Understanding, Identifying, and Treating Bipolar Disorder in Teens

“Could my teen have bipolar disorder?” The question can be part of a light-bulb moment for parents struggling to make sense of their son or daughter’s behaviors. But diagnosing mood disorders in teens isn’t always easy, as they overlap with other issues like attention deficit hyperactivity disorder (ADHD), major depression, and anxiety disorders. This overlap can delay bipolar diagnoses.

So what is bipolar disorder, how can you tell if your teen has it, and how can you help? Keep reading for answers to these questions.

What Is Bipolar Disorder?

As defined by the American Psychiatric Association:

“Bipolar disorder is a brain disorder that causes changes in a person’s mood, energy, and ability to function. People with bipolar disorder experience intense emotional states that typically occur during distinct periods of days to weeks, called mood episodes. These mood episodes are categorized as manic/hypomanic (abnormally happy or irritable mood) or depressive (sad mood). People with bipolar disorder generally have periods of neutral mood as well.”

The most common subtypes of bipolar disorder are:

  • Bipolar I: Involves manic episodes that last a week or longer, severe mania requiring hospitalization, or episodes of major depression lasting two weeks or more.
  • Bipolar II: Characterized by mania and depression, with periods of mania that are less severe than what’s experienced with bipolar I. Major depressive episodes will often directly precede or follow manic episodes.
  • Cyclothymic: Characterized by symptoms of hypomania and depression that last for two years or more in adults (one year for children) without entirely fitting the criteria for manic or depressive episodes.

Bipolar disorder in younger people

According to the National Institute of Mental Health:

  • While most people are diagnosed with bipolar during adolescence or adulthood, symptoms can appear at a younger age.
  • The extremes experienced with bipolar disorder are different from the ups and downs that all children experience. For example, children with this disorder may be much more excited or irritable than other kids.
  • Bipolar can make it difficult for younger people to do well in school or get along with friends and family members.
  • Young people with bipolar disorder may also be diagnosed with other issues such as ADHD and anxiety disorders.
  • Some teens with bipolar disorder may self-harm or attempt suicide during depressive episodes.

Dr. Jyotsna Nair, psychiatric services director at Calo Programs, a residential treatment program for adopted preteens and teens, noted that because of the significant self-harm and suicide related to bipolar disorder, the diagnosis should not be taken lightly.

Parents of teens with bipolar disorder should be familiar with the signs of suicidal thoughts and tendencies and seek help if they identify them, Nair said.* Readily apparent warning signs include saying they want to die and talking about what the world will be like after their death. Subtle signs include giving away possessions, withdrawing from friends, and loss of interest in treasured activities and interests.

Risk Factors for Bipolar Disorder

While there’s no crystal ball that can be used to determine if a young person will develop bipolar disorder, certain risk factors do exist. That said, not everyone with these factors will develop the disorder. With that in mind, here’s a look at a few of the risk factors:

  • Family history: Having a close family member such as a parent or sibling with bipolar disorder increases a person’s chances of developing this disorder. However, there’s no single gene that causes it. Development is thought to come down to a variety of genes working together.
  • Adversity, trauma, and stressful life events: The National Institute of Mental Health shares that research has suggested that adversity, trauma, and stressful life events can increase the chance of developing bipolar disorder in those who are genetically at risk.
  • Brain structure and functioning: According to NIMH, some studies have identified differences in brain structure and function between people with bipolar and those without bipolar.

Symptoms of Bipolar Disorder in Teens

When looking for bipolar symptoms in your teen, it’s essential to know the differences between depressive and manic symptoms.

Symptoms of a manic episode of bipolar disorder in teens include:

  • Rapid talking.
  • Racing thoughts.
  • Grandiosity.
  • Jumping around to different topics and tasks.
  • Showing intense happiness or silliness in an unusual way or for a long period of time.
  • A very short temper.
  • Decreased sleep but not feeling tired. 
  • Risky, reckless behaviors that show poor judgment.
  • Compulsive behaviors like binge shopping.
  • Overly sexual behaviors such as frequent sexual activity with different partners.
  • Trouble staying focused.

Symptoms of a depressive episode of bipolar disorder in teens include:

  • Frequent, unprovoked sadness.
  • Hostility or anger.
  • Irritable mood.
  • Complaints about stomachaches, headaches, or other pain.
  • Oversleeping.
  • Feelings of worthlessness, hopelessness, and emptiness.
  • Difficulty communicating.
  • Difficulty maintaining relationships or socializing with friends.
  • Changes in eating patterns, such as eating too much, too little, or not at all.
  • Low energy levels. 
  • Decreased or no interest in favorite activities.

Getting a Diagnosis

If you believe your son or daughter has bipolar disorder, seek out support from a trained professional specializing in treating bipolar disorder in teens. You can start with your child’s family doctor and request a referral to a psychiatrist for an assessment. You can also find a psychiatrist near you by using the Psychology Today search tool.

Sometimes parents are reluctant to get help for their teen because of the stigma of mental illness. But Nair stresses that it’s important to remember “There is no shame, and one is not damaged if diagnosed with bipolar disorder. With proper treatment and continued support, teens with this diagnosis can manage their symptoms and lead fulfilling lives.” 

Treatment Options for Bipolar Disorder in Teens 

If your teen is diagnosed with bipolar, a psychiatrist or another mental health professional will develop a treatment plan, which typically includes medication and working with a therapist.

When it comes to medications, Nair said research supports mood stabilizers, including lithium, as the best option. Mood stabilizers can decrease the extreme highs and lows your teen experiences.

Therapy options include psychotherapy (talk therapy), interpersonal therapy, family therapy, intensive outpatient therapy, and cognitive behavioral therapy.

Supporting Your Teen

Tips for supporting a teen with bipolar disorder include:

  • Be patient with your child. The road to wellness is a lifetime journey for us all!
  • Listen to your child carefully. Nair said listening is critical because it enables your child to share and communicate with you about what they’re experiencing. 
  • Be attentive to changes in mood and behavior. However, Nair said, don’t assume that a change is due to your teen not taking their medication. Talk to your teen’s psychiatrist about what you’ve observed.  
  • Get to know your child’s triggers, and develop strategies for helping your son or daughter manage emotional changes. For example, Nair said, you could help your teen recognize the triggers and use coping skills to manage emotional changes. Those skills could include distraction, listening to music, going on a walk, and playing with a pet.

Putting It All Together: Bipolar Disorder in Teens 

All teens experience the normal ups and downs associated with hormonal changes that occur during adolescence. But if you notice your son or daughter’s behavior is a little more erratic than usual, and they experience significant mood swings, it could be bipolar disorder. Remember: Bipolar disorder in teens is manageable with the right treatment. Seek professional help, and support your child as they navigate this mental health journey. 

*This article is for informational purposes only and not to be considered medical advice. If your child is having a mental health emergency, contact the 988 Suicide & Crisis Lifeline for immediate support by calling, texting, or chatting 988. You can also text HOME to 741741 -the Crisis Text Line- from anywhere in the country to talk with a trained crisis counselor.

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Embark Behavioral Health is a leading network of outpatient centers and residential programs offering premier mental health treatment for preteens, teens, and young adults. Dedicated to its big mission of reversing the trends of teen and young adult anxiety, depression, and suicide by 2028, Embark offers a robust continuum of care with different levels of service and programming; has a deep legacy of over 25 years serving youths; works with families to adjust treatment in real time to improve results; treats the entire family using an evidence-supported approach; and offers the highest levels of quality care and safety standards. For more information about Embark or its treatment programs, including virtual services, intensive outpatient programs (IOPs), therapeutic day treatment programs, also known as partial hospitalization programs (PHPs), residential treatment, and outdoor therapy, visit embarkbh.com.