Bipolar Depression In Children And How The Treatment Differs

Updated April 4, 2023by BetterHelp Editorial Team

Bipolar depression, which can stem from bipolar disorder, typically describes the “low” periods that often follow “high” periods of mania. On the whole, bipolar disorder can be characterized by extremes in mood and behavior, which can impact a person’s energy levels, relationships, ability to function, and much more. Though typically diagnosed in a person’s teenage to young adult years, it is possible for bipolar disorder to develop in younger children. Because it’s not as commonplace as other mental health disorders may be among children, it can be hard to spot the signs of bipolar disorder or depression in your child or loved one. Treatment is often helpful, though, especially when started early on in the development of a mental health disorder, which means learning to identify potentially concerning behavior and seeking the right help can be crucial. 

Learning To Manage Bipolar Disorder Can Be Hard At Any Age

What Is Bipolar Disorder?

Bipolar disorder is a mental illness typically characterized by extreme highs and lows. Many people know about depression that stems from things like major depressive disorder, but few are fully aware of the ways that other mental health disorders, including bipolar disorder, can cause similar symptoms. In addition to severe lows and depressive episodes, a person with bipolar disorder may also experience extreme highs known as mania (or, in some cases, hypomania). Unfortunately, both the highs and the lows that may come with bipolar disorder can spell trouble for an undiagnosed and untreated child, as they can each cause different types of problematic and even dangerous behavior.

Symptoms of Bipolar Depression in Children

It’s often particularly 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 might. Children may not understand what's happening to them, which can cause them to have even more extreme reactions to those highs and lows or to feel frightened or confused. Parents, guardians, and caretakers can help a child receive the care they may need by keeping an eye out for unusual changes in behavior that may point to the presence of a mental health disorder. Symptoms of bipolar disorder can manifest differently in children than they often do in adults, so it may first be helpful to familiarize yourself with some of its key signs.

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

  • 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

The Diagnosis Process

It's important to understand that your child, whatever their age may be, is likely going through a lot of changes in their life as they come into their own. They might 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 typically entirely different from this. They will generally seem far more extreme than a child who is simply testing the boundaries or trying out a new way of thinking or acting.

Learning To Manage Bipolar Disorder Can Be Hard At Any Age

The younger the child is, however, the more difficult it tends to be to accurately diagnose bipolar depression or bipolar disorder. What’s actually bipolar disorder may be misdiagnosed as another mental illness, such as generalized anxiety disorder or attention-deficit/hyperactivity disorder (ADHD). 

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. Currently, the most likely way a child may receive a diagnosis is like through communicating their experiences. A doctor will likely sit down with your child and ask them questions about their mood, their feelings, and a whole lot more. They may 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? The answer likely depends on your situation and your child’s needs. Treatment for bipolar disorder at any age typically requires a combination of medications and therapy. Children may benefit from different types of therapy or additional treatment options, so it’s typically best to work with your healthcare provider to determine the best next steps. 


Medications can, in some cases, help to balance out the emotions that your child is experiencing and may help them mitigate the emotional extremes bipolar disorder can cause. Not all children do take medication for bipolar disorder, and some children experience enough side effects to negate the helpfulness of these resources. Still, the potential benefits that can come with medication mean that many psychiatrists and doctors may recommend it, at least to see if it helps.


Attending some form of therapy is often necessary for children with bipolar disorder; it may be one of the best ways to help children gain important problem-solving skills and learn more about their symptoms so they can 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 help to gain more insight into how to best support a child with bipolar disorder.

If your child does attend therapy, try your best to encourage them  to be open and honest with their therapist. Remind them that what they say in therapy is entirely personal 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 it can help to encourage them to talk about it anyway, in any manner they can.

The Future With Bipolar Disorder

In most cases, bipolar disorder is a lifelong, chronic disorder. That means even with treatment and long periods of complacency, it is possible for the symptoms of the disorder to sneak up on you again. This is one reason it can be important to get your child into treatment as early as possible; creating the proper connections that a child may need to receive medical advice, continuous care, and long-term support can be significantly beneficial.

Make sure to impress upon your child how important it may be for them to watch for signs and symptoms throughout their life as well. It’s not uncommon for the nature of a person’s bipolar disorder to change as they age, so it’s possible that what may have been the norm in the past may shift into something entirely new. It may also be true that a child with bipolar disorder may be more likely to develop other mental health disorders in conjunction, so being aware of changes in behavior, mood, energy levels, etc. can be helpful in this sense, too.

Getting Help

Finding someone to talk with you or your child, if appropriate, can be easier than you might think. It may help to specifically seek out a professional who has experience working with families, parents, or adolescents to receive the best support for your needs. 

Resources like online therapy can make the process of finding a good fit for your family much more straightforward. No matter what type of therapy you may want to pursue, it’s likely you can find someone who understands your goals and can help you achieve them. Plus, you don’t have to leave the comfort of your own home to join sessions, which can save you money on gas, childcare, and more.

Studies show that online therapy options can be helpful for treating many mental health disorders. In fact, one recent literature review of studies analyzing online cognitive behavioral therapy (CBT) found it could lead to significant improvements in mental health symptoms related to anxiety, depression, PTSD, and more. No matter what your concerns may be, it’s likely that online therapy can offer you the guidance and support you may need.  


Bipolar depression may be experienced by children with bipolar disorder, but its signs and 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, which can likely help your child live a happy, healthy life. 

For additional help & support with your concerns

The information on this page is not intended to be a substitution for diagnosis, treatment, or informed professional advice. You should not take any action or avoid taking any action without consulting with a qualified mental health professional. For more information, please read our terms of use.
Get the support you need from one of our therapistsGet Started