Autism or Child Bipolar Disorder

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Often, I have parents who come to me wanting to know "Is it Autism or Bipolar Child Disorder?" With many differing diagnosis for their child, and they wonder which does their child “have”.

Firstly, please understand that these are man made categories, and unfortunately often very flawed. However, there are some distinct differences that can help in determining whether children have Autism or Bipolar Child Disorder.


Autism or Bipolar: Impairment in Social Interaction

Autistic disorder consists of impairment in social interaction, communication, and repetitive patterns of behavior interests or activities. A child who is autistic may have difficulty understanding other’s body language and nonverbal behaviors and utilizing their own body language to communicate. They often don’t have appropriate peer relationships, and don’t seem interested in sharing their interests with others. Socially they seem disconnected.

A child who has Bipolar Disorder may have difficulty with social interactions, but usually this is because their mood state ( ie depression or mania) is influencing the way they perceive interactions. Most often they will perceive danger or feel threatened when they do not need to be. They may feel that someone does not like them or that they are being targeted when they are not. At times they may lash out or become aggressive seemingly unprovoked. Although not always the case, children with bipolar may have friends (in my experience they often also pick other children with mood disorders to play with) who they seem to have very close and reciprocal relationships with.

Autism or Bipolar Child Disorder: Impairment in Spoken Communication

Children who have autism have impairments in actual spoken communication. They may have delayed or an absence of spoken language, they may have difficulty in conversation with others that becomes obvious when you are speaking with them. They may HAVE repetitive language or odd language patterns.

Children with Bipolar Disorder are often very articulate and do not have the same delays in spoken language. They may have repetitive language when they are raging, or, when they are in a mission mode state. A mission mode state is a mania related feature where a child becomes obsessed with having or acquiring something. If you have witnessed this you know exactly what I’m talking about! Many of my kids mission mode over weapons, toys, or food.

Autism or Bipolar Child Disorder: Preoccupation with Things of Interest

Children with autism may become preoccupied with things they are interested in and often Have difficulty to shifting out of this; they also may have meaningless rituals or routines. They may become preoccupied with parts of objects and may have repetitive motor manners such as hand flapping. They may also have trouble with imaginative play.

Children who are bipolar may have a preoccupation with things of interest when they are in a manic or creative state. Many of my children who are writers or artists or filmmakers reach this kind of intense focus during mania or hypo mania. They have no such trouble with imagination; in fact, it is often their biggest strength. Children who are bipolar may have meaningless rituals and routines, but only when they are struggling with Obsessive Compulsive Disorder, or Obsessions and Compulsions, or when they are psychotic.

Autism or Bipolar Child Disorder: The Asperger's Exception

NOTE in 2013 this diagnosis has been folded into what is called an AUTISM SPECTRUM DISORDER and has been since eliminated. 

Children with Asperger's do not have the communication deficits that children with regular autism have. It can be more complicated to differentiate between Asperger's and Child Bipolar Disorder. However, Children with Asperger's do not have the same mood cycles that children with bipolar disorder have. Children with Bipolar Disorder do not have the same social impairments that children with Asperger's have. Their social impairments and intense focus on ideas or themes of interest are bound to their mood state. There must be evidence of both depression and mania to make a diagnosis of Bipolar disorder in children. Yes, a child can have both!

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