What are the symptoms of bipolar disorder?

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What are the symptoms of bipolar disorder?

To understand bipolar disorder, it's helpful to know how mental health providers talk about severe mood swings. Mood swings are often termed as "mood episodes." Manic episodes describe periods when the child feels overly excited and confident. These feelings can quickly give way to confusion, anger and possibly rage.

Depressive episodes describe periods when the child feels very sad (depressed). Children may not have clear-cut episodes. Instead, they may have "mixed" episodes and exhibit both manic and depressive symptoms. Some children may show "rapid cycling" where they shift quickly between mania or hypomania and depression, sometimes even within the same day.

Depressive, manic, or mixed episodes, by definition, are a change in behavior that differs from the individual’s baseline. Children with symptoms suggestive of bipolar disorder but with chronic course should also be evaluated by a psychiatrist, in order to identify other disorders.

During manic or hypomanic periods, children with bipolar disorder may:

  • Be overly happy, hopeful and excited often inconsistent with external events.
  • Be irritable and have a short temper.
  • Become restless.
  • Show increases in distractibility.
  • Talk rapidly and in a pressured way where it is difficult to "get a word in."
  • Believe they have many skills and powers and can do things other people can't do (such as the children believe that they are in charge and not adults – in the extreme thinking, they believe they have special powers like a superhero).
  • Have a lot of energy and need very little sleep.
  • Talk and think about sex, and/or act older than their age.
  • Show poor judgment and make impulsive, harmful decisions.
  • Engage in risky behavior, including sexual or very impulsive behaviors such as charging parents' credit cards, abusing substances or putting themselves in unsafe circumstances.

During depressive periods, they may:

  • Feel empty, sad or hopeless.
  • Feel guilty, worthless or helpless.
  • Cry often.
  • Eat too little or too much.
  • Lose interest in things they usually enjoy.
  • Be unable to think clearly, make decisions, or remember things.
  • Sleep poorly.
  • Lose or gain weight.
  • Have low energy.
  • Have extreme sensitivity to rejection or failure.
  • Become focused on death.
  • Have thoughts of death, develop a plan or intentions to hurt themselves or someone else, and even attempt suicide or severe aggressive behavior.

The most frequent and useful symptoms for distinguishing bipolar disorder from other problems in youth are:

  • Rapid mood shifts.
  • Significant irritability.
  • Grandiosity.
  • Decreased need for sleep over a period of three to seven days.

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