have been misdiagnosed or just thought of as hyperactive and disruptive. The early symptoms of childhood bipolar disorder, distractibility, irritability, and hyperactivity are also the signs of attention deficit hyperactivity disorder (ADHD)(Harvard Mental Health Letter, March 1997). It is mainly for this reason that many cases might be misdiagnosed as ADHD and the prevalence of bipolar disorder in children could be much higher. A person suffering from bipolar disorder alternates from manic states to those of depression. These emotional states can alternate cyclically or one mood may dominate over the other. It is also possible for the two to be mixed or combined with each other. When the sufferer is in a manic phase of the disorder they may exhibit many unusual behaviors that are not normally present in their everyday life. Elation is probably the most obvious component, and it is often misplaced and without any real reason for being in this mood. Manic episodes bring with them extreme self-confidence and energy to meet people and engage in all sorts of activities and adventures. It is not uncommon to be unable to understand what a person in a manic state is saying because they are talking loud and fast, and can jump from one subject to the next without any provocation or knowing why. Irritability and lack of attention span are also trademarks of this state. In its most extreme, mania can also bring about violence and rage from the individual. During this period the sufferer often enrolls themselves in many activities or responsibilities that they cannot fulfill after the mania subsides, lending to further problems even after the episode has subsided (Encyclopedia Britannica, 23:847). The depressive state is the darker side of this disorder. There are two types of the depressive state, the agitated state and the retarded state. In the agitated state one may have sustained tension, over-activity, despair and possibly have apprehensive delusions. For the retarded state the stage becomes darker still as their activity is slowed and can almost become
catatonic. The patient is dejected and sad, and beats himself down with self-degrading talk. Suicide is most likely to happen in the depressive side of bipolar disorder and the patient must be closely watched for suicidal...