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Bipolar Disorder in Children

Is it bipolar or normal mood swings?

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Bipolar disorder is characterized by mood swings that cycle from high-energy mania to low-energy depressive states. While it is not an uncommon diagnosis, bipolar disorder in children is an “extremely controversial topic,” says Jordan Weisman, PsyD, vice president of clinical operations at the Philadelphia Mental Health Center in Newtown, PA. “Some believe it’s not a pediatric disorder.”

A New Bipolar Definition

“There was a thought that bipolar was being overdiagnosed,” says Dr. Nazli Gulab of pediatric cases of bipolar disorder. As a result, DSM-5 introduced a new disorder called Disruptive Mood Dysregulation Disorder. DMDD is a less severe diagnosis, characterized by a lot of irritability. The main distinction from bipolar disorder is that children with DMDD do not develop manic episodes.

Nevertheless, there has been a 40-fold increase in the number of children diagnosed with bipolar disorder over the past 20 years, according to the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). A certain amount of moodiness and acting out is normal as kids grow, so how can you tell when emotional swings result from this serious mental condition? 

Emma’s bipolar story

Emma (not her real name), a 13-year-old from Wilmington, DE, was a good student and sweet kid, but shortly after the beginning of 7th grade, her mother registered an extreme shift in behavior. Emma started failing at school, stayed in her room most of the time and refused to go out with friends. She was very irritable, speaking only in angry one-word retorts. Emma met with a therapist, who diagnosed her as bipolar when she admitted to having feelings of not fitting in. After only six weeks of getting extra support from her parents and working with the therapist to learn coping skills, Emma was feeling much better. 

Bipolar or mood swings?

“Everybody can be moody,” says Dr. Weisman. But with bipolar disorder, moods change more rapidly, often with no trigger event. While adults with bipolar disorder typically take weeks to cycle through manic and depressed phases, kids do this much more rapidly, in as quickly as one day. 

“Bipolar is an extreme change,” says Dr. Weisman. It significantly impacts school performance and social interaction for sustained periods. It can also affect eating habits and sleep patterns. The key is to recognize the change in behavior and face the challenge head-on. 

NEXT PAGE: Bipolar symptoms by age and treatment help

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