Symptoms of bipolar disorder can be mistaken for other medical/mental health conditions, and children with bipolar disorder can have other mental health needs at the same time. Other disorders that can occur at the same time as bipolar disorder include, but are not limited to, attention-deficit/hyperactivity disorder, conduct disorder, oppositional defiant disorder, anxiety disorders, autistic spectrum disorders, and drug abuse disorders. The roles that a family's culture and language play in how causes and symptoms are perceived and then described to a mental health care provider are important, too. Misperceptions and misunderstandings can lead to delayed diagnoses, misdiagnoses, or no diagnoses-which are serious problems when a child needs help. That is why it is important that supports be in place to bridge differences in language and culture. Once bipolar disorder is properly diagnosed, treatment can begin to help children and adolescents with bipolar disorder live productive and fulfilling lives.
Unlike some health problems where different people experience the same symptoms, children experience bipolar disorder differently. Often, children with the illness experience mood swings that alternate, or cycle, between periods of "highs" and "lows," called "mania" and "depression," with varying moods in between. These cycles can happen much more rapidly than in adults, sometimes occurring many times within a day. Mental health experts differ in their interpretation of what symptoms children experience. The following are commonly reported signs of bipolar disorder:
- Excessively elevated moods alternating with periods of depressed or irritable moods;
- Periods of high, goal-directed activity, and/or physical agitation;
- Racing thoughts and speaking very fast;
- Unusual/erratic sleep patterns and/or a decreased need for sleep;
- Difficulty settling as babies;
- Severe temper tantrums, sometimes called "rages";
- Excessive involvement in pleasurable activities, daredevil behavior, and/or grandiose, "superconfident" thinking and behaviors;
- Impulsivity and/or distractibility;
- Inappropriate sexual activity, even at very young ages;
- Hallucinations and/or delusions;
- Suicidal thoughts and/or talks of killing self; and
- Inflexible, oppositional/defiant, and extremely irritable behavior.
These feeling states are often painful, last a long time and are serious. They are very different from ordinary feelings of being really happy and excited or sad and blue. These feelings usually interfere with a person's ability to conduct a normal family, work and personal life. Sometimes the strong excitement or happy feelings make it hard to realize one can be ill. Some people find they want to use alcohol or other drugs to change the way they feel - this is a bad idea.