We Accept Insurance
It’s estimated that 2.9% of US adolescents have bipolar disorder, a mental illness characterized by extreme mood swings. The prevalence of bipolar disorder among adolescents is higher for girls than boys.
Frequent mood swings are an enduring cultural stereotype about adolescence. Because the raging hormones that characterize the teen years affect emotions, there’s some truth to this view. Indeed, it can be difficult to determine whether a teen is experiencing the usual adolescent mood swings or bipolar disorder.
What is bipolar disorder in teens?
Youth with bipolar disorder experience more intense emotional fluctuations than the average teenager. They may experience periods of mania, which are marked by increased energy levels and elevated, euphoric, or irritable moods. Manic episodes may be followed by depressive periods that include profound sadness or hopelessness. Although duration varies, teen mania episodes typically last one to two weeks.
Adolescents with bipolar disorder have more pronounced mood fluctuations than adults with this condition. These fluctuations may include bipolar rage, an anger response that has no obvious trigger or is disproportionate to a situation. For example, a teen may scream at a classmate for bumping them. Sometimes, symptoms of mania and depression co-occur, making diagnosis particularly challenging.
While the cause of bipolar disorder is unknown, it runs in families, suggesting that it has a genetic component. Medical experts once believed that bipolar disorder couldn’t be diagnosed until the mid-20s, when the brain is fully developed. However, recent research shows that children and teens can and do experience bipolar disorder.
Bipolar symptoms in teens
Symptoms of bipolar disorder in teens may include the following:
- Becoming more irritable, impatient, or easily annoyed than usual
- Engaging in risky behaviors, such as reckless driving, substance use, or unprotected sex
- Speaking rapidly and switching topics frequently
- Increased sexual desire
- Hallucinations (i.e., seeing or hearing things that aren’t there) or delusions (i.e., firmly held false beliefs)
- Physical symptoms with no apparent medical cause
- Needing significantly less sleep than usual
- Trouble focusing or staying on task
- A noticeable decrease in energy
- Withdrawal from friends, family, or activities previously enjoyed
- Dramatic changes in appetite
- Making uncharacteristically impulsive decisions, such as spending money recklessly
- Increased conflicts or misunderstandings with peers, family, or authority figures
- Thoughts about death or suicide—a sign that requires immediate attention
How are mood disorders in teens diagnosed?
Symptoms of bipolar in teens often coincide with other mental health conditions, such as depression, making diagnosis challenging. To be diagnosed, a teen must exhibit both depressive and manic symptoms. A typical diagnosis involves the following aspects of a thorough evaluation by a mental health professional:
- Health history review: A review of the teen’s medical history, including prior mental health issues, treatment, and family history of mental health conditions.
- Symptom assessment: Evaluation of the teen’s symptoms, including mood swings and behavior changes, for patterns of depressive and manic episodes.
- Health evaluation: A comprehensive health evaluation, which may include interviews, questionnaires, and a physical exam to rule out medical conditions.
After a thorough evaluation to confirm bipolar disorder, the child’s mental health provider will develop a treatment plan, which may include the following:
- Mood-stabilizing medications or antidepressants: These help manage the mood swings associated with bipolar disorder, reducing the intensity and frequency of manic and depressive episodes.
- Talk therapy (psychotherapy): Therapy allows teens to explore their feelings and develop coping strategies within a safe and supportive environment. Cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT) are the most frequently used treatment modalities.
- Family therapy: This form of treatment improves family communication and educates family members about ways to help their loved one manage their condition.
Bipolar over time
Does bipolar get worse without treatment?
Bipolar disorder usually worsens if overlooked or left untreated, with episodes lasting longer and occurring more often. Over time, worsening symptoms can prompt or exacerbate other problems, such as substance abuse, and can increase suicide risk.
Does bipolar disorder get worse with age?
While the average age of a first bipolar episode is 25, the disorder can arise at any time, including during childhood, adolescence, or old age. When it begins before age 18, the condition is known as early-onset bipolar disorder, and some research suggests that early onset is associated with more severe symptoms. Research also suggests that the condition tends to worsen with age.
Problems associated with bipolar in teens
Here are some problems related to bipolar disorder that may affect youth with the condition:
- Attention-deficit/hyperactivity disorder (ADHD): Many teens with bipolar disorder also have ADHD. Because the two conditions share many symptoms, such as impulsivity and restlessness, ADHD is frequently misdiagnosed as bipolar.
- Anxiety disorders: These disorders often occur alongside bipolar, making it more difficult for teens to manage their condition.
- Behavior problems: Mania sometimes prompts out-of-control behavior with negative repercussions.
- Substance abuse: Teens with bipolar may use alcohol or drugs to self-medicate, leading to dependency and a worsening of their condition.
- Suicidal thoughts: Some adolescents with bipolar disorder may try to hurt or kill themselves.
How to help your teen cope with bipolar disorder
Living with bipolar disorder is challenging, but with your support and understanding, your teen can learn to manage their condition. While there’s no cure for bipolar disorder, careful monitoring and appropriate care can improve symptoms over time. Here’s how you can help:
- Get your teen to attend appointments consistently: Stress that it’s crucial to keep all appointments with mental health providers, whether psychiatrists or therapists. Consistent treatment helps maintain symptom management.
- Check that your teen takes all prescribed medications: Help your child remember to take their medication by using timers, pillboxes, or mobile device alarms.
- Monitor side effects: Some teens suffer side effects when taking medications to treat bipolar disorder. Ask your child’s psychiatrist what to watch for and report all observations to minimize adverse effects.
- Consult with school staff: See what accommodations your child’s school can provide. For example, teens with bipolar disorder often perform better in classes with fewer students because there are fewer distractions.
- Seek support: Support groups provide not only valuable insights but also empathetic ears when things get difficult. Organizations like the National Alliance on Mental Illness (NAMI) and the Depression and Bipolar Support Alliance (DBSA) offer resources for children, teens, parents, and families.
Should my child be evaluated for bipolar disorder?
Many adolescents undergo behavior changes that disrupt sleep, academic performance, or relationships. Determining whether such behavior is run-of-the-mill adolescence or signs of bipolar in teens can be difficult. To determine whether your child should be evaluated for bipolar disorder, consider the following questions:
- Are your child’s mood swings more pronounced than those of the average teen? If your child experiences extreme highs in mood or energy or deep sadness or hopelessness, consider having them evaluated.
- Does your teen suffer from grandiosity or an exaggerated sense of importance? Some teens with bipolar disorder exhibit grandiosity or may feel indestructible.
- Does your teen’s mood swings interfere with their daily life? If your child’s mood shifts significantly disrupt their ability to manage everyday activities, such as schoolwork and chores, consult a psychiatrist.
- Have you seen dramatic changes in behavior? Consider whether your child’s behavior has markedly changed. Look for alterations in energy, sleep patterns, and interests as well as engagement in reckless or unsafe behavior.
Online therapy: Meeting teens where they are
If your adolescent has been diagnosed with bipolar disorder, consider online teen therapy. This modern, evidence-based alternative to in-person counseling is highly effective at treating bipolar disorder as well as anxiety, depression, and many other mental health conditions.
Most of today’s teens are digital natives—so comfortable online that the internet feels like a second home. This familiarity makes online teen therapy an attractive option for many adolescents. It’s also convenient, allowing you and your teen to overcome transportation limitations and avoid traffic jams and crowded waiting rooms. Fewer missed appointments mean faster and more consistent progress.
Another advantage of online counseling is its anonymity. Many teens fear seeking help because they worry about being judged poorly or running into someone they know. With online therapy, teens have fully confidential sessions. This added layer of privacy can help them feel safer and more willing to share their struggles.
Bipolar in teenagers: Final thoughts
Many parents feel uncomfortable talking about mental health issues, which can make it difficult for them to seek professional help for their teen, even if they know it’s needed. If you’re reluctant to get your child an assessment or therapist because of this stigma, consider this: you wouldn’t hesitate to contact a doctor if your child suffered a physical condition. You should likewise reach out for expert help when your child suffers a mental disorder.
Untreated bipolar disorder won’t go away on its own—it will only get worse. You owe it to your child to get them the treatment they need and deserve.