Mood swings, temper tantrums, impulsive behavior—these are normal signs of childhood, right? Well, it’s true that most kids display these traits from time to time, but if they’re extreme or persistent then your child may be suffering from pediatric bipolar disorder. When we think about bipolar disorder, we generally think of older teenagers and adults, but over recent years an increasing number of younger kids have been diagnosed with bipolar disorder—including some preschoolers. However, other conditions (e.g. ADHD) have similar symptoms to PBD, so it’s helpful to untangle some of the facts.
Pediatric bipolar disorder or normal childhood symptoms
Many of the symptoms of PBD can be found in children with no mental health problems. Most toddlers have tantrums when they can’t get their own way, while kids can often act first and think later, and becoming a bit low and withdrawn is a common experience for many teenagers. So it’s essential to realize that simply because your child shows this behavior from time to time doesn’t automatically mean they have PBD. It’s also important to remember that other conditions can cause symptoms that are very similar to those of PBD, so if you are seeking a formal diagnosis then it’s critical to get the correct one—the treatments for one condition could make another condition much worse.
Typical symptoms of PBD
As with the adult version, kids with PBD usually show two distinct phases: the manic phase and the depressive phase. During the manic phase, they are likely to be very restless and hyperactive, often finding it difficult to focus on anything for an extended period of time. Naturally, this can have a huge impact on their schooling, and may lead to them being disruptive in the classroom. Their speech is often very fast and impulsive, and often they refuse to be interrupted or listen to anyone else. They can frequently be annoyingly silly, and seem to have no concept of danger, perhaps indulging in risky behavior and showing an over-inflated sense of self-esteem. They frequently need very little sleep, which can be exhausting for parents, and older children may become hyper-sexualized during a manic phase.
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The depressive phase is often characterized by low mood, irritability and withdrawal. They may seem sad and lose interest in things that normally promoted enthusiasm. They may also lose their appetite or perhaps eat obsessively, causing weight fluctuations, and they might suffer from insomnia. Children in a depressive phase sometimes talk about self-harm or suicide.
PBD or another condition?
The signature feature of PBD is less about the actual symptoms and more about the pattern in which they occur. For example, many of the behaviors seen in the manic phase are also seen in kids suffering from ADHD, but children with this condition show those symptoms relatively continuously, whereas children with PBD have distinct shift between phases. These phases may be much shorter than those found in adults with bipolar disorder—each phase may only last a day or so, meaning the mood swings are generally much easier to spot. That being said, it can be difficult for the family around them to understand why their mood seems to vary so much “for no apparent reason.”
Getting a responsible diagnosis
No one wants a child to be mistakenly diagnosed with a mental health condition so tread carefully when trying to get a diagnosis. Make sure the physician is well-qualified in the field of childhood mental health and that they liaise with other professionals (such as teachers and therapists) to inform their diagnosis. They should do their best to get an overall picture of your child rather than merely relying on symptoms to diagnose PBD.
How can I help my child?
If your child is diagnosed with PBD, there are plenty of ways you can support them and help them to live their lives positively. Communicate well with the health professionals treating your child, especially as it may take time to work out the best medication dosage. Keep open communication with other professionals, such as their teacher, so you can work together to manage their behavior. Sometimes family therapy sessions can help everyone involved, because this kind of mental health condition affects the whole family, not only the child with PBD. And lastly, be vigilant about any talk of suicide or self-harm, getting professional support immediately.