r I Disorder, Bipolar II Disorder, Cyclothymia, and Mixed State Bipolar Disorder are all very rare in children. For many years it was assumed that children could not suffer the mood swings of mania or depression, but as more research has been done, we have realized that bipolar disorder can occur in children, and it is much more common than previously thought. Althoug, the DSM-IV does touch on the subject of children with mood disorders, they are still diagnosed according to adult criteria. In children, mania and hypomania appear as more of an irritable mood. These features come and go throughout the day and are not as persistent as in adults. When bipolar disorder is present in children it is more severe and harder to treat. Children tend to experience extremely rapid mood swings, often cycling from mania to depression and back to mania several times a day. The most typical pattern of cycling among those with COBPD, called ultra-ultra rapid or ultradian, is most often associated with low arousal states in the mornings followed by increases in energy towards late afternoon or evening(Facts about COBPD;http://www.mhsource.com/hy/ bipolarch.html). Difficulties with early onset bipolar disorder begin with diagnosis. The rapid cycling of moods in children with COBPD make it difficult to fulfill the duration criteria of Bipolar Disorder. The DSM-IV states that depressive or manic episodes are to last a specific length of time, at least 4 days in a manic episode and at least 2 weeks in a depressive episode. The majority of children suffering from COBPD do experience these ultra-ultra rapid patterns of mood swings. The DSM-IV does include a section entitled Bipolar Disorders Not Otherwise Specified (NOS), which allows for mood swings not lasting the full duration criteria(DSM-IV- Subaffective disorders: Dysthymic, Cyclothymic, and Bipolar II Disorders in the borderline realm). However, this is still not an accurate description of COBPD. Many p...
