Can a Child Have Bipolar Disorder?

Yes, a child can have bipolar disorder. The National Institute of Mental Health calls it "a common misperception that children cannot have bipolar disorder." But true bipolar disorder in young children is uncommon, it is easy to confuse with conditions that are far more frequent, and the history of how it has been diagnosed in children is a cautionary one. This page explains what pediatric bipolar disorder is, why the diagnosis surged and then was narrowed, what else can look like it, and where a family with a younger child should turn.

Safety first

For the full parent’s overview of teen and child bipolar disorder, including treatment and school, see our guide to bipolar disorder in teens and children.

What pediatric bipolar disorder means

Pediatric (or early-onset) bipolar disorder is the same illness adults have, starting before adulthood: episodes of mania or hypomania and, usually, episodes of depression. NIMH notes that most people are diagnosed in adolescence or adulthood, that symptoms most often begin in late adolescence or early adulthood, and that children "occasionally" have symptoms. In national survey data from 2001 to 2004, the lifetime rate among 13- to 14-year-olds was lower than among older teens, which fits the pattern of rising risk through adolescence.

When it does occur in children, it can be serious. Some lithium products are FDA-approved for bipolar I disorder in children as young as 7, and several other medicines are approved from age 10, which shows that regulators accept that the illness exists in childhood. It also shows how carefully the diagnosis needs to be made, because those treatments carry real side effects.

Signs in younger children

NIMH’s list of manic signs in youth applies to children as well as teens: long periods of intense happiness or silliness, a very short temper or extreme irritability, fast talk, trouble sleeping without feeling tired, racing thoughts, risky behavior, and an inflated sense of ability. Its depression signs include frequent unprovoked sadness, irritability, stomachaches or headaches, sleeping far more, hopelessness, appetite changes, and thoughts of death.

In a young child, each of those can have an everyday explanation. A six-year-old who is silly, does not want to sleep and throws tantrums is, most of the time, being six. What would raise concern is a distinct, sustained change: a child who for a week or more is unrecognizable from their usual self, with several of these signs together. Our page on signs of bipolar disorder in teens goes deeper on what an episode looks like as children get older.

The diagnosis surge of the 1990s and 2000s

In the late 1990s and early 2000s, many U.S. children who had severe, chronic irritability and explosive outbursts began to be diagnosed with bipolar disorder. A national study of office visits found that visits with a bipolar diagnosis among people aged 0 to 19 rose from about 25 per 100,000 in 1994 to 1995 to about 1,003 per 100,000 in 2002 to 2003, roughly a fortyfold increase. Youth visits were also far more likely than adult visits to carry an ADHD diagnosis as well (32.2% versus 3.0%).

Researchers were not sure these children had the same illness as adults. The American Academy of Child and Adolescent Psychiatry’s 2007 practice parameter, which AACAP now lists as historical, observed that children diagnosed in community settings typically had rapid mood and behavior swings, often with ADHD and disruptive behavior disorders, and that it was "not clear" whether these atypical presentations and the classic adult disorder were the same condition. That uncertainty matters, because the label shapes which medicines a child receives and what the family expects for the future.

Why DSM-5 created DMDD

In 2013 the American Psychiatric Association added a new diagnosis to DSM-5, disruptive mood dysregulation disorder, "to address concerns about potential overdiagnosis and overtreatment of bipolar disorder in children." DMDD describes children with persistent, near-daily irritability and frequent severe temper outbursts, a pattern that is chronic rather than episodic.

Follow-up research supported the split. Children with severe chronic irritability (the research forerunner of DMDD) rarely went on to develop mania, while children with classic bipolar disorder often did. You can read the full criteria in What is DMDD? and a side-by-side comparison in DMDD versus bipolar disorder.

Conditions that can look like bipolar disorder in children

NIMH names several conditions whose symptoms overlap with bipolar disorder in young people. Several of them are common in childhood:

• ADHD: restlessness, impulsivity and talkativeness that are present most of the time, usually from early childhood. See ADHD versus bipolar disorder in kids and teens.
• DMDD: chronic irritability and frequent outbursts, not distinct episodes.
• Oppositional defiant disorder and conduct disorder: patterns of defiance or rule-breaking, usually directed at authority figures.
• Anxiety disorders: anxiety can show up as irritability, poor sleep and meltdowns.
• Depression: bipolar depression can be hard to tell apart from major depression.

NIMH also notes that no blood test or brain scan can diagnose bipolar disorder, though tests can rule out medical causes. Trauma, sleep disorders, medical illness and some medicines can all affect mood too, which is why a full history is essential.

How careful clinicians approach a young child

Because the stakes are high, guidelines urge caution. The UK’s NICE guideline (CG185) recommends diagnosing bipolar disorder in children or young people only after intensive monitoring over time by a trained team, working with parents or carers. It also advises against diagnosing it based only on depression plus a family history of bipolar disorder, recommending follow-up instead. NICE’s criteria for young people are stricter than the U.S. DSM-5-TR (for example, NICE does not treat irritability as a core criterion), so they are not the U.S. standard, but the underlying message is shared: observe the pattern over time before labeling it.

In practice, that means a clinician will want a detailed developmental and family history, school reports, information from more than one setting, and often a period of tracked observation. A daily mood chart, which NIMH recommends for young people with bipolar disorder, is a good start even before the first appointment.

If your child is under 10, or 10 and older

Willow & Stone sees patients ages 10 and up. For a child younger than 10 with concerns about bipolar disorder or severe mood problems, we refer families to a child psychiatry specialist, who can provide the developmental assessment and longer observation that young children need. Your pediatrician can also help you find one locally.

For older children and teens, our page on bipolar treatment for teens and children 10 and older explains what an evaluation involves; bipolar disorder treatment at Willow & Stone describes the practice’s overall approach, and you can book a consultation or call to ask which path fits your child.

Common Questions

Sources & Further Reading

• NIMH: Bipolar Disorder in Children and Teens (NIH Pub. 23-MH-8081, 2023)
• NIMH: Bipolar Disorder (NIH Pub. 25-MH-8088, 2025)
• Moreno C et al. National trends in the outpatient diagnosis and treatment of bipolar disorder in youth. Arch Gen Psychiatry, 2007
• McClellan J, Kowatch R, Findling RL. AACAP Practice Parameter for children and adolescents with bipolar disorder, 2007 (historical)
• American Psychiatric Association: Highlights of Changes from DSM-IV-TR to DSM-5 (2013)
• NICE CG185: Bipolar disorder: assessment and management (last updated 2 Sept 2025)
• Baweja R et al. Disruptive mood dysregulation disorder: current insights. Neuropsychiatr Dis Treat, 2016

This article is general education, not a diagnosis or advice for your situation. Do not start, stop, or change a medication without talking to the clinician who prescribes it; stopping a mood stabilizer suddenly can trigger relapse.