Bipolar 

Disorder

in Children and Teens 

Does your child go through intense 

mood changes? Does your child have 

extreme behavior changes too? Does your 

child get too excited or silly sometimes? 

Do you notice he or she is very sad at other 

times? Do these changes affect how your 

child acts at school or at home?

Some children and teens with these symptoms 

may have bipolar disorder, a serious mental 

illness. Read this brochure to find out more.
What is bipolar disorder?

Bipolar disorder is a 

serious brain illness. It is 

also called manic-depressive 

illness. Children with bipolar 

disorder go through unusual 

mood changes. Sometimes 

they feel very happy or “up,” 

and are much more active 

than usual. This is called 

mania. And sometimes 

children with bipolar disorder 

feel very sad and “down,” 

and are much less active 

than usual. This is called 

depression. 

Bipolar disorder is not the same as the normal ups and 

downs every kid goes through. Bipolar symptoms are more 

powerful than that. The illness can make it hard for a child 

to do well in school or get along with friends and family 

members. The illness can also be dangerous. Some young 

people with bipolar disorder try to hurt themselves or 

attempt suicide. 

Children and teens with bipolar disorder should get 

treatment. With help, they can manage their symptoms 

and lead successful lives.

Who develops bipolar disorder? 

Anyone can develop bipolar disorder, including children and 

teens. However, most people with bipolar disorder develop 

it in their late teen or early adult years. The illness usually 

lasts a lifetime.

How is bipolar disorder different in children and 

teens than it is in adults?

When children develop the illness, it is called early-onset 

bipolar disorder. This type can be more severe than bipolar

disorder in older teens and adults. Also, young people with 

bipolar disorder may have symptoms more often and 

switch moods more frequently than adults with the illness. 

Models are used for illustrative purposes only.
What causes bipolar disorder?

Several factors may contribute to bipolar disorder, including:

s Genes, because the illness runs in families. Children 

with a parent or sibling with bipolar disorder are more 

likely to get the illness than other children.

s Abnormal brain structure and brain function.

s Anxiety disorders. Children with anxiety disorders are 

more likely to develop bipolar disorder.

The causes of bipolar disorder aren’t always clear. Scientists 

are studying it to find out more about possible causes and 

risk factors. This research may help doctors predict whether 

a person will get bipolar disorder. One day, it may also help 

doctors prevent the illness in some people.

What are the symptoms of bipolar disorder?

Bipolar mood changes are called “mood episodes.” Your child 

may have manic episodes, depressive episodes, or “mixed” 

episodes. A mixed episode has both manic and depressive 

symptoms. Children and teens with bipolar disorder may have 

more mixed episodes than adults with the illness.

Mood episodes last a week or two—sometimes longer. During 

an episode, the symptoms last every day for most of the day. 

Mood episodes are intense. The feelings are strong and happen 

along with extreme changes in behavior and energy levels. 

Children and teens having a manic episode may:

s Feel very happy or act silly in a way that’s unusual

s Have a very short temper

s Talk really fast about a lot of different things

s Have trouble sleeping but not feel tired

s Have trouble staying focused

s Talk and think about sex more often

s Do risky things.

Children and teens having a depressive episode may:

s Feel very sad 

s Complain about pain a lot, like stomachaches and 

headaches

s Sleep too little or too much
s Feel guilty and worthless

s Eat too little or too much

s Have little energy and no interest in fun activities

s Think about death or suicide.

Do children and teens with bipolar 

disorder have other problems?

Bipolar disorder in young people can co-exist with 

several problems. 

s Substance abuse. Both adults and kids with bipolar 

disorder are at risk of drinking or taking drugs.

s Attention deficit/hyperactivity disorder, or ADHD.

Children with bipolar disorder and ADHD may have 

trouble staying focused.

s Anxiety disorders, like separation anxiety.

Children with both types of disorders may need to 

go to the hospital more often than other people 

with bipolar disorder.

s Other mental illnesses, like depression.

Some mental illnesses cause symptoms that look 

like bipolar disorder. Tell a doctor about any manic 

or depressive symptoms your child has had.

Sometimes behavior problems go along with mood 

episodes. Young people may take a lot of risks, like drive 

too fast or spend too much money. Some young people 

with bipolar disorder think about suicide. Watch out 

for any sign of suicidal thinking. Take these signs 

seriously and call your child’s doctor.

How is bipolar disorder diagnosed?

An experienced doctor will carefully examine your child. 

There are no blood tests or brain scans that can diagnose 

bipolar disorder. Instead, the doctor will ask questions 

about your child’s mood and sleeping patterns. The 

doctor will also ask about your child’s energy and 

behavior. Sometimes doctors need to know about medical problems in your family, such as depression or alcoholism. The doctor may use tests to see if an illness other 

than bipolar disorder is causing your child’s symptoms. 
How is bipolar disorder treated?

Right now, there is no cure for bipolar disorder. Doctors 

often treat children who have the illness in a similar 

way they treat adults. Treatment can help control 

symptoms. Treatment works best when it is ongoing, 

instead of on and off. 

1. Medication. Different types of medication can help. 

Children respond to medications in different ways, 

so the type of medication depends on the child. 

Some children may need more than one type of 

medication because their symptoms are so complex. Sometimes they need to try different types of 

medicine to see which are best for them.

Children should take the fewest number and 

smallest amounts of medications as possible to 

help their symptoms. A good way to remember this 

is “start low, go slow.” Also, medications can cause 

side effects. Always tell your child’s doctor about 

any problems with side effects. Do not stop 

giving your child medication without a doctor’s 

help. Stopping medication suddenly can be 

dangerous, and it can make bipolar symptoms worse. 

2. Therapy. Different kinds of psychotherapy, or “talk” 

therapy, can help children with bipolar disorder. Therapy can help children change their behavior 

and manage their routines. It can also help young 

people get along better with family and friends. 

Sometimes therapy includes family members.
What can children and teens expect 

from treatment?

With treatment, children and teens with bipolar disorder 

can get better over time. It helps when doctors, parents, 

and young people work together. 

Sometimes a child’s bipolar disorder changes. When 

this happens, treatment needs to change too. For 

example, your child may need to try a different 

medication. The doctor may also recommend other 

treatment changes. Symptoms may come back after a 

while, and more adjustments may be needed. Treatment 

can take time, but sticking with it helps many children 

and teens have fewer bipolar symptoms.

You can help treatment be more effective. Try keeping 

a chart of your child’s moods, behaviors, and sleep 

patterns. This is called a “daily life chart” or “mood 

chart.” It can help you and your child understand and 

track the illness. A chart can also help the doctor see 

whether treatment is working.

Models are used for illustrative purposes only.
How can I help my child or teen?

Help your child or teen get the right diagnosis and 

treatment. If you think he or she may have bipolar 

disorder, make an appointment with your family doctor 

to talk about the symptoms you notice.

If your child has bipolar disorder, here are some basic 

things you can do:

s Be patient

s Encourage your child to talk, and listen to him or her 

carefully

s Be understanding about mood episodes

s Help your child have fun

s Help your child understand that treatment can help 

him or her get better.

How does bipolar disorder affect parents and 

family?

Taking care of a child or teenager with bipolar disorder can 

be stressful for you too. You have to cope with the mood 

swings and other problems, such as short tempers and risky 

activities. This can challenge any parent. Sometimes the 

stress can strain your relationships with other people, and 

you may miss work or lose free time. 

If you are taking care of a child with bipolar disorder, take 

care of yourself too. If you keep your stress level down you 

will do a better job. It might help your child get better too.Models are used for illustrative purposes only.
Where do I go for help?

If you’re not sure where to get help, call your family doctor. 

You can also check the phone book for mental health 

professionals. Hospital doctors can help in an emergency.

I know a child or teen who is in crisis. 

What do I do?

If you know a child who is in crisis, get help quickly.

s Do not leave him or her alone

s Call your doctor

s Call 911 or go to the emergency room

s Call a toll-free suicide hotline: 1–800–273–TALK 

(8255) for the National Suicide Prevention Life- line. The TTY number is 1–800–799–4TTY (4889).

Contact us to find out more about 

bipolar disorder.

National Institute of Mental Health

Science Writing, Press & Dissemination Branch

6001 Executive Boulevard

Room 8184, MSC 9663

Bethesda, MD 20892–9663

Phone: 301–443–4513 or

Toll-free: 1–866–615–NIMH (6464)

TTY Toll-free: 1–866–415–8051

Fax: 301–443–4279

E-mail: nimhinfo@nih.gov

Web site: http://www.nimh.nih.gov

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

National Institutes of Health

NIH Publication No. TR-08-6380