Reviewed by Aaron Horn, LMFT
Bipolar disorder is a major mental illness. It is also known as manic-depressive disorder or manic depression. Patients with bipolar disorder experience strange mood swings. Sometimes they feel excited and are more active and high-spirited than normal – this is the manic episode. Other times, they feel gloomy and are less active than before – this is depression or a depressive episode.
This type of mental disorder causes radical changes in mood, sleep, energy levels, and regular functions. These changes are more drastic than the normal ups and downs that everyone goes through, and they have a different presentation. These mood changes do not occur daily, but usually every few weeks or even months apart. This can cause the person to battle depressive thoughts for weeks before getting into the manic, active stage. Between these stages, the person may return to a relatively normal mood and behavior.
Bipolar disorder can be intense and affects a child’s performance in school and how they relate with friends and family. Patients may experience strain in their relationships and a loss of optimism and direction. The condition can also be life-threatening. Some young people with bipolar disorder attempt self-harm or suicide during the depressive phase. It is important that patients with bipolar disorder get a diagnosis and early treatment. The intervention can help them manage the symptoms and live successful lives.
The Presentation Of Bipolar Disorder In Teens And Young Adults
The most prominent sign of bipolar disorder in teens and young adults are manic and depressive episodes. These highs and lows are known as mood episodes. The emotional and mental disruptions can make it hard for teenagers to keep up with their responsibilities and maintain friendships during a vital developmental stage in life. Bipolar disorder is different from the normal highs and lows of teenagers and young adults because of the recurrent patterns and the intensity of the experience.
During manic episodes, the patient may be irritable, restless, unable to concentrate, and indulge in risky or impulsive behavior while moving from one focus to another. They often get the impression that they can make anything happen, and the teen may notice that they complete tasks faster during the manic stage than on other days. This stage can last between three to six months, generally, but could be shorter or longer.
The depressive episode is the stage where the teen experiences signs of depression. They may feel devastatingly sad and hopeless. People with bipolar disorder often experience this stage after a normal or manic episode. They may feel gloomy, sluggish, lose desire, and irritable. Typically, this episode can last between six months to a year but may be shorter or longer. Depressive episodes differ in severity and are not usually recurrently severe.
Manic episodes may usher in periods of creativity and enlightenment, but they do not mean a happy or better mood – just a burst of energy. It is necessary to remember that bipolar disorder symptoms can vary remarkably, which means a teenager can have symptoms anywhere along with the range of the two extremes, or in rare cases, experience both episodes at the same time – known as a “mixed state.”
How Bipolar Disorder Affects People
Both males and females can have bipolar disorder. In most cases, the first symptoms appear in their early twenties. However, studies have shown that the first instance of bipolar disorder often occurs earlier. It generally shows up during the teenage years and even children can develop the disorder.
Recent studies suggest that teenagers with bipolar disorder do not usually have similar behavioral traits as adults with bipolar disorder. For instance, teens with bipolar may notice drastic mood changes and experience some mood-related symptoms, such as severe anxiety and irritability. However, they may not have other symptoms prevalent among adults.
Since mental functions are involved, the condition affects how people with bipolar disorder think, act, and feel. This can make it incredibly challenging for other people to make sense of their condition. It can be frustrating for other people who care about someone with bipolar disorder. They often encourage the person to “snap out of it,” as if the patient can get better by just wanting it. Bipolar disorder should not be considered a character flaw or weakness – it is an ailment that needs intervention, like other medical conditions.
Types Of Teen Bipolar Disorder
Bipolar I Disorder – indicated by serious manic or mixed episodes and generally lasts between seven to 14 days. Due to the severity, teenagers with this type of bipolar usually get hospitalized, arrested, or both, during this phase. The nature of the consequence stems from a sense of invulnerability and absence of long-term thought by the patient, or from a pervasive feeling of complete hopelessness during a depressive episode.
Bipolar II Disorder – This type is indicated when a person switches from a relatively active phase to a depressive low without experiencing the complete manic phase. The teenager may notice shifts in mood, but often do not experience the extreme behaviors of a manic episode. It is possible to manage this less severe type of bipolar disorder by learning to identify the signs that accompany the mood changes, followed by learning to implement a self-care plan.
Rapid Cycling Disorder – indicated by patients suffering manic and depressive episodes up to four times in one year, instead of the regular single or double cycles of each episode per year. The symptoms of this form of the disorder are the same as bipolar I and II, but changes in mood and outlook on life happen more regularly. The occurrence of rapid cycling can make it hard to sustain concentration and accomplish long-term goals.
Mixed Episode Bipolar Disorder – indicated by the presence of manic and depressive episodes at the same time or a quick alternation between the stages. This may occur as crying and laughing at the same time or claiming to be energetic yet unable to leave the bed. The confused state of mind and emotion can persist for many days or sometimes months.
Cyclothymia – indicated by slower changes between moods and episodes, present over the patient’s lifetime with signs of mild depression. Teens with this type of bipolar disorder may be unaware that it is not what other people deal with regularly. Without intervention, it often becomes a form of orientation that lasts until adulthood. Depression often shows as a lack of motivation or push to continue with objectives, and the hypomanic episodes are judged to be the time when the teen or young adult completes tasks that were abandoned or overlooked in the previous phase. They may experience sleep disruptions, with either excess or inadequate sleep.
The Signs Of Bipolar Disorder
While looking through the symptoms, some might think that it is what most teens exhibit–mood swings. This is true, but there are noteworthy differences that the mental health professional will check to know if it is a case of teenage bipolar symptoms or another issue that is confused with the disorder.
Generally, a person showing signs of bipolar disorder will:
- Have a history of occasional mood swings
- Be relatively young at onset
- Be less prone to show agitation and weight loss
- Be more likely to be low-spirited and sleep more, instead of less
- Have a family history of bipolar disorder
- Respond poorly to antidepressants
- Have short but many episodes
- Frequently exhibit unusual symptoms of depression
- Show seasonal patterns to their moods
- Be prone to substance abuse
- Be prone to psychotic behavior
The differences may be elusive but distinct. This is why parents need to monitor their teen’s symptoms and keep a record of moods and episodes if they can. This will give the doctor enough details to make a clear and accurate diagnosis.
Bipolar disorder can start at any age, even in children, but it more often starts in the late teens and early adult years. Estimates show that 2.8 percent of people above 18 years of age in the United States have bipolar disorder. The prevalence of the disorder among men and women is nearly similar.
When the onset of symptoms starts during adolescence or teenage years, it is necessary to consider that the person is already battling plenty of changes caused by puberty and hormonal imbalances. Therefore, doctors will try to maintain closer supervision of the teen to ensure that they are not confusing regular mood changes with symptoms of bipolar disorder.
Some of the signs that may be apparent during a manic episode include:
- A short temper or strange outburst
- Feeling active
- Looking thrilled or behaving silly in an unusual way for those in their age group
- Difficulty concentrating on one thing
- Risky or impulsive behavior
- Talking fast or saying too many things at once
- Difficulty sleeping or sleeplessness
- Inflated ego or self-grandiose
- Talks or thoughts of sex or having it more often
Some of the signs to look for during depressive episodes include:
- Gloomy or depressed feeling
- Feeling guilty and worthless
- Feeling lonely or isolated
- Crying regularly
- Feeling angry or irritated for no reason
- Changes to eating patterns, like eating too little or much
- Feeling fatigued even after getting enough sleep
- Disinterest in activities they typically find exciting
Co-occurring Disorders With Bipolar Disorder
Teens with bipolar disorder may experience other issues at the same time, including:
- Attention Deficit Hyperactivity Disorder (ADHD) – children with both bipolar disorder and ADHD will often struggle with concentration
- Substance abuse: Both adults and kids with bipolar disorder are vulnerable to excessive alcohol intake or drug use.
- Anxiety Disorders
- Often, behavioral disorders accompany mood episodes. The young adult may take many risks or indulge in dangerous activities like driving too fast or wastefulness.
Diagnosing Bipolar Disorder
Most bipolar disorder patients can be treated successfully, but a mental health professional needs to diagnose the disorder first. Unfortunately, many people with the disorder never get a diagnosis or get the wrong diagnosis. Without accurate diagnosis and treatment, the disorder may worsen. When bipolar disorder goes undiagnosed in teens, they may abuse drugs or end up in a residential rehabilitation center, psychiatric hospital, or the juvenile justice system.
Since children and teens with bipolar disorder do not often exhibit the same behavioral traits as adults with the disorder, a mental health professional will carefully examine the teen’s behavior to make a diagnosis. This includes obtaining a full history of the patient’s past and present experiences. Friends and family can also provide helpful information on the person’s character. The doctor may also recommend a medical examination to rule out underlying conditions.
It can be hard to diagnose bipolar disorder. Currently, there are no laboratory tests like blood tests or brain scan for diagnosing the condition. In teens, bipolar disorder may be confused with Post-Traumatic Stress Disorder, Schizophrenia, ADHD, and other depressive disorders. Therefore, it is necessary to get a fully comprehensive history of the patient.
Bipolar disorder can occur in anyone, including teens and children. However, most people with the disorder develop it in the later teenage ages or early adult years and the condition continues for a lifetime. Medical professionals are still unable to determine the precise causes of bipolar disorder, but certain factors can contribute to the ailment. Genetics is one factor because bipolar disorder tends to run in the family. However, it is crucial to remember that having a person with bipolar disorder in the family does not mean every other person in the family will develop the condition as well.
Another factor that may contribute to bipolar disorder is the structure of the patient’s brain. Scientists are learning more about the disorder through research. The research may assist doctors in providing better treatment. In addition, the research may help doctors envisage the occurrence of bipolar disorder in patients. Eventually, this may help them prevent the condition in some people. If you suspect your teen is exhibiting signs of bipolar disorder, take them to see a medical professional as soon as possible. You can begin the process by having them take a bipolar disorder assessment test.