Bipolar Disorder in Children

What to Do If You Think Your Child Has Bipolar Disorder

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Updated on October 18, 2021

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Up to 65% of adults with bipolar disorder experienced symptoms prior to the age of 18. So while the condition is often associated with adults, kids of any age can have bipolar disorder.

Childhood-onset bipolar is associated with a more severe course of illness compared to people who don’t begin to experience symptoms until adulthood. Early intervention can be the key to getting symptoms under control.

Even if you know an adult with bipolar disorder—or you have been diagnosed with it yourself—it might not look the same in a teenager.

Teens tend to be more irritable than elated during manic episodes and their depressive episodes may involve more complaints of physical symptoms other than sadness.

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When to Seek Help

Children and adolescents with bipolar disorder experience severe mood and behavior changes that are extreme and represent a major change from their typical mood and behavior. It might be difficult to know when the symptoms are severe enough to warrant evaluation and, potentially, diagnosis, so consider these three basic factors: functioning, feeling, and family.

Functioning

Here are some questions to ask yourself about your child's functioning:

Are the problem behaviors of your child interfering with their daily functioning?
Are they able to play with other children their age?
Are they able to attend school regularly?
Do the demands of their difficulties outweigh the needs of other members of the family, maybe including you?

Feeling

Here are some questions to ask yourself about your child's feelings:

Does your child feel like there is something wrong with them?
Do they feel overwhelmed handling normal activities other kids their age engage in?
Does your child worry about things other kids don’t even think about?

Family

Is there a history of mental illness in your child’s family?

Research indicates that having a parent or sibling who has bipolar disorder increases your child's chances of developing it. However, just because there is a family history of bipolar disorder does not mean your child will necessarily develop the condition

Symptoms

If you've said "yes" to questions in at least two of the three items above (functioning, feeling, and family), you're probably curious about the specific symptoms of bipolar disorder. Experts disagree about the exact symptoms that may appear in childhood and adolescent bipolar disorder because they appear to manifest differently than the symptoms of adults, but some of these symptoms may include:

Separation anxiety
Rages & explosive temper tantrums (lasting up to several hours)
Marked irritability
Oppositional behavior
Frequent mood swings
Distractibility
Hyperactivity
Getting involved in many projects or activities at once
More energy than normal
Less need for sleep
Impulsivity
Restlessness/ fidgetiness
Silliness, goofiness, giddiness
Racing thoughts
Aggressive behavior
Grandiosity
Risk-taking behaviors
Depressed mood
Lethargy
Low self-esteem
Difficulty getting up in the morning
Night terrors
Rapid or pressured speech
Thoughts of death or suicide

Many of these symptoms are not specific to bipolar disorder and can reflect a variety of concerns.

If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see our National Helpline Database.

Diagnosis

If you think your child may have bipolar disorder (or any other mental health issue), talk to their physician. Schedule an appointment to discuss your concerns.

A physician may refer you to a mental health treatment provider for a complete evaluation. A mental health expert will likely want to interview you and your child to get a full picture of the signs and symptoms.

There isn’t a lab test that identifies bipolar disorder.

Sometimes other conditions such as depression or ADHD have similar presentations; so it’s important to offer as much information as you can about your child’s mood, sleep patterns, energy level, history, and behavior to help rule out other possibilities.

Treatment

Bipolar disorder must be managed throughout a person’s life. Treatment may require adjustments over time. Your teen’s treatment team may recommend:

Medication: A psychiatrist may prescribe medication to stabilize your child's mood. It’s important to monitor your child’s medication and be on the lookout for side effects. Finding the right medication and the right dosage may take some time as there isn’t a single medication that works best for everyone with bipolar disorder.
Talk therapy: A therapist may educate your child about bipolar and may offer coping strategies to help manage the symptoms. Therapy often includes family members. Family therapy may address relationship issues, behavior management problems, or strategies to help the entire family cope with a child's mental illness.

A psychiatric hospitalization may be required at one time or another if a child poses an acute safety risk. A serious suicide attempt, thoughts of suicide with a clear plan, self-injury, or psychosis are just a few of the possible reasons a child with bipolar disorder may need to stay in a hospital.

Treatment works best when the child, parents, doctors, therapists, and other treatment providers work together as a team. So it’s important to attend your teen’s appointments, ask questions, communicate with other treatment providers, and continue to educate yourself about your child’s mental health needs.

A therapist or psychiatrist may request that you log your teen’s moods, sleep patterns, or behavior. Charting your child's progress can help treatment providers determine how well therapy or medications are working to keep your child’s moods stable.

Risks With Teens

Teens are already prone to risky behavior, but that risk is multiplied when the teenager also has bipolar disorder. Keep an eye out for substance abuse, such as drinking or taking drugs, as well as suicidal behavior.

The risk for suicide in people with bipolar disorder is among the highest for all psychiatric disorders.

One study showed that between 25% and 60% of adults with bipolar make at least one suicide attempt over the course of their lives and between 8% and 19% of individuals with bipolar disorder die from suicide.

The lifetime suicide attempt rate of young people living with bipolar disorder is by some estimates between 20% and 47%.

If your teen has been diagnosed with bipolar disorder, take the risk of suicide seriously. Work with your teen’s treatment providers to assess your teen’s risks and to develop a safety plan.

Co-Morbid Conditions

Many children with bipolar disorder have an additional mental illness, addiction, or behavior disorder. Some research has estimated that between 60% to 90% of youth with bipolar disorder may have attention deficit hyperactivity disorder as well.

Anxiety disorders, substance use, and disruptive behavior disorders are among the other most common issues children with bipolar disorder may experience.

Support at School

It’s important to work with your child’s school if they've been diagnosed with bipolar disorder. School officials can assist with a plan that will best support your child’s education.

Your child’s academic needs will depend on their symptoms and his academic issues. If they exhibit behavior problems at school, the teachers may create a behavior plan that will use appropriate disciplinary action.

If they struggle academically, the school may provide services to help ensure they are able to get an education. The school may be able to offer things such as a modified schedule or a hall pass that lets your teen visit the guidance counselor whenever necessary. Encourage your child to participate in meetings to talk about how the school could support their education as well.

Support at Home

Bipolar disorder affects the entire family so it’s important to work together to help your child manage the symptoms.

Learn as much as you can about bipolar disorder and the latest treatment options—and make sure other family members learn about it too. It’s important for siblings to understand what to expect.

Hold regular conversations with your child about treatment and treatment-related issues. There’s a good chance that at some point your child won’t want to take medication or attend therapy. Validate their feelings and talk about the importance of following doctors’ recommendations.

It’s important to take care of yourself as well. Coping with the challenges of raising a child with bipolar disorder can be stressful. Consider joining a support group for parents with teens with bipolar disorder (or mental illness in general). Connecting with other parents may help you gain emotional support as well as practical advice about how to support your child.

A Word From Verywell

It is common for children to experience some of the symptoms listed above, and it doesn't necessarily mean they have bipolar disorder.

If your child is having difficulty with daily functioning or if your child is struggling with feeling normal—especially over an extended period of time—an evaluation by a psychiatrist may be warranted. An unbiased, professional opinion could bring you some peace of mind and perhaps a few new parenting skills. Talk to your pediatrician and seek out advice for your precious one so that you are not carrying your worries or concerns alone.

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7 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Singh T. Pediatric bipolar disorder: diagnostic challenges in identifying symptoms and course of illness. Psychiatry (Edgmont). 2008;5(6):34-42.
Washburn JJ, West AE, Heil JA. Treatment of Pediatric Bipolar Disorder: A Review. Minerva Psichiatr. 2011;52(1):21-35.
Goldstein TR. Suicidality in pediatric bipolar disorder. Child Adolesc Psychiatr Clin N Am. 2009;18(2):339-52, viii. doi:10.1016/j.chc.2008.11.005
Goldstein TR. Suicidality in pediatric bipolar disorder. Child Adolesc Psychiatr Clin N Am. 2009;18(2):339-52, viii. doi: 10.1016/j.chc.2008.11.005
Novick DM, Swartz HA, Frank E. Suicide attempts in bipolar I and bipolar II disorder: a review and meta-analysis of the evidence. Bipolar Disord. 2010;12(1):1-9. doi: 10.1111/j.1399-5618.2009.00786.x
Goldstein TR, Ha W, Axelson DA, et al. Predictors of prospectively examined suicide attempts among youth with bipolar disorder. Arch Gen Psychiatry. 2012;69(11). doi:10.1001/archgenpsychiatry.2012.650
Joshi G, Wilens T. Comorbidity in pediatric bipolar disorder. Child Adolesc Psychiatr Clin N Am. 2009;18(2):291-319, vii-viii. doi:10.1016/j.chc.2008.12.005

Additional Reading

Children and Adults With Attention-Deficit/Hyperactivity Disorder (CHADD). Pediatric Bipolar Disorder.
National Alliance on Mental Illness (NAMI). Bipolar Disorder. Updated August 2017.
National Institute of Mental Health (NIMH). Bipolar Disorder in Children and Teens. National Institutes of Health. U.S. Department of Health and Human Services. Updated 2015.

By Kimberly Read
Kimberly Read is a writer with experience covering mental health conditions, including bipolar disorder.

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