Most children and adolescents have moods that come and go, and this is normal. Their feelings of sadness or elation are typical reactions to daily occurrences in their lives, environmental or personal stress, or just hormones. The moods of children and adolescents who have bipolar disorder, however, can strongly interfere with interpersonal and normal functioning.

Bipolar disorder is characterized in the Diagnostic and Statistical Manual on Mental Disorders (DSM-IV) as a mood disorder. Unfortunately, it makes no distinction between adult bipolar disorder and child bipolar disorder, and children are still being diagnosed using adult criteria.

Although traditionally diagnosed in the late teens and early 20's, bipolar disorder is now being detected in children as young as toddlers, although symptoms of bipolar disorder can emerge as early as infancy.

Symptoms of bipolar disorder in both children and in adolescents involve changes in mood and energy, with a shifting between extreme moods. They both experience the highs of bipolar mania as well as the lows of bipolar depression.

Depression can be characterized as a state of irritability or intense sadness accompanied by low energy. Symptoms of depression in adolescents can include persistent crying spells, extreme sadness, agitation, worry, sleeping too much, change in appetite, disinterest in activities which they used to enjoy, low energy, problems with focus and concentration, and thoughts of death and suicide.

Mania is at the opposite end of the mood spectrum. It is characterized by persistent states of extreme elation or agitation accompanied by high energy. Symptoms of mania in adolescents can include elevated mood, rapid speech, sleeping less, grandiose delusions, increased mental and physical activities (including excessive involvement in risky activities – such as sexual promiscuity), poor judgment, and hallucinations.

The symptoms of bipolar disorder in adolescents look much like the classical adult symptoms. However, in younger children, the disorder may look different. Children usually have a continuous mood disturbance that is a mixture of mania and depression, rather than the more obvious shift in moods that adolescents exhibit. Because of this, it is difficult to apply standard diagnostic criteria to very young children.

Parents with children who are diagnosed with bipolar disorder report that symptoms may include the following: lack of interest in play, hyperactivity, explosive and destructive rages, defiance of authority, bed wetting, frequent cravings for sweets, extreme dare-devil behaviors, impaired judgment and delusions.

Although to date there is still no cure for bipolar disorder, with proper treatment, the disorder can be managed and stabilized. There are several treatments that have been effective for children and adolescents with bipolar disorder -- medication, proper diet, good sleep patterns, watching for episode triggers (monitoring symptoms), education regarding bipolar disorder, psychotherapy or other counseling/psychiatric care, and stress reduction.

Therapeutic parenting has also been found to be effective – and even essential -- in the treatment of bipolar disorder in children and adolescents. Various techniques are used to help calm children when their symptoms are manifesting and, in addition, these techniques can help prevent recurrent bipolar episodes.

Such techniques include: teaching children relaxation techniques, reducing stress in the home and teaching the child stress management techniques, providing routine structure for the child, prioritizing or 'choosing' battles, promoting creativity in the child, and developing a safe home environment by removing harmful objects.

Unfortunately, bipolar disorder in both children and adolescents appears more severe and seems to have a much longer road to recovery than that which is typically seen with adults. Although bipolar disorder in children and adolescents is a lifelong condition, it can still be managed through medication, psychotherapy, and lifestyle change, just as it is with adults.