Some ways Childhood Onset Bipolar Disorder differs from adult Bipolar Disorder: Children have much faster and more frequent cycles than adults Children rarely have pure euphoric mania as defined by the DSM-IV. Children are more likely to have dysphoric mania or mixed states. Depression in children often manifests as anger and aggression instead of sensitivity and withdrawal. Children often have co-morbid conditions accompanying the bipolar disorder that are commonly found in childhood: ADD, ADHD, Tourette’s Syndrome, OCD (Obsessive Compulsive Disorder), ODD (Oppositional Defiant Disorder) and Autism, to name a few. The co-morbidity of other disorders can make medical treatment very difficult in children. Children are more likely to be activated by certain medications, namely antidepressants and psychostimulants, than adults. Bipolar in children is very often misidentified as unipolar depression with hyperactivity. Treatment for unipolar depression in is vastly different from treatment for bipolar in children, and can result in severe problems. Children are not “little adults”, i.e., their metabolisms run differently than adults, so merely prescribing smaller doses of adult medications do not sufficiently treat bipolar disorder. Many times, the rate of metabolism in children is so great that doses larger than typical for adults need to be used. Some ways Childhood Onset Bipolar is similar to adult Bipolar Disorder: Children can be suicidal, even as young as 2 years of age. These ideations can quickly develop into plans and actions because of the impulsive nature of Bipolar Disorder and the inability to weigh consequences of actions. Children with mania have the same urges that adults do in the sense that they also become hypersexual, grandiose, obsessive and desire to spend money.  Children with depression also have the same tendencies as adults to avoid talking about their situation, to withdraw from activities and people once enjoyed, to require extraordinary amounts of sleep in order to function, and have a decreased stress threshold making daily functioning nearly impossible. Children, like adults, require medication to stabilize, but cognitive behavior therapy (CBT) has been shown quite successful in helping the child with bipolar to develop insight and control over their moods and actions.  Stress, just as with adults, can trigger a relapse of the bipolar condition.   FULL ARTICLE