Early Signs of Bipolar Disorder...

When they are anxious children with bipolar patterns seeking sensory experiences, including movement in space; (5) as they become more active, craving sensations, sensory overload is increased, escalating the problem; (6) self-critical, self-blaming behaviors; (7) “all-or-nothing” thinking; (8) counterphobic defenses.

The earliest milestone includes the ability to regulate emotions in order to attend to the child’s external surroundings. Children with bipolar patterns evidence a combination of sensory over-reactivity and extreme sensory carving. Typically, when children become overloaded in their sensory systems, they tend to become more cautious. The child with a bipolar pattern, in contrast switches to a sensory craving mode, and becomes more impulsive, aggressive, over-agitated, or excited. This tends to elicit punitive limit-setting on the part of the parent who also “up-regulates” emotionally and matches the child’s emotional intensity. In this matched but maladaptive "dance," the child may then shift to self-incriminations and depressive states.

As children move to the next higher level that involves engagement and attachment, these children evidence the capacity to be purposeful and related, but appear to have difficulty sustaining long co-regulated emotional reciprocity. Themes relating to aggression or sadness and loss cannot be handled and lead to emotional dysregulation. Children seem to be unable to read and respond to parental emotional signals that would enable the child to tolerate feelings associated with these themes. Parents provide cues to either “up-regulate” the children when they are feeling sad of “down-regulate” the children when they are in a heightened or excited emotional state.

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