| If the behavior problems only occur while the child is in the midst of an episode of mania or depression, and the behavior problems disappear when the mood symptoms improve, the diagnoses of oppositional or conduct disorder should not be made. |
| If a child has "off and on" oppositional or conduct symptoms, or these symptoms only appear when the child has mood problems, the diagnosis of bipolar disorder (or other disorders such as recurrent unipolar depression or substance abuse) should be considered. |
| If the child had oppositional behaviors before the onset of the mood disorders, both diagnoses may be given. |
| If a child has severe behavior problems that are not responding to treatment, consider the possibility of a mood disorder (bipolar and non-bipolar depressions), other psychiatric disorder (eg, ADHD or substance abuse), and/or exposure to stressors. |
| If a child has behavior problems and a family history of bipolar disorder, consider the possibility that the child has a mood disorder (unipolar major depression or bipolar disorder). |
| If a child has behavior problems and is having hallucinations and delusions, consider the possibility of bipolar disorder. Also consider the possibility of schizophrenia, use of illicit drugs/alcohol, or medical/neurological conditions. |
