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Behavioral Psychology

Pediatric Mood and Bipolar Disorder

by Lori Bolnick, Psy.D.

Over the past few years, there has been an increase in the diagnosis of Pediatric Mood and Bipolar Disorders. Early-Onset Bipolar Disorder is often mistaken for ADHD or depression. A thorough family history is important in the diagnostic process as there is a strong genetic component. Red flags include a family history of mood or bipolar disorders, or alcoholism.

Symptoms of Pediatric Bipolar Disorder are not like the traditional manic and depressive states seen in Adult Bipolar Disorder. In childhood, it is much more typical to have ultrarapid cycling (5-365 manic episodes per year) or ultradian/continuous cycling (365+ manic episodes a year). Mood states can rapidly shift from irritable, easily annoyed, and angry to silly, goofy, and elated to low energy with boredom, depression, social withdrawal, and suicidal ideation. Rage states can occur for prolonged periods of time with physical and verbal aggression, grandiosity, and racing thoughts. Additionally, children can be very oppositional and defiant, experience severe separation anxiety, have night terrors, and demonstrate ADHD-like symptoms (e.g., inattention, hyperactivity, and impulsivity).

Pediatric Bipolar Disorder is treatable with mood stabilizers, individual and family therapy, and accommodations at school. Families dealing with such an illness can quickly become isolated, exhausted, and traumatized by the rapid cycling and "walking on eggshells" on a daily basis. Currently, there is a movement towards psychosocial education and support groups for children/teens and their parents.

For more information about Pediatric Bipolar Disorder, check out the following website links:

  • National Institute of Mental Health
    (Fact Sheet on Child and Adolescent Bipolar Disorder)

  • Juvenile Bipolar Research Foundation
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