Early-onset Bi-Polar Disorder (Manic Depression)

This mood disorder can involve sharp swings from episodes of "manic" highs to depressive "lows" or a mixed state in which manic energy combines with the depressed mood. Two important pieces of information help to make an accurate diagnosis: strong family history of the disorder and a pattern of symptoms that are unique to this age-group. The symptoms of bipolar disorder can look like ADHD, Oppositional/Defiant Disorder (ODD), Conduct Disorder (CD), or depression.

Symptoms include:

• Hair-trigger arousal system set off by the slightest irritation or change
• Overreaction takes the form of irritable, oppositional, negative behavior
• Multiple mood shifts: the child acts like two different people (devil/angel)
• Usually rage is controlled in school, in front of classmates
• Hyperactivity; highly distractible, inattentive; decreased need for sleep
• Grandiose behavior such as telling the teacher how to run the class or harassing the teacher in an attempt to take over the class
• Overt hypersexual activities and comments in the classroom
• Great sensitivity to temperature and often hear-intolerant
• Insatiable craving for carbohydrates and sweets
• Psychotic episodes of auditory hallucinations (common); may not be reported
• May have serious sleep disturbances, night terros, violent nightmares
• May have separation anxiety; may refuse to go to school
• Rages may be described as "wild-eyed"; violent tantrums of kicking, hitting, biting, screaming foul language, thrashing that lasts for hours
• May be hard to rouse from sleep, gains energy throughout the day and "bounces off the walls" by the end of the school day
• Extreme sensitivity to sensory stimuli: clothes much feel "just right", food temperature must be "just right"
• Child may act worse at home than at school

Bipolar in Adolescence

Teens with this illness are at high risk for drug or alcohol addiction, and it doesn't take long for them to get a reputation for their wild behavior. Hoever, they do fel genuine remorse for their destructive actions, even though they are likely to repeat them. 94% of adolescents with bipolar disorder have symptoms of ADHD.

Depressive Phase:

• Crying; catastrophizing (gloom and doom)
• Moodiness; irritability (picks fights with others)
• Tremendous fatigue; oversleeping, lethargy; carbohydrate cravings
• Insecurity; separation anxiety; low self-esteem
• School avoidance; gaining sickness to stay home; constant physical complaints
• Self-isolation; pushing people away
• Suicidal thoughts and attempts

Manic Phase:

• Difficulty sleeping; high activity level late at night
• Increased goal-setting and unrealistic expectations
• Very rapid and insistent speech
• All-or-nothing mentality
• Spending sprees
• Aggressive, touchy, irritable, "in-you-face" manner
• Receless driving; drinking and driving; repeated car accidents
• Hyper sexuality, provocativeness; lack of concern for harmful consequences
• Lying and making up stories; sneaking out of class; sneaking out of the house late at night to party
• Psychotic episodes; delusions; hallucinations; paranoia; may have romantic delusions about teachers

*The above information was printed from Red Flags in Children's Behavior and Parents published by the Mental Health Association of Summit County, Inc. and Teachers as Allies: Recognizing Early-onset Mental Illnesses in Children and Adolescents published by NAMI.