Bipolar Disorder is classified by the American Psychiatric Association (APA) as a brain disorder that causes significant, overwhelming, uncontrollable and enduring changes in the patient’s moods, thoughts, behaviors and activities. Although the APA reports 750,000 children nationwide are affected by Bipolar Disorder, not much research has been conducted in this area. This is due in part to the difficulty that surrounds the detection of bipolar symptoms as well as a child's limited ability to convey moods and experiences.
Depression in Toddlers
For a toddler who may not yet have mastered the ability to communicate verbally, the articulation of depressive thoughts or feelings will be difficult. Instead, toddlers experiencing a depressive episode will likely exhibit their disposition through their behavior. Symptomatic behaviors of bipolar depression include oppositional behavior at preschool or in playgroups, difficulty in school or group atmosphere, expressed irritability, complaints of boredom and low energy.
Mania in Toddlers
Just as with depression, toddlers may not be able to articulate their thoughts or feelings when experiencing episodes of mania. Instead, toddlers will likely exhibit their mood in the following behaviors: obsessive or compulsive activities, a decreased need or ability to sleep, preoccupation with and attempts to create weapons (or fire), inflated self-esteem or elaborateness, hyperactivity, talkative speech patterns with racing thoughts and flying ideas, inattentiveness or difficultly staying on task, fixation on ideas and aggression when confronted with obstacles.
Since bipolar toddlers have difficult remaining on task and paying attention, and since they can appear hyperactive even fidgety, it is a common misconception that the child is exhibiting Attention Deficit Hyperactive Disorder (ADHD). A misdiagnosis of this kind is particularly dangerous for two reasons: 1) if treatment for the actual bipolar disorder is delayed, the child’s condition could be seriously exacerbated and 2) if the child receives a typical ADHD treatment using prescribed stimulant medication, the medication will actually make the disorder’s manic-depressive episodes significantly worse.
Additional Signs and Symptoms
Toddlers with bipolar disorder can be easily frustrated and can likely produce long and enduring temper tantrums. Such tantrums can be provoke by even the smallest of incidents: a transition of some sort, such as a change in schedule or a parent or caregiver’s refusal to meet a request or demand of the child. Bipolar toddlers can also be destructive and defiant exhibiting blatant refusals to follow instructions of a parent or caregiver or demonstrating significant stubborn and overbearing behavior.
Nighttime Signs and Symptoms
Nighttime is generally a source of great anxiety for toddlers with bipolar disorder. Some bipolar toddlers will even experience night terrors: an event that occurs during slow-wave sleep (not completely asleep, not fully awake) characterized by feelings of extreme terror, the temporary inability to fully awaken, and frightful expressions through screams, gasps and moans. For those bipolar children who experience such night terrors, they generally start at a very young age.