How Does Bipolar Disorder Actually Present in Childhood?
Children with bipolar disorder veer from irritable, easily annoyed, angry mood states to silly, goofy, giddy elation, and then just as easily descend into low energy periods of intense boredom, depression and social withdrawal, fraught with self-recriminations and suicidal thoughts. These abrupt swings of mood and energy can occur multiple times within a day, and intense outbursts of temper (rages that can go on for hours), poor frustration tolerance, and oppositional defiant behaviors are commonplace. The children frequently suffer severe anxiety–separation anxiety, generalized anxiety, and panic disorders–as well as obsessive-compulsive symptoms, particularly aggressive obsessions, hoarding, the need for symmetry and ritual requests for reassurance. Moreover, many of the children have sleep disturbances, often accompanied by night terrors, nightmares filled with blood and gore and themes of pursuit and abandonment, as well as other arousal disorders of sleep. Accompanying elevated
