Bipolar Disorder (Childhood Onset)

Bipolar disorder (BD), or what historically was called manic-depressive disorder, has long been identified as an adult disorder. BD is characterized by extreme shifts in mood, energy, and behavior that significantly impair an individual's functioning. In adults, it is characterized by cycles of depression alternating with either mania (i.e., feelings of elation, inflated self-esteem, excessive talking, flight of ideas, increased goal-directed and risk-taking behavior, and agitation) or hypomania (manic-like symptoms but less severe and shorter in duration); each component of the cycle lasts at least 4 days. With children, it has been suggested that the components of the cycle can be very short (i.e., rapid or ultrarapid cycling) (Papolos & Papolos, 1999). Furthermore, in children, the depression may manifest as irritability, low motivation, poor concentration, ...