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Recognizing Bipolar Disorder in Teens

Reviewed by Aaron Horn, LMFT · October 28, 2020 ·

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 usual – this is the manic episode. Other times, they feel gloomy and are less active than before – this is depression or a depressive episode.

This mental disorder causes radical changes in mood, sleep, energy levels, and regular functions. These changes are more drastic than the usual ups and downs that everyone goes through, and they have different presentations. These mood changes do not occur daily but are usually every few weeks or months apart. This can cause the person to battle depressive thoughts for weeks before entering the manic, active stage. The person may return to a normal mood and behavior between these stages.

Bipolar disorder can be intense and affects a child’s performance in school and how they relate with friends and family. Patients may experience strained relationships and a loss of optimism and direction. The condition can also be life-threatening. Patients with bipolar disorder must 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. Bipolar disorder is different from the average 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. Generally, this stage can last between three to six months 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 be 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 appears during the teenage years; even children can develop the disease.

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 others 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 severe manic or mixed episodes and generally lasts between seven to 14 days. Due to the severity, teenagers with this 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 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 the mood but often does 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 accompanying the mood changes and implementing 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 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 simultaneously or a quick alternation between the stages. This may occur as crying and laughing simultaneously or appearing energetic yet unable to leave the bed. The confused mind and emotions can persist for many days or 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 a lack of motivation or push to continue with objectives. Hypomanic episodes are judged to be when the teen or young adult completes tasks 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 the 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 inclined to psychotic behavior

The differences may be elusive but distinct. This is why parents need to monitor their teen’s symptoms and record moods and episodes if they can. This will give the doctor enough details to diagnose clearly and accurately.

Bipolar disorder can start at any age, even in children, but it often begins in the late teens and early adult years. Estimates show that 2.8 percent of people above 18 in the United States have bipolar disorder. The prevalence of the disease among men and women is nearly similar.

When symptoms start 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 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
  • Anxiety
  • 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 wasteful.

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 disease never get a diagnosis or the wrong one. Without accurate diagnosis and treatment, the condition 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, a mental health professional will carefully examine the teen’s behavior to make a diagnosis. This includes obtaining a complete 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 scans 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 patient history.

Final Note

Bipolar disorder can occur in anyone, including teens and children. However, most people with the disease develop it in their later teenage ages or early adult years, and the condition continues for a lifetime. Medical professionals are still unable to determine the causes of bipolar disorder, but certain factors can contribute to the ailment. Genetics is one factor because the 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 also develop the condition.

Another factor that may contribute to bipolar disorder is the structure of the patient’s brain. Scientists are learning more about the disease through research. The research may assist doctors in providing better treatment. In addition, the study 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.

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