. Currently, diagnosis is made by a mental health professional observing the child and talking to them about their symptoms and experiences. When you attend your child's psychological appointment, their psychologist may ask you both questions about their mood, feelings, and behavior. If the professional thinks the child's symptoms are undeniably due to bipolar disorder, they may make a diagnosis. In some cases, children are monitored by a professional for a few years before a sure diagnosis is made. 

Treatment After Diagnosis

Treatment for bipolar disorder at any age often involves a combination of medication and therapy. Children may benefit from different types of therapy or additional treatment options, so work with your healthcare provider to determine your next steps.  


Medications may balance out the emotions your child is experiencing and help them mitigate the emotional extremes bipolar disorder can cause. Not all children take medication for bipolar disorder, and some children experience enough side effects to negate the helpfulness of these resources. However, the potential benefits of medication mean that some psychiatrists and doctors may recommend it. 


Children with bipolar disorder can attend therapy to learn problem-solving skills and explore their symptoms to manage them as they age. Even if a child is too young to benefit from therapy, it can be helpful for caregivers, parents, and guardians to pursue professional guidance to gain more insight into how to support their child best. 

If your child attends therapy, encourage them to be honest with their therapist. Remind them that what they say in therapy is between them and the therapist. A small child may not understand what they are experiencing or how to articulate it, but it can help to encourage them to talk about it anyway, reminding them their therapist is not there to judge them. 

The Prognosis For Children With Bipolar Disorder 

Bipolar disorder is a lifelong mental illness. Even with treatment and long periods of complacency, the disorder's symptoms can return. For this reason, it may be beneficial to enroll your child in treatment as early as possible. Allowing them the connections to receive medical advice, continuous care, and long-term support can be beneficial.

Remind your child to watch for symptoms throughout their life, as well. The symptoms of a person's bipolar disorder may change as they age, so it's possible that what may have been the norm in the past may shift into a new symptom. A child with bipolar disorder may also be more likely to develop other mental health conditions in conjunction, so being aware of changes in behavior, mood, and energy levels can help them catch changes in their mental health as teens and adults.

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Support Options For Parents 

Navigating a mental health diagnosis in your family may be challenging. You may not have expected your child to live with bipolar disorder, or you may also have the condition and want to know how to receive support. In these cases, talking to a therapist may be beneficial. 

Online therapy through a platform like BetterHelp can be a significant resource for parents. Through an online platform, you can outline your goals when signing up to find someone who understands your mental health concerns. In addition, you don't have to leave home for sessions, which may save you money on gas, childcare, and parking. 

Studies show that online therapy can be effective in treating mental health conditions. In a recent review analyzing online cognitive-behavioral therapy (CBT), researchers found treatment could lead to significant improvements in mental health symptoms related to anxiety, depression, PTSD, and other conditions with results similar to in-person options. 


Children can experience depressive episodes due to bipolar disorder before adolescence, but its symptoms can be tricky to spot from the outside. Being aware of common experiences related to bipolar disorder and knowing how they may manifest in a child can help you seek proper treatment for your family. Consider reaching out to a child or family psychologist to get started.

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