Facts About Childhood-Onset Bipolar Disorder

What is childhood-onset bipolar disorder (COBPD), and how does it differ from Bipolar disorder (manic-depression) in adults?

All those with Bipolar disorder experience mood swings that alternate from periods of severe highs (mania) to severe lows (Depression). However, while these abnormally intense moods usually last for weeks or months in adults with the illness, children with bipolar disorder can experience such rapid mood swings that they commonly cycle many times within a day.

The most typical pattern of cycling among those with COBPD, called ultra-ultra rapid or ultradian, is most often associated with low arousal states in the mornings followed by increases in energy towards late afternoon or evening.

It is not uncommon for the initial episode of COBPD to present itself as major depression. But as clinical investigators have followed the course of the disorder in children, they have observed a significant rate of transition from depression into bipolar mood states.

Is COBPD usually inherited?

Yes. One of the most important factors in establishing the diagnosis is family history. According to several recent studies, a history of mood disorders (particularly bipolar disorder) and/or alcoholism on both the maternal and paternal sides of a family appears to be commonly associated with COBPD.

How early in childhood does the disorder start? What are some common early symptoms?

Many parents report that their children have seemed different since early infancy. They describe difficulty settling their babies, and they note that their children are easily over-responsive to sensory stimulation. Sleep disturbances and night terrors are also commonly reported.

Later in a child's development, hyperactivity, fidgetiness, difficulties making changes, and high levels of anxiety (particularly in response to separation from the child's mother) are commonly seen. Additionally, being easily frustrated, having difficulty controlling anger, and impulsiveness (difficulty waiting one's turn, interrupting others) often result in prolonged and violent temper tantrums.

Are there other childhood psychiatric conditions that can co-occur with bipolar disorder?

Yes. Rarely does bipolar disorder in children occur by itself. Rather, it is often accompanied by clusters of symptoms that, when observed at certain points of the child's life, suggest other psychiatric disorders such as attention-deficit/hyperactivity disorder (ADHD), , oppositional defiant disorder, and conduct disorder.