Childhood Onset Bipolar Disorder (COBD) is a complex and often difficult disorder for parents to cope with; it is also a treatable disorder that is currently being heavily researched. Bipolar Disorder can occur in children and adolescents as young as 6 years old, and even younger in some rare cases. Although once thought rare, caseloads of patients examined for federally funded studies have shown that approximately 7% of children seen at psychiatric facilities meet the diagnosis for Bipolar Disorder. It is thought that many children who may have been diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) in the past actually have COBD. But symptoms like elated mood, grandiose behaviors, flight of ideas, decreased need for sleep, and hyper sexuality occur primarily in COBD and are uncommon in ADHD.

Here is how to recognize these COBD specific symptoms in children:

Elated children may laugh hysterically and act infectiously happy without any reason at home, school or in church. If someone who did not know them saw their behaviors, they would think the child was on his way to Disneyland. Some parents report this as being a silly or giddy like behavior that is disruptive and/or inappropriate to the setting.

Grandiose behaviors are when children act as if the rules do no pertain to them. For example, they believe they are so smart that they can tell the teacher what to teach, tell other students what to learn and call the school principal to complain about teachers they do not like. Some children are convinced that they can do Superman like feats without getting seriously hurt, e.g. "flying" out of windows.

Flight of ideas is when children jump from topic to topic in rapid succession when they talk and not just when a special event has happened.

This is different than the inattentiveness seen in children with ADHD. Children experiencing this may talk incessantly, even if it appears no one is listening. Their speech may seem pressured, as if they have so many thought at one time that they are rushing to get them all out at once.

Decreased need for sleep is apparent in children who sleep much less than would be expected, sometimes as little as 4-6 hours and are not tired the next day. These children may stay up very late at night and then wake up at 5:00am ready to go.

Some parents report this decreased need for sleep occurring at younger ages by children and sometimes even in infants who stop taking naps at a very young age.

Hyper sexuality can occur in children with mania without any evidence of physical or sexual abuse. These children act flirtatious beyond their years, may try to touch the private areas of adults (including teachers), and use explicit sexual language.

It is also very common for children with COBD to have multiple cycles (rapid cycle) during the day from extremely high (manic) moods to extremely low (depressed) moods.

Adults may have better functioning periods between bouts of mania or depression but children seem to have continuous illness over months and years. As well, these moods may look different than you would normally see in adults. The manic episodes may appear as extreme giddiness, silliness or goofiness that is beyond what would be considered appropriate. The depressed episodes will sometimes appear as sadness but many parents report that rather than sadness, the depression appears as agitated, anxious or even angry feelings.

There are several ongoing studies of how to best treat children with COBD, but few results have been released. In the meantime, clinicians are left using their best judgment on how to manage using medications that have been effective in adults. Right now, it is trial and error. It is very important that children on these medications be monitored for the development of serious side effects. These need to be weighed against the dangers of the illness itself, which can rob children of their childhood.

When seeking help make sure you find someone experienced with COBD. Perhaps the best way to get the disorder treated is to participate in one of the research studies being conducted on COBD.

More information about studies focused on COBD can be found at:

www.bpkids.org or www.bpchildresearch.org