Bipolar disorder is a mental condition characterized by extreme mood swings, such as elevated moods (mania) and periods of depression. Teenagers with bipolar disorder often experience academic problems, issues dealing with peers, and high levels of family dysfunction. They may also have an increased risk of substance abuse and suicidal thoughts and behavior.
Previously, it was believed that bipolar disorder was prevalent only in adults; however, studies have found that it might occur in 0.1–1% of children and adolescents (1). Not all teenagers who show extreme emotions may have bipolar disorder, so a proper diagnosis is necessary before labeling a child with this mental disorder. No cure is available for this condition, but the symptoms can be managed with therapy and medication.
In this post, we discuss the signs, symptoms, diagnostic methods, and treatment options for bipolar disorder in teens.
Symptoms Of Bipolar Disorder In Teens
As bipolar disorder is characterized by extreme emotions, teenagers with this disorder have episodes of mania or depression. They may show extreme energy levels at one time and suddenly get depressed and feel low at the next instant. This disorder is also known as manic depressive illness.
Most patients show initial symptoms of bipolar disorder between the ages of 17 and 42 years; however, studies suggest that some teenagers may show symptoms even before the age of 17. In a few rare cases, the first symptoms may appear before the age of 13 (1).
The onset of this disorder is characterized by swift mood swings. One moment, the person will be delighted and happy, and the next moment, they will be low and moody. However, it is common for teenagers to show elevated emotions due to the hormonal changes during puberty, which can be confused with the symptoms of bipolar disorder. This is why a thorough examination from an experienced physician is required to determine the presence of the condition in your teen.
The symptoms of bipolar disorder in teens can be grouped into two types based on the extremities of emotions (2).
During these episodes, the child might show extreme changes in mood and energy. Some common symptoms of manic episodes include:
- Decreased sleep – sometimes, they can go with little or no sleep for days and not feel tired
- Extremely energetic with feelings of euphoria and grandiosity
- Extreme distractibility – the child’s attention will change from one topic to another randomly and swiftly
- An abnormal increase in talking – you may notice them jabbering without a break
- Unrealistically high self-esteem – the child or the teenager might imagine themselves as a superhero or feel superior to everyone around
- Reckless behavior leading to risk-taking activities, such as drug or alcohol abuse, reckless driving, and sexual promiscuity
- A tendency to think too quickly – their thoughts would be on a fast-forward mode
During manic episodes, the child might look either extremely happy or irritable. You may also find them acting silly in an unusual way.
In contrast to the manic episodes, teenagers with bipolar disorder may also experience depressive episodes, the symptoms of which are poles apart from those of maniac episodes.
These episodes are characterized by:
- Low energy levels – the teenager may sit quietly in their room without interacting with anyone
- Decreased interest to do anything, even their favorite activities
- Changes in sleep patterns, characterized by too much or too little sleep
- Poor eating habits, such as decreased appetite or overeating
- Head and joint aches
- Frequent suicidal thoughts or lack of interest in living
- A feeling of depression, sadness, guilt, and despair
- Low self-esteem
- Trouble concentrating
Sometimes, bipolar disorders are associated with other psychiatric disorders. Also, children with this disorder are at a high risk of mortalities due to mental disturbances or medical complications.
Complications Of Bipolar Disorder In Teens
Bipolar disorder is a multicomponent disorder that can cause the following complications (1).
- Teenagers with bipolar disorder are at a high risk of indulging in substance abuse.
- They may also show symptoms of attention-deficit hyperactivity disorder (ADHD).
- Some teenagers may experience anxiety disorders, oppositional defiant disorder (ODD), and conduct disorder (CD).
Causes For Bipolar Disorder In Teens
The exact cause for bipolar disorder is not known. However, scientists believe there are quite a few contributing factors. Some of them include (3):
- Genetics: Children who have a family history of bipolar disorder may have a higher chance of developing this disorder. However, this is not certain as studies have found that some children from a family with bipolar disorder never developed it, and even if one among the identical twins developed this disorder, the other twin did not.
- Cranial structure and functioning: Although brain scans are not suitable for diagnosing bipolar disorder, studies found a subtle difference in the average size or activation of some brain parts in teenagers with bipolar disorder.
- Stress: Extreme stress due to the death of a family member, illness, fights in the family, etc., may also contribute to bipolar disorder in teenagers.
As bipolar disorder can often go undiagnosed or be misinterpreted in teenagers, it is important to know the diagnostic methods for bipolar disorder. The next section covers this information.
Diagnosis Of Bipolar Disorder In Teens
A specialist medical care provider experienced in diagnosing bipolar disorders in children can determine if a teenager has bipolar disorder.
The doctor will ask questions about your child’s behavior, mood swings, sleeping patterns, appetite, etc., to understand if they have any symptoms of bipolar disease. Although blood tests and brain scans may not be useful for diagnosing this disorder, they might help rule out certain medical conditions, such as hyperthyroidism, which is also a potential risk factor for bipolar disorder (4) (5).
Treatment For Bipolar Disorder
There is no cure for bipolar disorder, but you can work with your healthcare provider to develop a treatment plan to minimize the symptoms and recurring episodes of mania and depression.
The American Academy of Child and Adolescent Psychiatry recommends a combination of medication and psychotherapy (6). Let’s have a look at both in detail.
- Psychotherapy: In this therapy, the child will have one-on-one meetings with a psychiatrist or a licensed social worker. In these sessions, the psychiatrist will work with the child to identify and solve the problems developed due to bipolar disorder.
The psychiatrist may implement different techniques in these sessions. Some of them include:
- Cognitive-behavioral therapy: This therapy aims to identify the thinking patterns that may be causing emotional stress and help teach teens to deal with the issues by adjusting their thoughts and actions. This therapy also helps children identify the triggers for manic or depressive episodes. The psychiatrist may suggest behavioral strategies to minimize these triggers.
- Interpersonal psychotherapy: By increasing the child’s social support and improving their ability to manage interpersonal relationships, this therapy aims at reducing the intensity of the symptoms.
- Other therapies: Therapies such as family-focused therapy and social rhythm therapy may also help identify the underlying triggers and help children deal with the symptoms of bipolar disorder.
Some therapies involve only the child, whereas others involve the child’s family and social support group (7).
- Medications: Your child’s doctor might prescribe mood stabilizers and antipsychotic drugs to stabilize the kid’s mental state. This might help them participate in psychotherapies effectively. However, these medications might have side effects, such as weight gain and an increased risk of type 2 diabetes. Discuss the potential side effects with your child’s doctor before offering any medications (6).
Dealing with bipolar disorder in teenagers can be challenging for both the child and family members. Family members can play a significant role in supporting teenagers to identify and deal with this disorder.
How Can Parents Help Teenagers Cope With Bipolar Disorder?
Since there is no permanent cure for bipolar disorder, parents and family members need to be supportive and patient. Here are a few things parents can do to help their teenagers.
- Attend all the family therapy sessions with your child. You can also keep in touch with the therapist to understand your child’s progress.
- Talk to your child’s doctor about the disorder, try and gather information, and keep yourself updated about the disorder. You can also read some well-known books or research articles on teenage bipolar disorder.
- Dealing with your teenager’s mood swings can be overwhelming. Do not lose your cool. Instead, be patient as the mood swings are a part of their disorder and not intentional.
- Encourage your child to talk openly about their feelings and emotions. Be careful not to judge them. Assure them that it is okay to have extreme feelings and show them how to deal with them.
- Reach out to other parents for support. If you feel stressed, they can help you soothe and get back to normal. A support group assures you that you are not alone in dealing with your child, it also helps you to share useful information in dealing with the condition.
- Closely monitor your child’s mood swings; if you notice any suicidal thoughts, contact your doctor or therapist immediately.
- Keep all the emergency information handy and design a plan on the course of action.
- Enroll your child in peer support groups to let them engage with other children with a similar disorder. This might give them hope and also motivate them to get better.
- Promote a healthy lifestyle. Encourage them to eat healthily, sleep on time, spend time with friends and family, and exercise for at least 40 minutes every day.
The teenage years are often filled with a roller coaster of emotions. When coupled with bipolar disorder, it can be confusing and hard for your child. However, with effort, dedication, and patience, your child will be able to deal with the symptoms and reduce the manic or depressive episodes.
2. Bipolar Disorder In Children And Teens; American Academy of Child & Adolescent Psychiatry
3. Bipolar Disorder; National Alliance on Mental Illness
4. Li-Yu Hu, et al.; Hyperthyroidism and Risk for Bipolar Disorders: A Nationwide Population-Based Study; PloS One (2013).
5. Bipolar Disorder in Children and Teens; National Institute of Mental Health
6. Zara Abrams; Treating bipolar disorder in kids and teens; American Psychological Association (2020).
7. Behavioral Therapy for Bipolar Disorder in Children; NYU Langone Hospitals
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