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Question:

What signs should parents look for in terms of a child with possible bipolar condition? Obviously the mood swings, but what specific day-to-day activities or behavior of a young child or adolescent provide warning signs for parents?

Answered by: Maria Oquendo

Well, I think that the most reliable thing to observe has to do with sleep patterns. Sleep is sort of the lynch pin of mood stability.

We know that the less you sleep, the more euphoric or manic you become. If you've ever had to work late into the night and not get very much sleep, you may have noticed that even though you're tired, you might feel giddy or elevated the next day. And you can imagine what that does in someone who has a predisposition towards mania or hypo-mania. So sleeping regularly and sleeping a serious six to eight hours a night is absolutely critical for adults, and for children it would be more, of course.

If you observe as a parent that your child seems to be sleeping much less then this, doesn't appear to be tired, and isn't having trouble waking up in the morning, then I would be concerned about looking for other symptoms of bipolarity. In addition, unusual behavior such as more pressured speech, meaning speaking much more quickly than usual, or being more active physically or in terms of creative projects would also be something that I would be alert to. Of course, the first presentation could be one of depression and not mania or hypomania.

It's worth saying that if these things are not a change from their usual, I would be a lot less concerned. We're looking at things that are changes in the usual things. So for example, for an adult who has only needed four to six hours of sleep their entire life, I would not pathologize them. But if somebody needs eight hours usually, and then all of a sudden is only sleeping two hours a day for days and days in a row, I think that would be more of concern.