What Are The Signs Of Bipolar Disorder In Children?

Updated January 31, 2023by BetterHelp Editorial Team

Bipolar disorder is often considered an adult condition, but bipolar in children is more common than some might realize. Although it's not as common as in adults, bipolar disorder is found in about 3% of children in the United States. In addition, children as young as five years old have received bipolar disorder diagnoses, known as early-onset bipolar disorder or pediatric bipolar disorder. 

This article explores the signs and potential causes of bipolar disorder in children. We'll also highlight how treatments like online therapy for both parents and children can help with symptom management. 

Bipolar Disorder In Kids

Learn More About The Signs Of Bipolar Disorder

Children experiencing bipolar disorder typically have mood swings with periods of hyperactivity alternating with severe depression. However, because children have such a wide variety of moods and behavior, it may not be easy to notice that they have the condition. 

Bipolar might be misdiagnosed as attention deficit hyperactivity disorder (ADHD) or a behavioral or mood disorder. For example, when your child has a period of mania, you may think they are misbehaving or hyperactive.

What Is Bipolar Disorder?

Understanding bipolar disorder can help you identify the symptoms of bipolar disorder in children. Bipolar disorder can cause mood swings from extreme lows to extreme highs, which may occur in episodes lasting several days to several weeks. It can be a severe condition and may make daily activities difficult. 

Although an individual experiencing bipolar may sometimes feel energetic and productive, they may not feel able to get out of bed at other times. The signs of bipolar disorder in adults are different than signs of bipolar in children, mainly because children may have more erratic behavior and mood pattern than adults. 

Symptoms Of Bipolar In Children

Recognizing the signs of bipolar disorder in children may help a parent decide to seek a diagnosis from a licensed professional. From there, they can help their child receive appropriate treatment. 

Here are some potential signs of bipolar mania in children: 

  • Not sleeping and have more energy than usual

  • Trouble staying focused

  • Doing whatever they want without concern for the consequences

  • Talking faster than usual

  • Moving from one topic to another

  • Irritability or aggressive

  • Impulsive behavior

  • Acting sillier than usual

Here are potential signs of bipolar depression in children: 

  • Acting or feeling more sad than usual for no reason

  • Chronic fatigue

  • Sleeping more than usual

  • Low energy

  • No interest in fun activities

  • Feeling worthless or guilty (may be hard to determine with younger children)

  • Changes in appetite

  • Complaining of aches and pains

  • Nausea or vomiting

  • Zoning out

  • Falling asleep during class

  • Complaining about feeling sick

Understanding Signs Of Childhood Bipolar Disorder

A child experiencing bipolar disorder may not present all the symptoms listed above, and their presentation will likely depend on their age. For example, a child under ten years old usually has different symptoms than those in their teens. 

Types Of Bipolar Disorder

Bipolar disorder is classified into different types, which can make early-onset bipolar disorder harder to diagnose. Here is a summary of each primary type of bipolar disorder.

Bipolar I Disorder

Bipolar I disorder usually causes at least seven days of manic symptoms, which may include hallucinations and delusions. This can alternate with periods of severe depression where the individual can barely get out of bed and feels overwhelmingly sad. Bipolar I may also include episodes of psychosis and mania or require hospital treatment. 

Bipolar II Disorder

A bipolar II diagnosis requires the individual to have had at least one major depressive period lasting at least two weeks and at least one period of hypomania, a less severe form of mania. In addition, children with this disorder might have depression and hypomania at the same time.

Cyclothymic Disorder 

Cyclothymic disorder is similar to bipolar II disorder, but the periods of elevated and depressive moods may fluctuate more quickly. However, the episodes are not as severe as with bipolar I and II.

Understanding Psychosis And Hallucinations

Some individuals with bipolar I disorder can have episodes of psychosis or hallucinations. Psychosis refers to not being able to recognize what is real in the world around you. It's sometimes confused with schizophrenia, and children with this symptom might be misdiagnosed. 

Hallucinations can be auditory or visual, including things like hearing voices, and they may also lead to a misdiagnosis of schizophrenia. 

Potential Causes Of Early Onset Bipolar Disorder

Learn More About The Signs Of Bipolar Disorder

Doctors and researchers are still trying to determine the cause of bipolar disorders, but many things can contribute to the condition. For example, it can be genetic. There is some proof that some abnormal genes can cause bipolar disorder and other mental health conditions. Another possible cause of bipolar disorder is a chemical imbalance or structural abnormality in the brain. 

Here are additional risk factors of bipolar disorder:

  • Lifestyle of the parent (e.g., drugs or alcohol during pregnancy or breastfeeding)

  • Hormonal changes (older children)

  • A stressful environment (e.g., abuse or neglect)

  • Being exposed to toxins like heavy metals during pregnancy or infancy

Treating Early Onset Bipolar Disorder

Treating bipolar disorder in children may include medication and psychotherapy, also known as talk therapy. A child's treatment provider may also ask the parents to get involved, often to help stabilize their lifestyle. For example, this may include a schedule that organizes their meals, play times, and sleep schedule.

Caregivers might also consider talk therapy as it can help them learn more about bipolar disorder and overcome parenting challenges. Family therapy is another option and may be beneficial if the child is nervous about individual therapy. 

With online therapy, these options can be easier to schedule and accommodate. Online therapy is as effective as in-person therapy and often more affordable. Depending on where you live, online options may also give you access to a broader range of providers and specialists. 


If you notice signs of bipolar disorder in your child, a professional diagnosis can help you learn more. Speaking with a therapist can also help you understand bipolar disorder and how to approach the diagnosis process. In addition, talk therapy for your child can help them learn to express their feelings and teach them ideas on how to counteract the symptoms they experience. 

You and your child can do this from home with online therapy, saving you time and money during treatment. BetterHelp provides access to licensed mental health professionals for adults over 19. 

After signing up, we'll match you with a provider based on your needs and preferences, and you can schedule your appointments based on your availability. And you can meet with your provider via phone, video, or in-app messaging using any device with an internet connection. And for children, TeenCounseling serves individuals from 13-19 years old, providing similar treatment options. 

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