Symptoms of Bipolar Mania

Unlike the depressed child who wonders what's wrong with himself and why the world is so unfair to him, the child in the manic phase acts as though he's the center of the universe and is annoyed if others fail to realize his specialness and follow his lead. The term mania refers to the "up" mood phase that characterizes Bipolar Disorder. During this period, a child may feel abnormally happy, expansive, or irritable. In adults, symptoms of mania must last at least one week. But in a child, mania is not so clear-cut, since kids' moods can swing up and down many times in the course of a day.¹ In the manic state, a child exhibits different combinations of the following symptoms:

• Grandiosity: The child may brag that she is a better softball player than anyone else, even before she's taken to the field for the first time. Or she might say, "My swim teacher at camp said I'm a natural and I could be in the Olympics in two years."
• Decreased need for sleep: Sleep? Who needs it? When kids are in the manic phase, getting them to sleep at night can seem like a never-ending battle. And they don't stay asleep for long: It's as if they find sleep a waste of their precious time.
• Pressured speech: A child may talk more than usual or have speech that sounds nonstop or forced. I describe it as "hyperactivity of the mouth." Trying to get a word or comment into the conversation can be virtually impossible for anyone else. For example, Maurice's mother told him they would go to the supermarket after the cleaners. He became very animated and excited by the plan: "When we go to the store, I want to get vanilla ice cream, chocolate syrup, whipped cream, and rainbow and chocolate sprinkles. I think it'd be great with bananas on top, too. I got it, we'll buy cherries… maybe we should get nuts… I love almonds." At that point, his mom tried to interrupt to say they didn't have that much time to shop, but Maurice's enthusiasm for his creations wouldn't let her get a word in edgewise. She got as far as "Honey, I don't think…" before he chimed in, "I got it! We'll get cones, and fancy cups. Like they do at Supercones. How about caramel syrup? We can't forget the strawberry syrup. I forgot… we'll cut up fresh fruit! We'll make little slices of pineapple, peaches, and melon! If we can't get the things there, we can go to Dessert Heaven. I'm sure they've got the stuff there."
• Flight of ideas: The child's mind jumps from one idea to another fairly rapidly, and the youngster may feel as if his thoughts are racing, so much so that it's hard to gather them together in a reasonable way. One little boy, Raymond, was talking to his Aunt Evelyn in the kitchen but seemed very restless and couldn't get himself comfortable on his stool, almost falling off multiple times. She told him how she had just flown back from a vacation in Florida on a new jumbo jet. Raymond responded, "I want to fly. If I can't fly, I want to die. My cat died last week. My dog died two years ago. Have you seen the neighbor's new dog? When are my parents going to get me the dog they promised me for my birthday? They also promised me a DVD player for my birthday. They didn't get that for me either!"
• Increased interest in goal-directed activity: Kids may make plans for Christmas when the calendar still says July. Or they begin in October to make lists of ten possibilities where the family might spend spring vacation. Granted, most children love holidays and vacations. But in bipolar kids, the sense of anticipation takes on an entirely different quality; they are constantly planning and turning things over and over in their minds, sometimes thinking about events that are months in advance.
• Poor judgment: A youngster's impulses can have exceedingly negative results. For example, most kids know that punching a schoolmate on the bus can get them in trouble faster than they can say "detention," but when a bipolar child is enraged, he may think of this outcome only after the fact.

1. B. Geller and J. Luby, Child and adolescent bipolar disorder: A review ofthe past 10 years, Journal of the American Academy of Child and Adolescent Psychiatry 36 (1997): 1168.

Excerpted from:

Excerpted from Bipolar Kids: Helping Your Child Find Calm in the Mood Storm © 2007 by Rosalie Greenberg. All rights reserved including the right of reproduction in whole or in part in any form. Used by arrangement with Perseus.

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