elevated, expansive, or irritable mood;
pressured speech (rapid, excessive speech);
decreased need for sleep;
grandiose beliefs (for example, feeling like one has super powers or superlative talents or faults);
tangential speech (repeatedly changing conversational topics to topics that are hardly related);
increased goal directed activity;
impulsivity and poor judgment.
Symptoms of the manic episode of early onset bipolar disorder tend to include outbursts of anger and rage, as well as irritability, as opposed to the expansive, excessively elevated mood seen in adults. The adolescent with bipolar disorder is more likely to exhibit depression and mixed episodes, with rapid changes in mood. Despite differences in the symptoms of bipolar disorder in teens and children compared to adults, many who are diagnosed with certain kinds of bipolar disorder before adulthood continue to have those symptoms as adults. Symptoms of bipolar disorder in women tend to include more depression and anxiety and a rapid cycling pattern compared to symptoms in men.
Although a major depressive episode is not required for the diagnosis of bipolar disorder, such episodes often alternate with manic episodes. In fact, depression occurs more often than mania in many people with bipolar disorder. Characteristics of depressive episodes include a number of the following symptoms: persistently depressed or irritable mood; decreased interest in previously pleasurable activities; change or problems in appetite, weight, or sleep; agitation or lack of activity; fatigue; feelings of worthlessness; trouble concentrating; thoughts of death or suicidal thoughts, plans or actions.
Reviewed by Melissa Conrad Stöppler, MD on 6/12/2012