In order to understand bipolar disorder diagnosis in children, it helps to understand how we define it in adults. In adults, according to the Diagnostic and Statistical Manual (DSM) used to diagnose all psychological disorders, a specific number of symptoms must occur within a specified timeframe. For bipolar disorder, which includes manic episodes and depressive episodes, there are specific criteria for both types of episode in order for the individual to be diagnosed as bipolar. The episode(s) must also not be induced by a medical prescription or condition, nor by drug abuse. The details of the diagnostic criteria and the timeframes are below, however, some of the difficulty in diagnosis of bipolar in children with these adult criteria is that the time frames are not applicable. Children’s episodes may last minutes and hours instead of days. The outward expression of depression and mania also look somewhat different in children.
This page will explain some of the basic information necessary for understanding the diagnosis of bipolar disorder. This page is linked to many more pages about bipolar disorder in both children and adults.Scroll down to the bottem and check them all out.
To understand how bipolar disorder diagnosis is made, it is important to understand the concept of episodes. Episodes and their length are how psychiatric professionals determine whether someone meets the criteria for bipolar disorder. It is important to note that even with these guidelines in place, mental health professionals make mistakes all the time when diagnosing bipolar disorder. Sometimes they diagnose it when it’s not there, and sometimes they don’t see it when it is there. Other pages on the site will go into more detail describing this. The purpose of this page is simply to describe the current system mental health professionals use when diagnosing bipolar disorder.
There are several kinds of bipolar mood disorders described in the Diagnostic and Statistical Manual (DSM), the book used to make a bipolar disorder diagnosis. Each different bipolar disorder diagnosis is distinguished by episodes. Below are some of the definitions we need to understand to differentiate between different types of bipolar disorder ( Bipolar I, II, NOS, and Cyclothymia).
Learn more about types of bipolar here
Types of Bipolar Diagnoses
Bipolar I: At least one manic episode along with at least one major depressive episode. This is the classic definition of bipolar as mania is the defining feature.
Bipolar II: At least one hypomanic episode and at least one major depressive episode.
Cyclothymia: Hypomanic symptoms along with mild or moderate depression.
Bipolar Disorder NOS (Not Otherwise Specified): This diagnosis is used with individuals who have some aspects of bipolar symptoms, but not others. For example, they may exhibit symptoms of depression or mania, but the episodes may not meet the criteria for duration.
Mood Disorder NOS (Not Otherwise Specified): This diagnosis is used with individuals with even less clearly defined mood symptoms or issues. Oftentimes, this will be the diagnosis given to children who have a variety of mixed presentations, but who do not meet the criteria for anything specific.
Major Depressive Episode
All of the symptoms below must occur most of every day for two weeks.
Either a depressed mood (in children this can be irritability)
No pleasure or interest in previously enjoyed activities or any activities
4 of the other symptoms below:
Symptoms are present to a significant degree for a week. This mood state must cause some kind of an impairment in functioning, a hospitalization or be accompanied by psychosis.
3 or more of the symptoms below accompany a week of elevated or expansive mood
4 or more symptoms accompany and irritable mood
All the symptoms are met both for a Manic Episode and for a Major Depressive Episode nearly every day for a week.
The mood disturbance is sufficiently severe to cause impairment in functioning,
there is psychosis
hospitalization is necessary
Hypo manic Episode
At least 4 days of period of elevated, expansive, or irritable mood, which meet the criteria of mania except that the episode is not severe enough to cause marked impairment in social or occupational functioning, or to necessitate hospitalization, and there are no psychotic features.
Symptoms Must Cause Impairment
In addition to these symptoms existing, to make a bipolar disorder diagnosis they must also cause impairment in an area of a person’s functioning (i.e. work or social). A person who is having these symptoms but moving along just fine in life would not qualify as having an episode.
Can’t be Caused by a Medical Condition or Drug Use
These symptoms also cannot be related to a medical condition or due to drug abuse or medication. I have seen people receive a bipolar disorder diagnosis, when in fact, they had a medical disorder. Certain medical disorders can mimic the appearance of bipolar disorder as can certain drugs. For example, someone who is on crack may appear manic, but they are not manic, they are high on crack.
Bipolar and Kids
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Medical information obtained from our website is not intended as a substitute for professional care. If you have or suspect you have a problem, you should consult a healthcare provider.