How to Recognize Bipolar Disorder in Children

Bipolar disorder in children, also known as pediatric bipolar disorder, is a mood disorder that can cause a child to oscillate between mania, depression, or somewhere in between. However, the condition tends to look different in children, with more irritability, mixed episodes, and mood swings than in adult bipolar disorder. [1] While bipolar disorder is a lifelong condition, early diagnosis and treatment is associated with better outcomes, so recognizing the signs of the condition is important.

Part 1
Part 1 of 4:

Watching for Mood Swings

  1. Bipolar disorder can cause someone to cycle between mania, hypomania, depression, mixed states, and a normal mood. [2] [3] As a result, a child with bipolar will likely have much more severe and inconsistent emotional reactions, beyond the typical highs-and-lows of childhood.
    • Mania typically presents itself as an elevated mood and a surge of energy. Hypomania is a less severe form of mania.
    • Depression usually presents itself as reduced energy and a low mood.
    • Mixed states are typically a combination of mania (or hypomania) and depression at the same time. [4] For example, a child might be extremely chatty and engage in highly risky behavior, but have low self-esteem and feel suicidal.
    • It's possible for bipolar disorder to go into remission, and to have time without symptoms. However, this isn't as common in childhood-onset bipolar. [5]

    Did You Know? Some children experience full manic episodes, while others only have hypomanic episodes. It's also possible to experience both. [6]

  2. Children with bipolar are more likely to experience mixed states and rapid-cycling (quickly shifting between mania and depression). [7] [8] They may seem to swing from one extreme to another with little discernible cause, sometimes within days or even hours. [9]
    • The moods associated with bipolar tend to be far more severe than typical mood swings that a child or preteen might experience. Bipolar episodes also usually don't blow over as quickly, don't always have an identifiable cause, and parents typically find they can't get their child to "snap out of it". [10]
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  3. Kids with bipolar disorder tend to have rapid, dramatic changes in their self-esteem depending on what kind of episode they're in. Mania can cause your child's self-esteem to skyrocket, whereas depression can cause it to plummet. [11]
  4. Unstable relationships are quite common in bipolar disorder; children with bipolar may have difficulty making friends because of their moods, and inadvertently drive friends away.
    • Mania can frighten or upset a child's peers. Inappropriate or risky behavior can result in peers ridiculing them, and violent or aggressive reactions can make others afraid of them. They may be labeled the "bad kid" or "weird kid" in school.
    • Depression can result in self-isolation, which can damage existing relationships and prevent new ones. A depressive phase may also result in a child lashing out or being harsh with existing friends.
    • Regardless of whether they're experiencing mania or depression, children with bipolar are far more likely to get into fights (physical or verbal) as a result of their moods. [12]
  5. In rare cases, a child may display signs of bipolar disorder at an early age. [13] [14] However, in general, bipolar disorder tends to suddenly become prevalent when it wasn't an issue before. [15] Take time to think back on the past - when did the behavior become prominent?
    • While depressive episodes can take longer to settle in, mania and hypomania tend to start quite rapidly (and in the case of mania, can be extremely apparent). [16]

    Did You Know? Bipolar disorder is fairly rare in prepubescent children. It's more likely to develop during adolescence or early adulthood. [17]

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Part 2
Part 2 of 4:

Recognizing Signs of Mania

  1. Unlike bipolar in adults, one of the typical defining features of bipolar in children is irritability. [18] A child in mania or hypomania may seem easily agitated or grumpy, and prone to snapping at people or even flying into rages.
    • The child may be more aggressive than usual, or threaten others.
  2. Mania or hypomania can result in euphoria, where the child is in an abnormally good mood for an extended period of time. They may be extremely excitable and giggly, to the point where it's atypical for them, and seem very animated or energetic. [19] [20] It may seem like they have a surge of energy or happiness that's come out of nowhere.
    • Consider whether anything seems to snap the child out of their euphoria; for example, if the child is punished for misbehavior, do they continue laughing hysterically? [21]
    • Euphoria can quickly give rise to irritability and anger during mania or mixed episodes. [22]

    Tip: Euphoria is not as common in children with bipolar disorder. While adults may experience euphoria, children are more likely to be grumpy and easy to irritate. [23]

  3. Mania tends to inflate a child's self-esteem, and they may believe their talents or abilities are far beyond what they're really capable of. (For example, a five-year-old might genuinely believe they're ready to become a bestselling author, even when given evidence that they're not ready.) [24] In some cases, they may even believe things that aren't true - for instance, that they have control over the weather. [25]
  4. During mania, a child with bipolar is likely to talk quickly and go off on tangents, and may be highly chatty. [26] They may suddenly switch topics in the middle of a conversation (sometimes mid sentence or multiple times), seemingly without notice, and become difficult to follow. [27]
    • In some cases, the child may experience pressured speech . This means that they're speaking so rapidly, their words "blend together" and it becomes difficult for listeners to understand the child. [28]
  5. A common component of mania is reckless behavior that can have severe consequences. [29] [30] [31] The child may seem to have abnormally poor judgement, and do things they know are unsafe. This behavior is not usually present outside of mania. [32] Risky behavior can look like:
    • Very inappropriate behavior for the setting (e.g. undressing in public or shrieking in class)
    • Physically risky behavior - climbing onto too-tall things, pulling dangerous stunts, getting in fights, starting fires
    • Giving away or breaking things that are important to them
    • Stealing
    • Spending money impulsively
    • Use of alcohol, tobacco, or drugs
    • Dangerous or inappropriate sexual activity

    Tip: Consider how the child acts if they're caught or punished. Bipolar often causes a child to feel they don't need to follow rules, or treat adults as authority. [33]

  6. During mania, children with bipolar disorder may express or act on sexual thoughts that are developmentally inappropriate. They may fixate on sex, display an inappropriate amount of knowledge or interest in adult-level sexual topics, and might not respect other people's sexual boundaries, seemingly for their own enjoyment or amusement. [34] Hypersexuality can include: [35] [36]
    • Obsession or fixation on genitalia, breasts, or butts
    • Repeatedly trying to touch another person's breasts, butt, or genitals
    • Making overtly sexual comments
    • Frequently talking about sex
    • Masturbating excessively, in front of others, or in public
    • Watching or reading pornography at a developmentally inappropriate age
    • Risky or developmentally inappropriate sexual activity with others

    Warning: Children who have been sexually abused may also show signs of hypersexuality, but their hypersexuality is typically anxiety-driven. Do not mistake the effects of sexual abuse for hypersexuality in bipolar disorder. [37]

  7. During mania, a child with bipolar disorder may not feel that they need to sleep, and sleep much less than usual (or even not sleep at all). Despite this, they'll usually be just as energetic as if they'd slept the whole night. [38] They may be up later than they should be, engaging in a variety of activities, rather than trying to sleep. [39]
    • This differs from insomnia in that a child without bipolar will typically suffer from a lack of sleep, and may seem tired, grumpy, or less focused. Children with bipolar often seem completely unaffected. [40]
  8. Mania or hypomania can affect a child's focus and either cause them to hyperfocus or lose focus. They'll frequently have many ideas for what they want to do, and may seem to jump from thing to thing far more quickly than they usually do. Their projects might be highly creative or imaginative. [41]
    • A child with bipolar might fixate on goals and ideas they have. They may spurn up so many ideas that it seems impossible to finish that many, but they often do finish them. [42] [43]
    • Difficulty focusing also isn't uncommon; the child has so much energy and so many things racing through their mind that they struggle to sit still and do something calmly. They may get in trouble in school for disrupting class. [44]
  9. In severe cases of mania, a child may experience psychosis and have beliefs or experiences that don't match reality. Cases of psychosis require immediate intervention, as it's disruptive to daily life and scary to the child. Psychosis can involve: [45]
    • Delusions: The child may have beliefs that nobody can convince them are false. They may have persecutory delusions ("somebody is out to get me") or grandiose delusions ("I can do anything in the world").
    • Hallucinations: The child may see, hear, smell, feel, or taste things that don't really exist. (Auditory and visual hallucinations are most common.)
    • Language deterioration: The child may say things that don't make sense ( word salad ), or seem to lose their train of thought frequently. In severe cases, they might stop speaking and/or not understand speech.
    • Lack of self-care: The child may stop eating, sleeping, bathing, or otherwise taking care of their needs.
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Part 3
Part 3 of 4:

Noticing Signs of Depression

  1. Depression often results in a lack of energy, and this can present as lethargy, engaging in fewer activities, and less interest in things around them. It may seem like they're exhausted, disinterested, or "blue".
    • Unlike in major depression, children with bipolar disorder often move around much more slowly as well. [46]

    Did You Know? Most children with bipolar disorder start off experiencing depression rather than mania. [47]

  2. Like in mania, children in a depressive state are likely to be irritable and angry, and might snap at the slightest provocation. Constant irritability and a low or sad mood may indicate a depressive phase. [48]
  3. While irritability is common, a child in a depressive phase may cry often, sometimes for seemingly little reason. They might seem constantly unhappy, with nothing that can snap them out of it - even things that used to cheer them up likely won't work. [49]
  4. Depressive episodes in bipolar disorder tend to hurt self-esteem. A child with bipolar may believe that nobody likes them, or that they're not a good person - even if this couldn't be farther from the truth. Their low self-esteem and negative beliefs about themselves are often a stark contrast to the high self-esteem associated with mania. [50]
    • A child with bipolar may feel intensely guilty for little reason, or strongly believe they're a failure or that they've failed at something, even if this isn't the case. [51]
  5. A child going through a depressive episode often struggles to concentrate on anything at all, even if they normally like what they're doing. This is often apparent at school, but will likely also be present with other activities - for example, a child who used to love reading may suddenly no longer focus on their books. [52]
    • Depressive phases can result in cognitive problems. The child may feel their brain isn't running as fast as it should be, or that their mind is fuzzy (in other words, "brain fog"). [53]
    • The child may lose interest in everything they once enjoyed, even if they were truly passionate about it. They may seem more like they're "going through the motions" than actually enjoying it, or drop activities they used to love. [54]
  6. Depressive episodes often cause children with bipolar to avoid people and activities they normally like; a normally social child may withdraw from playing with peers, and hide in their room when guests are over. It may seem like they're frequently "sitting off to the side" rather than engaging with other people. [55]
    • A child with bipolar might cling to a trusted adult, like a parent, and resist going to school or activities they used to enjoy.
    • Children with bipolar may believe that none of their peers like them, even if this isn't true. [56]
  7. It's very common for depression (in bipolar or otherwise) to affect someone's eating habits, and in turn, affect their weight. Be alert if your child stops eating and seems to have no appetite, or starts eating more than usual but doesn't appear to be having a growth spurt. [57] [58]
  8. Many children with bipolar experience psychosomatic illnesses and pains, and may frequently report headaches or stomach aches. However, when taken to the doctor, the doctor often can't identify anything physical causing the pain. [59]
    • Kids experiencing these pains may frequently end up in the nurse's office at school, and you might end up bringing them home early often.
    • Be sure to distinguish this from other conditions such as stress or anxiety, which can also cause psychosomatic symptoms.
  9. Depression in bipolar disorder often negatively impacts sleep patterns. A child with bipolar may sleep for long periods of time, yet feel lethargic or exhausted when they wake up; alternatively, they may have difficulty falling asleep and lay awake for a long time, despite being tired. [60]
  10. In some cases, depression can cause a child to become hopeless and feel suicidal. Seek help as soon as possible if your child seems to be suicidal. Signs that your child is suicidal include: [61] [62]
    • Avoidance or withdrawing from others
    • Sudden anger or aggression towards others
    • Making reckless choices, like walking into traffic
    • Drawing, writing, or talking excessively about death or suicide
    • Subtle comments such as "I wish I could just disappear" or "You'd be better off without me"
    • Obvious comments such as "I wish I had never been born" or "I wish I was dead"
    • Giving away things they love, and/or writing a will
    • Comments implying they plan to end their life, like "It won't hurt for much longer" or "Thank you for everything you did for me"
    • Obtaining a means to end their life (gun, pills, rope, knife, etc.)

    Warning: Children with bipolar disorder are at increased risk for suicide. Take any warning signs seriously and seek help immediately. [63]

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Part 4
Part 4 of 4:

Moving Forward

  1. There are some conditions that can closely resemble bipolar, and because bipolar disorder is uncommon in prepubescent children, it's important to avoid jumping to conclusions. Some conditions that can be mistaken for pediatric bipolar disorder include: [64]
    • Disruptive mood dysregulation disorder
    • Intermittent explosive disorder
    • Oppositional defiant disorder
    • Depression
    • ADHD (which can look like bipolar disorder)
    • Autism
    • Anxiety
    • Trauma, particularly if it was extensive and ongoing [65]
    • Conduct disorder
    • Childhood-onset schizophrenia (if psychosis is present)
  2. It's fairly common for children with bipolar to have another co-occurring condition, or to develop one if they go untreated. Conditions that often coincide with bipolar disorder include: [66]
    • ADHD
    • Anxiety disorders
    • Oppositional defiant disorder
    • Conduct disorder
    • Drug or alcohol abuse
  3. Doctors may misdiagnose your child with ADHD, depression, or a psychotic disorder if they don't have the full picture of your child's moods. [67] Over a period of weeks or months, keep a log of your child's moods, behaviors, and potential triggers on paper or on your phone or computer. This can help paint a clearer picture to your child's doctor.
  4. Teachers often get a good insight into a child's behavior, since they're around them so much. Check in with your child's school and ask about their mood, behavior, and focus. This gives them an opportunity to relay any concerns to you.
    • Take note if your child has a sudden drop in grades; while this doesn't always mean bipolar disorder, it may mean something is wrong.
    • It's not at all uncommon for children with bipolar to frequently get in trouble in school during manic phases or to struggle with school during depressive phases, so you might already have some idea of what's going on.
    • You may want to ask your child's teacher(s) to write down any concerns or problems that they've noticed, so that medical professionals can get a clearer insight as to what's happening.

    Tip: Anyone who interacts with your child regularly will likely have insights. For example, coaches and babysitters would likely be good people to ask.

  5. In order to diagnose your child with bipolar disorder, you'll need to take them to a medical professional for a psychological assessment. If the screenings confirm that your child has bipolar disorder, you and your child will be referred for further treatment.
    • There is some controversy in the medical field about how bipolar disorder presents in children. [68] Don't be afraid to get a second opinion if you feel it's needed.
  6. Especially in younger children, it's important to treat bipolar disorder early, as it can have severe effects on the child's life if untreated. Treatment options for bipolar disorder usually include therapy and medication, and finding what works for your child may be a process of trial and error. [69] [70]

    Tip: Ensure that your child is eating healthy meals, being physically active, and sticking to a regular sleep schedule. Doing so can help with managing their mental health. [71]

  7. . Growing up can be difficult enough for neurotypical children, and bipolar disorder can make this even harder. A child with bipolar may worry that their mood swings are their fault or that they're a "bad kid". Showing them your love and support is vital for treatment and success.
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Expert Q&A

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  • Question
    What does a manic episode look like in a child?
    Liana Georgoulis, PsyD
    Licensed Psychologist
    Dr. Liana Georgoulis is a Licensed Clinical Psychologist based in Los Angeles, California. She is the founder and clinical director of Coast Psychological Services. With over 12 years of experience, her mission is to provide clients with effective, well-studied, and established treatments that bring about significant improvements in her patients' lives. Her practice provides cognitive behavioral therapy and other evidence-based therapies for adolescents, adults, and couples. Additionally, she provides group therapy for social anxiety, social skills, and assertiveness training. Providing a space where clients feel understood and supported is essential to her work. Dr. Georgoulis also provides clinical supervision to post-doctoral fellows and psychological assistants. She received her PhD in Clinical Psychology from Pepperdine University and a BA in Psychology from the University of California, Los Angeles.
    Liana Georgoulis, PsyD
    Licensed Psychologist
    Expert Answer
    Your child might be more hyperactive or impulsive towards making bad decisions if they're having a manic episode.
    Thanks! We're glad this was helpful.
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  • Question
    How often does someone with bipolar disorder change moods?
    Liana Georgoulis, PsyD
    Licensed Psychologist
    Dr. Liana Georgoulis is a Licensed Clinical Psychologist based in Los Angeles, California. She is the founder and clinical director of Coast Psychological Services. With over 12 years of experience, her mission is to provide clients with effective, well-studied, and established treatments that bring about significant improvements in her patients' lives. Her practice provides cognitive behavioral therapy and other evidence-based therapies for adolescents, adults, and couples. Additionally, she provides group therapy for social anxiety, social skills, and assertiveness training. Providing a space where clients feel understood and supported is essential to her work. Dr. Georgoulis also provides clinical supervision to post-doctoral fellows and psychological assistants. She received her PhD in Clinical Psychology from Pepperdine University and a BA in Psychology from the University of California, Los Angeles.
    Liana Georgoulis, PsyD
    Licensed Psychologist
    Expert Answer
    It varies depending on the person. Some people may cycle rapidly, meaning they shift between mania and depression often. However, episodes may last for longer periods.
    Thanks! We're glad this was helpful.
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      • Bipolar disorder is more likely in children who have immediate family members with bipolar. [72]
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      • While adults with bipolar disorder may have "remission periods" where the person displays no symptoms, this is not usually the case for children. Instead, bipolar disorder tends to be constant with less breaks between episodes. [73]
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      Warnings

      • A child with depression may develop bipolar disorder later on, and begin showing symptoms of mania. Be cautious to differentiate between your child feeling better and hypomania or mania. [74]
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      • Don't attempt to diagnose your child yourself, even if you're certain they have bipolar disorder. See a professional.
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      References

      1. ↑ https://www.bphope.com/kids-children-teens/the-differences-between-childhood-and-adult-bipolar-disorder/
      2. ↑ Liana Georgoulis, PsyD. Licensed Psychologist. Expert Interview. 6 September 2018.
      3. ↑ https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/symptoms-causes/syc-20355955
      4. ↑ http://www.childrenshospital.org/conditions-and-treatments/conditions/b/bipolar-disorder/symptoms-and-causes
      5. ↑ https://www.bphope.com/kids-children-teens/the-differences-between-childhood-and-adult-bipolar-disorder/
      6. ↑ http://www.childrenshospital.org/conditions-and-treatments/conditions/b/bipolar-disorder/symptoms-and-causes
      7. ↑ https://chadd.org/for-parents/pediatric-bipolar-disorder/
      8. ↑ https://www.bphope.com/kids-children-teens/bipolar-in-kids-symptoms/
      9. ↑ Liana Georgoulis, PsyD. Licensed Psychologist. Expert Interview. 6 September 2018.
      1. ↑ http://www.childrenshospital.org/conditions-and-treatments/conditions/b/bipolar-disorder/symptoms-and-causes
      2. ↑ https://www.uofmhealth.org/health-library/ty6916#ty6917
      3. ↑ https://www.bphope.com/kids-children-teens/8-signs-your-child-might-have-bipolar-disorder/
      4. ↑ https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/expert-answers/bipolar-disorder-in-children/faq-20058227
      5. ↑ http://www.childrenshospital.org/conditions-and-treatments/conditions/b/bipolar-disorder
      6. ↑ https://www.bphope.com/kids-children-teens/bp-kids-adhd-or-mania/
      7. ↑ https://childmind.org/article/bipolar-disorder-difficult-to-diagnose-in-adolescents/
      8. ↑ https://www.nimh.nih.gov/health/publications/bipolar-disorder-in-children-and-teens/index.shtml
      9. ↑ https://childmind.org/article/is-it-adhd-or-bipolar-disorder/
      10. ↑ http://www.childrenshospital.org/conditions-and-treatments/conditions/b/bipolar-disorder/symptoms-and-causes
      11. ↑ https://www.bphope.com/kids-children-teens/8-signs-your-child-might-have-bipolar-disorder/
      12. ↑ https://www.bphope.com/kids-children-teens/10-signs-your-child-is-having-a-bipolar-manic-episode/
      13. ↑ https://www.additudemag.com/symptoms-of-bipolar-disorder-in-children-what-you-are-seeing/
      14. ↑ https://childmind.org/article/is-it-adhd-or-bipolar-disorder/
      15. ↑ http://www.childrenshospital.org/conditions-and-treatments/conditions/b/bipolar-disorder/symptoms-and-causes
      16. ↑ https://my.clevelandclinic.org/health/diseases/14669-bipolar-disorder-in-children
      17. ↑ http://www.childrenshospital.org/conditions-and-treatments/conditions/b/bipolar-disorder/symptoms-and-causes
      18. ↑ https://www.bphope.com/kids-children-teens/bp-kids-adhd-or-mania/
      19. ↑ https://chadd.org/for-parents/pediatric-bipolar-disorder/
      20. ↑ Liana Georgoulis, PsyD. Licensed Psychologist. Expert Interview. 6 September 2018.
      21. ↑ https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/expert-answers/bipolar-disorder-in-children/faq-20058227
      22. ↑ https://www.bphope.com/kids-children-teens/10-signs-your-child-is-having-a-bipolar-manic-episode/
      23. ↑ https://www.healthline.com/health/childrens-health/bipolar-disorder-in-children#symptoms
      24. ↑ https://www.bphope.com/kids-children-teens/bipolar-adhd-children-kids/
      25. ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2695748/
      26. ↑ https://www.bphope.com/kids-children-teens/straight-talk-about-kids-and-hypersexuality/
      27. ↑ https://www.bphope.com/kids-children-teens/10-signs-your-child-is-having-a-bipolar-manic-episode/
      28. ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2695748/
      29. ↑ https://www.bphope.com/kids-children-teens/10-signs-your-child-is-having-a-bipolar-manic-episode/
      30. ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2695748/
      31. ↑ https://www.bphope.com/kids-children-teens/8-signs-your-child-might-have-bipolar-disorder/
      32. ↑ https://www.additudemag.com/symptoms-of-bipolar-disorder-in-children-what-you-are-seeing/
      33. ↑ https://www.bphope.com/kids-children-teens/10-signs-your-child-is-having-a-bipolar-manic-episode/
      34. ↑ http://www.childrenshospital.org/conditions-and-treatments/conditions/b/bipolar-disorder/symptoms-and-causes
      35. ↑ https://www.additudemag.com/symptoms-of-bipolar-disorder-in-children-what-you-are-seeing/
      36. ↑ https://www.nhs.uk/conditions/psychosis/symptoms/
      37. ↑ https://childmind.org/article/bipolar-disorder-difficult-to-diagnose-in-adolescents/
      38. ↑ https://www.bphope.com/kids-children-teens/the-differences-between-childhood-and-adult-bipolar-disorder/
      39. ↑ https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/expert-answers/bipolar-disorder-in-children/faq-20058227
      40. ↑ https://www.additudemag.com/symptoms-of-bipolar-disorder-in-children-what-you-are-seeing/
      41. ↑ https://www.uofmhealth.org/health-library/ty6916#ty6917
      42. ↑ https://childmind.org/article/bipolar-disorder-difficult-to-diagnose-in-adolescents/
      43. ↑ https://chadd.org/for-parents/pediatric-bipolar-disorder/
      44. ↑ https://childmind.org/article/bipolar-disorder-difficult-to-diagnose-in-adolescents/
      45. ↑ https://www.additudemag.com/symptoms-of-bipolar-disorder-in-children-what-you-are-seeing/
      46. ↑ https://www.additudemag.com/symptoms-of-bipolar-disorder-in-children-what-you-are-seeing/
      47. ↑ https://www.additudemag.com/symptoms-of-bipolar-disorder-in-children-what-you-are-seeing/
      48. ↑ http://www.childrenshospital.org/conditions-and-treatments/conditions/b/bipolar-disorder/symptoms-and-causes
      49. ↑ https://www.additudemag.com/symptoms-of-bipolar-disorder-in-children-what-you-are-seeing/
      50. ↑ https://www.nimh.nih.gov/health/publications/bipolar-disorder-in-children-and-teens/index.shtml
      51. ↑ https://www.nimh.nih.gov/health/publications/bipolar-disorder-in-children-and-teens/index.shtml
      52. ↑ https://www.choc.org/articles/9-signs-your-child-may-be-considering-suicide/
      53. ↑ https://www.stanfordchildrens.org/en/topic/default?id=teen-suicide-learning-to-recognize-the-warning-signs-1-1696
      54. ↑ https://www.healthline.com/health/bipolar-disorder/bipolar-or-adhd
      55. ↑ https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/expert-answers/bipolar-disorder-in-children/faq-20058227
      56. ↑ https://chadd.org/for-parents/pediatric-bipolar-disorder/
      57. ↑ https://www.healthline.com/health/childrens-health/bipolar-disorder-in-children#symptoms
      58. ↑ https://childmind.org/article/bipolar-disorder-difficult-to-diagnose-in-adolescents/
      59. ↑ https://chadd.org/for-parents/pediatric-bipolar-disorder/
      60. ↑ http://www.childrenshospital.org/conditions-and-treatments/conditions/b/bipolar-disorder/symptoms-and-causes
      61. ↑ https://www.uofmhealth.org/health-library/ty6916#ty6917
      62. ↑ https://www.uofmhealth.org/health-library/ty6916#ty6917
      63. ↑ https://www.bphope.com/kids-children-teens/8-signs-your-child-might-have-bipolar-disorder/
      64. ↑ https://www.bphope.com/kids-children-teens/the-differences-between-childhood-and-adult-bipolar-disorder/
      65. ↑ https://chadd.org/for-parents/pediatric-bipolar-disorder/

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