This illness afflicting children may appear to be very different compared to adults. Generally, children have continuous, ongoing mood disturbances with combined symptoms of depression and mania. This severe and rapid cycling among moods can produce chronic irritability. Sometimes, state of wellness is manifested between episodes.

Parents revealed that their children that have bipolar disorder display symptoms such as irritable or expansive mood, lack of enthusiasm in play, extreme sadness, rapid mood swings that can last for several hours and even in days, rages that is lengthy, explosive, and destructive, separation anxiety, defies authority, hyperactivity, distractibility, agitation, night terrors, bed wetting, sleeping too little or too much, frequent and strong cravings for sweets and carbohydrates, excessively involve with multiple activities and projects, impaired judgment, racing thoughts, impulsivity, pressure on talking too much, display behaviors of a dare-devil, precocious or inappropriate sexual behavior, hallucinations and delusions, and grandiose belief or too much self confidence defying laws or logic.

Bipolar disorder symptoms may emerge earlier. The manifestations can even be diagnosed in infants. More often, mothers have reported that their children who are diagnosed later with a bipolar disorder have difficulty in sleeping and settle erratically. These children extraordinarily seemed clingy, and often had seizure-like, uncontrollable rages or tantrums that are sometimes not appropriate for a certain event. These rages are often triggered with the "no" word.

There are other factors that may triggers symptoms in teens. A traumatic event or loss can trigger the first episodes of mania or depression. Later episodes sometimes independently occur when stressed out. Puberty is another risk factor triggering the illness especially during menstrual cycle in girls. Once the disorder begins, the recurrence of episodes is possible in most untreated cases. Some studies show that a lag of ten years after the first episodes is possible. It is advisable that parents let their teens undergo an evaluation if more than four symptoms persist.

In addition, teens with bipolar disorder that is left untreated can lead to drugs and alcohol abuse. Some adolescents who display a normal behavior until puberty but experiences sudden onsets are more vulnerable to alcohol or drug addiction. Any child or teen that abuses such substances must be properly assessed. There are instances that the illness is highly genetic but environmental factors influences a lot if it will really occur.

There are studies conducted to further explore the characteristics of children with bipolar disorder. The results are promising thus the safety and effectiveness of treatments for adults are also appropriate for children.