I am the mom to two children that have bipolar disorder (bpd). Bpd can and is diagnosed in children. Back in the late 1800's a german psychiatrist, Emil Kraepelin, devised the DSM for mental disorders. He was the expert of his time and his word was law. Kraepelin did not recognize and therefore dismissed the possibility of bpd in children. Since the late 1990's much of the psychiatric world has revisited the thought that children can have bpd. It is now accepted that children can and do present with bpd but the signs and symptoms differ from that of an adult.
Children can present with bpd very early in life. It is diagmosed by symptoms reported by the parent(s) of the child (or care giver). A pediatric psychiatrist would take a very detailed history and interview from the parents. The child will be observed and interviewed, if appropriate, by the psychiatrist. Usually this occurs over 2-4 visits to the doctor.
Pediatric bpd has many symptoms. They range from extreme separation anxiety, raging, night terrors, unusually high energy hallmarked with silly, giddy behavior, agitation, irritable moods, anger outbursts, unable to accept the word "no" which often results in a "meltdown" and raging tantrum, sensitivity to stimuli often displayed in being very sensitive to clothes - ie socks, shoes, tags in clothes, the weave of a sweater or shirt, pockets, the stictching on clothes, etc., complaints of feeling too hot much of the time, "sugar addict" and craving carbohydrates and sugary foods. This is just a brief list.
My older son with bpd can be difficult. He is often agitated, highly irritable and becomes irate when he is frustrated. He is easliy frustrated by tasks he can't perform on the first try. Prior to being treated he would go into what I call a meltdown if he was told no. This IS NOT just a kid being a brat. This is extreme behavior. It would result in him falling on the floor, screaming, crying, flailing arms and legs and running blindly in anger and distress. He was very sensitive to clothes. Getting him ready for school was a nightmare. I literally had to tie his shoes 10-12 times before I got the tension in the shoelaces "right". He refused to wear socks that had a seam across the toe because it bothered him. He had night terrors that would wake him screaming in fright. He told finally was able to tell me and his doctor about the dreams. The content was gory and usually involved him being attacked and maimed in some way. I could go on and on. Each child has their own twist on bpd but some things are very common. "The Bipolar Child" by Papolos and Papolos is a well written book by a psychiatrist and his wife, a psychologist. It gives great detail into pediatric bpd symptoms, treatments, the pathophysiology of the disorder and tons of other information.
I knew there was something wrong with my 3rd son. I had other children and they never acted like my 3rd boy, even on their worst day. I am an RN so I started to question his behavior and moods. I took him to be evaluated by a social worker. I did not agree with what they said. I continued to research and read and learn. I didn't look at bpd at first. Why? I was frightened. I finally started to read about the disorder. Wow! The authors of many articles must have been spying and looking in the windows of my house! They were describing my son to a tee. I sobbed and felt sorry for myself, for him, for his future. Then I found a pediatric psychiatrist. After conducting the interviews and taking the history she asked me what I thought was wrong with my son. I told her I believed he had bpd. She told me that was her conclusion. Later, she told me that was the easiest confirmation of a diagnosis she had ever had. I didn't get angry, cry or go into denial. I just wanted help for my son. Treatment varies for each person. It is often trial and error. Some medications work for some people and not others.
You suspect there is something wrong with your daughter. You KNOW her better than anyone on the planet. Go with your gut instincts. Get her evaluated. Perhaps it is bpd or perhaps some other disorder. Early intervention is usually best in most disorders. Medicating children is not taken lightly, however, no intervention leaves the child and family in chaos.
Lithium is a alkaloid that is produced in small quantities in the body. It has been used for treating the manic episodes in bpd for many years. It is currently used in this application with success. Blood tests are done to check the serum levels of lithium for theraputic range and toxicity. Bpd is not a lithium deficiency. It is a treatment for bpd. BPD is a mood disorder and it is currently believed to be a chemical imbalance in the neurotransmitters serotonin, dopamine and norepinephrine and perhaps others. Serotonin and dopamine are targeted with medications to try to bring balance and thus stability to the patient. There are structural differences in the brains of people with bpd. The pre-frontal cortex is smaller with fewer glial cells compared to those that do not have bpd. The hippocampus shows structural differences as well. There is more and more research within the neurobiology field and science community is trying to gain greater understanding into the pathophysiology of bpd and other mental health and neurological disorders.
I hope this helped.