Recognizing Adolescent Bipolar Disorder

Bipolar disorder can develop at any point during the teenage years. Untreated adolescent bipolar disorder is especially debilitating, often leading to teenage abuse of alcohol and illicit drugs, poor academic and social performance, suicidal behavior and suicide fatalities.

If I have bipolar disorder, will my teenager?

The risk of a teenager developing bipolar disorder increases if a parent has a history of manic depression. If one parent has bipolar disorder, the teenager has a 15 to 30 percent chance of developing the disorder. If both parents have bipolar disorder, the teenager’s risk increases to between fifty and seventy five percent.
Such statistics show a strong genetic component for bipolar disorder. A teenager with a sibling diagnosed with bipolar disorder has a 15 to 25 percent risk of developing the disorder. If the sibling is an identical twin, the teenager’s risk of bipolar disorder rises to seventy percent.

Teenage Bipolar Disorder Symptoms

A teenager with bipolar disorder will appear unusually moody, agitated, distracted and irritable. However, such symptoms actually describe a wide range of physical and mental disorders, including depression and attention deficit hyperactivity disorder.

Specific bipolar disorder symptoms in teenagers resemble the symptoms experienced by adults. These differ markedly from symptoms of depression and mania in young children.

A teenager may exhibit symptoms of the following bipolar disorder types:
Bipolar I: Bipolar I is “classic” bipolar disorder. The teenager displays signs of intense mania followed by equally intense depression. The length of manic and depressive episodes varies from teenager to teenager. Between episodes of mania and depression the teenager will have periods of normalcy.

Mania and depression symptoms associated with bipolar I include:

Teenage BP I
Mania Symptoms

Teenage BP I
Depression Symptoms

irritabilityracing speech

little sleep with no apparent fatigue

poor judgment

increased risk-taking behavior

hypersexuality

delusions

hallucinations

pervasive sadnesscrying

social withdrawal

increased sleep/insomnia

decrease in school grades

lack of energy

sudden change in appetite

suicidal behavior/thoughts of suicide

Bipolar II: Bipolar II describes recurring episodes of hypomania and depression. Hypomania describes an elevated mood that is less severe than full-blown mania, and causes irritability and increased mental and physical activity. Many teenagers and adults report periods of exceptional creativity during hypomanic episodes.
Cyclothymia: This type of bipolar disorder is less severe than bipolar I or bipolar II, but the teenager still experiences definite mood swings between mania and depression.

Bipolar Disorder NOS: Bipolar disorder NOS, or Not Otherwise Specified, is the diagnosis made when the teenager exhibits signs of bipolar disorder, but the exact type cannot be specified.

Triggers of Adolescent Bipolar Disorder

Sometimes no identifiable trigger for the first episode of bipolar disorder can be found in teenagers. In other cases, the disorder has been present since childhood, but undetected. Traumatic events, grief and other stressors can also trigger an initial episode of mania or depression.

Teenage girls may experience their first episode when they get their first period, and many teenage girls find that the severity of both mania and depression fluctuates with their menstrual cycle.

Diagnosing Teenage Bipolar Disorder

Diagnosing bipolar disorder in children and teenagers is complicated by a lack of standardized diagnostic criteria. The DSM-IV (Diagnostic Criteria for Mental Disorders) only includes criteria for diagnosing adults with bipolar disorder. Fortunately, symptoms of bipolar disorder in teenagers are similar enough to those in adults that it is usually possible to make an accurate diagnosis.

Other disorders often mistaken for teenage bipolar disorder include:

  • attention deficit hyperactivity disorder (ADHD)
  • borderline personality disorder
  • conduct disorders
  • post-traumatic stress disorder (PTSD)
  • schizophrenia

Complications of Untreated Bipolar Disorder

Misdiagnosed or untreated bipolar disorder can cause serious health problems for teenagers.

Teenagers with untreated bipolar disorder have a high risk of alcohol and substance abuse. Some teenagers may abuse these substances to “self-medicate,” attempting to control sleep disturbances and mood swings. Teenagers who have no bipolar symptoms prior to puberty and who suddenly develop the disorder after puberty are at especially high risk for substance abuse.

The danger of suicide in untreated bipolar disorder is high: Untreated adults have an 18 percent suicide rate, and there is no reason to assume rates aren’t equally high among teenagers.

Given the severity of untreated bipolar disorder complications, any teenager exhibiting signs of suicidal behavior or substance abuse should be screened for bipolar disorder. If alcohol or drug addiction coexists with bipolar disorder, both disorders must be treated to improve symptoms.

Bipolar Disorder Treatment

Bipolar disorder treatment requires both mood-stabilizing medication and intensive psychotherapy. Medication reduces symptoms enough that therapy can progress.

Bipolar disorder psychotherapy includes cognitive-behavioral therapy to teach the teenager how to monitor and cope with mood swings and symptoms. Family therapy is also essential, educating parents and siblings about bipolar disorder and healing interpersonal rifts caused by the pressure of living with untreated bipolar disorder.

Almost all bipolar disorder medications are designed with adults in mind. The older the teenager, the less this is a problem. However, younger teenagers present challenges when medication is prescribed. The possible effects of prescribing the teenager adult medication must be weighed against the risks of untreated bipolar disorder.

Discovering you or your teenager has bipolar disorder is a shock, but with proper treatment and therapy, teenagers with bipolar disorder can overcome the symptoms of bipolar disorder and reclaim their lives.

Resources:

National Alliance for the Mentally Ill (NAMI), www.nami.org
National Institute of Mental Health, www.nimh.nih.gov

Locations

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