Juniper Files: Signs & Symptoms of Pediatric Bipolar Disorder
So, you’re chillin’ in the check out line at Walmart when your darling little one starts throwing a tantrum of earth-shattering proportions. Suddenly you remember a fabulous post written by Moi and you wonder, “But how did she know?” I mean all kids throw tantrums and can act slightly psychotic at times, right? So, what makes a kid bipolar? When do you know you’ve crossed that invisible line between a difficult child and a child who is suffering from mental illness? So, I give you:
The Signs and Symptoms of Early Onset Bipolar Disorder***
(Credit for this list of symptoms goes to Demitri Papolos, M.D., and Janice Papolos authors of “The Bipolar Child: The Definitive Guide to Childhood’s Most Misunderstood Disorder”)
Separation Anxiety: My kids essentially grew up in daycare (where I worked) When my daughter was okay as an infant and younger toddler, however, by the time she turned 2 she was out of control. She stayed with me (I taught prek 3’s & 4’s). When she left me to start VPK, it was horrible! She would cry and rage. I thought kindergarten would be worse but by then she had started medication and her brother was always nearby. Over the years, it’s been touch and go but mostly she couldn’t make it through a full school day.
Rages and explosive temper tantrums: These are scary. To see my child so out of control, so furious, and often over something very small. You can expect broken, well, whatever’s nearby, holes in walls and doors and possible injuries. To hear the words that come out of her mouth during a rage you would think she was raised by sailors!
Marked irritability: Her face almost looks different, likes there’s another, angrier child lurking there, waiting to be triggered. This is the state I am constantly on the look out for. Because if I don’t catch it and try to alleviate it, otherwise we end up with a rage (see above).
Opposition/defiant disorder: My daughter can not tolerate being told what to do. I have learned how to phrase requests so they don’t upset her, but more importantly, I give her tools to help her do what she needs to without being told. I am trying to raise her to be self-motivated and able to anticipate what she needs to do. I hope this will help her have fewer problems as an adult. I will admit, this gets harder the older she gets. As a teenager now I just wish she could just do stuff without me having to dance around her.
Rapid Cycling: Severe changes in mood. Sometimes very silly, happy and hyper, other times very angry, or easily irritated or aggressive. These moods can change over several days, within a single day or (if you want to keep things really exciting like us) within an hour!
Racing thoughts: With a mouth to match. One she talked to me for 45 minutes. Straight. I’m not sure if she even stopped for breaths. I never got more than one word at a time in. Mostly I nodded or relied upon my vast inventory of facial expressions. She probably covered 57 topics, without ever missing a beat. Here’s an excerpt:
“…then we could cut up the hot dogs for a recipe and share it with people like Santa share’s toys, and I wonder what I’m getting for Christmas, don’t you? Then it won’t be so hot like it is now and that gave me the rash that is almost gone and I’m glad because it’s almost time to go back to school and I can’t wait to go back because I want to meet my teacher, do you think she will be nice? Will I be packing my lunch? What are we having for lunch tomorrow? Do we have any plans tomorrow? Can we go to the library? Hey remember…..” (I was thinking how exhausting it must be to be her sometimes!)
Aggressive Behavior: Did I mention that she was kicked out of 3 preschools and in kindergarten she was suspended about once a week? She’s highly “reactive” if someone bumps her she will knock them down. She’s also been kicked out of two junior highs, and high school. *sigh*
Distractibility: This is not always a bad thing. Her distractibility makes it easier to head off her rages.
Hyperactivity: I constantly refer to her as a hurricane, though I think tornado is more appropriate. I swear sometimes when she really gets going it feels like the air around her vibrates.
Impulsivity: This one scares the crap out of me. This is where darting into traffic and other unsafe behaviors came into play when she was younger. Now I worry about sneaking out, sex, and drugs.
Restlessness/fidgetiness: This goes hand in hand with the hyperactivity in my opinion. She is constantly in motion. If she’s sitting with a book she will be tapping her foot and playing with her hair. And shifting, always shifting.
Risk-taking behaviors: Running to traffic, opening the doors in a moving car, jumping off of high surfaces, sneaking out bedroom windows. At night. During a storm. Since she was 4ish. (See also: Impulsivity)
Elation as represented by periods of extremely silly, giddy, or goofy behavior: This is also the Period of Wet Kisses and Big Squeezes.
Night Terrors: I can’t say 100% if LeBella has these because she will rarely share her dreams with anyone. Though she has recapped a doozie or two.
Difficulty falling asleep: I remember those long, exhausting nights. She could bounce off the walls until 12, 1, 2 in the morning. I remember crying. A lot. Now she’s asleep by 8:30 every night when she takes her meds correctly.
Difficulty getting up in the morning (sleep inertia): Here’s an interesting fact: she was late to school 85% of the school year every year. I try not to make any morning appointments because we never make them.
Grandiosity: Marsha, Marsha, Marsha…they think they are the Master of the Universe and we are all their lowly servants. Or they think they’re a superhero (like for reals) and nothing can hurt them. She once did a Kamikaze jump off the 4’ kitchen counter. She bruised a bone in her foot and was on crutches for 2 weeks. Natural consequences trump punishment every time!
Periods of low energy and withdrawal: I see this mostly in the morning time. She’s sluggish and just doesn’t want to be bothered. It also gets worse during Fall/Winter.
Low-self esteem: Her weight has been a constant issue. She is always comparing herself to everyone else and pointing out how she “falls short”. I always try to tell her how she’s beautiful and smart and funny.
Carbohydrate cravings: And here I thought she got that from me! We are not big meat eaters but bring on the pasta, cereal, bread, etc!
Hoarding or avidly collecting objects or food: When I used to clean her room you wouldn’t believe some of the stuff I’d find! Fruit snacks stashed under the bed and what not. She also “hoards” papers. School work, artwork, random scribbled on papers. If I try to get her to throw them away she acts like I’m asking her to sacrifice her first born! So, I have to sneak things into the trash when she’s, you know, distracted.
Lying to avoid consequences of his or her actions: Oh Em Gee. This frustrates me to no end because I can WATCH her do something and then have her deny it and fall apart and start with the “You don’t love me, everybody hates me” drama queen movie of the week act.
Easily humiliate or shamed: This one is so hard. You can’t tease her about anything, ever. She takes everything to heart no matter how it is said.
Complaints of body temperature extremes: She is always hot, hot, too hot, mom I’m hot, turn on/down the air, fan me, can I take a shower, I’m sooo hot!
Hallucinations and delusions: When she was about 10 we moved into a new house and she refused to sleep in her room. She said there was a “blue boy” in there who kept trying to bite her toes. Several times during the day she would shriek and come running out saying the “blue boy” was in there. Eventually “blue boy” faded away, but if I mention him she gets scared.
Rapid or pressured speech: I actually recorded a portion of her “monologue” and sent it to my mom so she could see what I was talking about! And this is a regular thing with her.
Hypersexuality: Luckily, she still thinks boys are gross, lol, however, she does have a strong desire to look “fashionably cute” and I’m teaching her what I consider to be “too fresh”. She also dances too provocatively and we’re working on that.
Obsessive behavior: She always had to have certain dishes, cups, and silverware at meals. Seriously. Every time.
Compulsive behavior: Her clothes always have to fit a certain way or she won’t wear them. Sleeves cannot be fitted on her upper arms and she will only wear low rise shorts, pants, and skirts. Socks must feel just right.
Excessive daydreaming: Maybe, if she was less talkative she would be a daydreamer, but I think she pretty much speaks all her thoughts. All of the thoughts. All of them.
Learning Disabilities: She performs poorly in class, but tests very well. Most of her learning issues were addressed in an IEP that was rarely followed.
Poor working memory: This one’s tricky. She can remember things from when she was 3. In preschool she could remember what kind of shoes every kid in her class wore. But she forgets words. She will describe around a word until I provide it.
Lack of organization: She needs visual aids and lists. If I nag her with reminds she gets pissy. Then I get pissy. Then nothing gets done.
Fascination with gore or blood or morbid thoughts: She once decorated 5 of her Bratz dolls to look like Chucky. (Don’t ask)
Manipulative behavior: Thank goodness for my Momdar! It takes a skilled eye, and mind, and heart to tell the difference from her bipolar symptoms and pure child manipulation.
Extremely bossy behavior with friends/bullying: Check! When she is hanging around friends she is usually the bossy one. I try to remind her to be nicer but at 15, it’s hard to remind her without embarrassing her.
Self-mutilating behaviors: Even though I knew what to watch for, this one still caught me off guard. It was so heartbreaking to see the scars that she had hidden.
Destruction of property: It’s amazing the things a little girl can break when she puts her mind to it!
Suicidal thoughts: When my 4 ½ year old daughter pulled a knife out of a drawer, held it to her wrist and said, “I want to kill myself” I knew it was time to get help. She still gets suicidal when she’s depressed but we talk through it.
Paranoia: Most days she would come home from school and tell me about all her perceived slights from the other students.
Bedwetting: I’m glad we didn’t struggle much with this one. Changing bedsheets in the middle of the night is never fun.
Bingeing/eating disorders: I worry that this might be an issue in the future. As she hits puberty and her body image is becoming more of an issue for her, I am trying very hard to raise her self-esteem.
Motor and vocal tics: I do watch for them because some medications can cause them. We’ve seen them a few times over the years but always med related.
Cruelty to animals: She loves animals, she finds them soothing, I think.
Do you think this may apply to your child? There are a couple wonderful online questionnaires that you can take to get a clearer picture. This is not a replacement for profession intervention, merely a reassurance that its time to get help.
To access the questionnaires go to:
I sincerely hope this information helps you or someone you love. Or maybe makes a little more aware and sympathetic towards that mom in Walmart who appears to have no control over her minions.
Until next time, scribe happy and stay sassy,
***I am not a medical professional. I am just a mom who has been in the trenches. Please consult with a medical professional if you have concerns.