Adolescent Bipolar Disorder
How Concerned Should You Be?
Bipolar disorder is a serious, but treatable, disorder characterized by extreme alternating moods that range from depression to mania. Irritability, silliness, moodiness, and rapid speech are symptoms of bipolar disorder, but they are also normal parts of adolescence! The diagnosis of teen bipolar disorder is further complicated by the fact that its symptoms differ from those of adult bipolar disorder and often mimic the symptoms of other disorders, such as ADHD.
So how do you know if your teen has the serious but treatable condition of bipolar disorder or is just experiencing normal adolescent moodiness?
Look for the Signs
It should first be noted that parents are generally not in a good position to diagnose their children; this should be left to a licensed mental health professional outside of the family system. Nonetheless, it is critical that parents pay close attention to behaviors that might require the involvement of a physician, therapist, or treatment program. Research has revealed that up to 67% of persons with bipolar disorder experienced the onset of the illness before the age 18. Missing the opportunity to accurately diagnose bipolar disorder during childhood can actually exacerbate the condition later in life, further impairing functioning as an adult.
Conditions that, on first blush, may seem similar often have very different risks and require different treatment approaches, so accurate diagnosis is critical. The suicide rate for bipolar disorder, for instance, is double that of major depression. So if you are in doubt about whether your child is exhibiting normal teen behavior or a budding emotional or psychological disorder, seek the help of a professional immediately to ensure an accurate diagnosis and appropriate treatment.
Any combination of the following behaviors may be symptomatic of bipolar disorder. If your child exhibits these symptoms to a degree or with a frequency that concerns you and/or impairs your child’s relationships or functioning, it could be a sign of a serious condition. Signs of bipolar disorder, while mimicking those of adolescence itself, is a serious and potentially life-threatening illness that requires medical and psychological treatment.
- Elevated mood to the point of functional impairment
- Rapid or ultra-rapid cycling of moods (e.g. shifting from a normal positive mood to depression to irritability in a single day)
- Acting more cheerful and/or sillier than the situation warrants
- Moods elevated to the point of causing discomfort in others; these moods are typically difficult to redirect
- Intense irritability, often accompanied by an increase in physical or verbal aggression
- Uncontrollable outbursts and tantrums
- Grandiose thoughts, e.g.
- Periods of seeing oneself as better and smarter than others
- Being overly directive of peers
- Believing oneself to have special abilities and talents
- Constructing elaborate plans for unrealistic projects
- Periods of thinking that rules of nature and/or society do not apply to oneself
- Decreased need for sleep and difficulty falling sleep
- Increased sexual interest and/or promiscuity
- Rapid speech and frequent interrupting; reports of racing thoughts
- Increased risk-taking behaviors, often including substance abuse
- In addition to the symptoms listed above, it is important to pay attention to family history. If members of your family have been diagnosed with bipolar disorder, your teen is at a higher risk of mental illness generally and bipolar specifically. Research indicates that the children of those suffering from bipolar disorder have double the risk of developing a mental illness than the general population.
Treatment for Bipolar Disorder
While bipolar disorder is a serious and sometimes life-threatening condition, the good news is that it is treatable. If your child is diagnosed with bipolar disorder, there is hope for a healthy and productive life through the application of modern treatment approaches that include:
- Cognitive-Behavioral Therapy
- Family-based interventions
- Modifications in environment, starting with hospitalization or residential care
- Alteration of social rhythms
- Stabilizing sleeping patterns through circadian-rhythm intervention
- Multi-modal treatment, using several or all of the approaches listed above, has proven to be as to be the most effective way to address adolescent bipolar disorder
Coville & Miklowitz (2008) Correlates of High Expressed Emotion Attitudes Among Parents of Bipolar Adolescents Journal of Clinical Psychology, Vol 64(4) 438-449
Youngstrom, E.A. (2008) Pediatric Bipolar Disorder: Evidence for Its Diagnostic Validity and Recommendations for Making the Diagnosis Clincian’s Digest
Apps & Winkler (2008) Bipolar Disorders: Symptoms and Treatment in Children and Adolescents Pediatric Nursing Vol.34. No.1
Duffy. A (2007) Does Bipolar Disorder Exist in Children? A Selected Review The Canadian Journal of Psychiatry Vol. 52, No 7