MEEHL Foundation


Many children, especially teens, experience mood swings as a normal part of growing up, but when these feelings persist and begin to interfere with a child’s ability to function in daily life, bipolar disorder could be the cause.

Symptoms can occur in childhood but most typically occur in adolescence or early adulthood. It is estimated that of the four million kids diagnosed with depression, one-third have bipolar disorder.

In addition, one-third of the kids diagnosed with ADHD are either misdiagnosed or have bipolar disorder with ADHD. It is extremely important that children with bipolar disorder (BD) receive proper treatment.

Kids that do not get treatment will be at extremely high risk for alcohol abuse, drug abuse and suicide.

As a parent, try and remember that all humans, especially kids, will only stay in emotional pain for so long before they will do anything to relieve that pain, no matter how wrong it may be and no matter what you have taught them.

Any child who has abused substances should be evaluated for a mental health disorder. If an addiction develops, it is essential for both the mental illness and the substance abuse to be treated at the same time.

Listed below are seven criteria for differentiating ADHD from bipolar disorder (BD).

Along with this list, you must find a doctor that specializes in children. And yes, you may have to travel hundreds of miles to find the right one, but in the end your child will thank you for a better life.

  1. Do you notice “aggressive depression” or “mixed states” of emotion?
    ADHD children may experience discomfort or irritability during medication rebound, but they are not chronically irritable as are children with BD. They do not attack their parents in blind rage. They do not go screaming off into their rooms. ADHD children do not experience the extreme highs and lows that BD kids do.
  2. Does the child have a first-degree family member with BD?
    “First-degree” means siblings, parents, or grandparents. A meticulous study of family is critical. Do you have family members that are alcoholics, drug users, suicide survivors or victims? How about eccentric, lazy, gambling, can’t hold down a get the idea here. Families that have those hidden skeletons or secrets need to ask the question, “Could this be mental illness?”
  3. Is your child’s speech pressured or hypomanic?
    Children with BD have rapid, pressured speech with an outpouring of words and shifting topics that may have little to do with one another. There is a flight of ideas, jumble of thoughts, and a brain storming of ideas. The child needs to interrupt others to continue speaking. Children with ADHD can talk too loud and too much, but they can be redirected to slow down and tone down. Kids with hypomania (BD) cannot.
  4. Is it impulsivity or hypomania that leads to dangerous or risky behavior?
    For the BD teen, dysinhibition (inability to control impulses) and craving can take over the child’s personality and be directed by extreme purposeful energy (hypomania) during which he does not need sleep and can power himself toward goals for several days, only to collapse into exhaustion and depression. He may steal the family car and run away to pursue his dreams only to return and sleep 20 hours; he may steal your credit cards and sample all the porn on the Internet. All the while he feels indestructible and may even attempt daredevil stunts. Addictive opportunities are compelling for ADHD kids, but they do not experience driven craving for stimulus that BD kids do.
  5. Does she rage (BD) or is she angry (ADHD)?
    Teens and adults that experience BD rage usually have pleasurable feelings afterwards. The rage actually shifts the chemicals in their brains, and they can become almost blissful. Unfortunately, they can be violent during the rage. Afterwards, they are often exhausted and have amnesia (otherwise called disassociation). They plainly don’t remember what triggered them or what happened during the rage. ADHD kids can be hotheaded and be frustrated into becoming enraged, but not at the drop of a hat, and they don’t feel pleasantly energized afterward.
  6. Does your child have hallucinations or severe thought distortion?
    Kids with ADHD can be extremely silly and show a profound lack of judgment or common sense because of their inability to focus and make good decisions, but they usually do not have hallucinations. Kids with BD may experience visual hallucinations, but most would rather cut off their own arms than tell you about it. Kids with auditory hallucinations are usually diagnosed with schizophrenia. But here is the main point: Kids with BD will not admit that they are wrong! Even when confronted with the facts of the issue, “cognitive hallucinations” block their perception of reality, and no amount of talking will change their minds. They simply do not remember what they said or did. This is why medication is critical. You cannot and will not break this barrier without it, their lives will spiral out of control, and they will never understand why they cannot “get it right” or “fit in.”
  7. Does your kid have a hard time sleeping? Is your child super-sensitive to the feelings of others, or is the child lacking in empathy for the feelings of others?
    ADHD kids are very sensitive to the feeling of others, and they wear their hearts on their sleeves. They can have a nighttime hyper-arousal that is usually a medication side effect. The BD kid comes alive at night when his serotonin level is at a 24-hour low and may become unbearably nasty, have fits of rage, or tyrannize everyone in the family. Constant irritability and inability to sleep are two of the main criteria for diagnosing BD.

Early identification, diagnosis, and treatment are the key to helping kids reach their full potential. Bipolar disorder is treatable. Remember, the worst possible situation for a child with a mental illness is to go without treatment at all. The second leading cause of death in teens is suicide; one teen dies every 100 minutes. Asking your kids to go without medication is like asking the diabetic to go without insulin. Bipolar disorder is not something kids will grow out of; BD can be a life-threatening illness. Children who exhibit symptoms should be evaluated by a mental health professional that specializes in children. Child psychiatrists can conduct psychological testing and medical testing to rule out any underlying conditions that might explain the behavior

A treatment plan must include medication and therapy with someone who knows, understands and has success with the treatment of people with bipolar disorder. And everyone in the family needs to go to therapy. Research has shown that family training and support is second only to medication in bipolar recovery. Training children and parents in Mindful Awareness (of thoughts and feelings), Emotional Regulation, Distress Tolerance, and Interpersonal Skills is the key to creating successful, productive kids. And most of all, remember this: Bipolar children are some of the most gifted, talented, creative, intelligent people on the planet, and they want success just as much as you want it for them!


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Debra Meehl

Debra Meehl, DD Pastoral Counselor, DBT Trained Skills Trainer, Board Certified Hypnotist & President, Meehl Foundation Intenselevly Tained DBT Team

Speaking Engagements
Texas TAAP Convention-San Antonio, TX
August 15, 2014 (11:00am-12:30am)
West Coast Symposium- Cape Cod
Bipolar Borderline & Substance Abuse
Sept, 13, 2014 (10:45am-12:15am)
NAADAC- Seattle, WA
Radical Acceptance-Getting to the root of the problem
September 28,2014 (1:30pm-3:00pm)
NASW-Texas State Conference
Bipolar Borderline & Substance Abuse
San Marcos, TX October 18, 2014 (2:30pm-4:00pm)
NASW-Atlanta, GA State Conference
Using DBT Therapy for Mood Disorders and SA October 23, 2014 (9:00am-12:15)
Radical Acceptance-getting to the root of the problem
October 24th, 2014 (1:30pm -3pm)
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