Bipolar Disorder in Adolescents
What is bipolar disorder?
Bipolar disorder, previously referred to as manic depression, is classified as a type
of affective disorder (also called mood disorder). It goes beyond the day's ordinary
ups and downs, and is a serious medical condition and important health concern in
this country. Bipolar disorder is characterized by periodic episodes of extreme elation,
happiness, elevated mood, or irritability (also called mania) countered by periodic,
classic major depressive symptoms. That is why there are two "poles" or symptoms of
Who is affected by bipolar disorder?
Bipolar disorder affects 2.6% of American adults each year. The median age of onset
is 25. When symptoms are present before the age of 12, they are often confused with
attention-deficit/hyperactivity disorder (ADHD). ADHD is a syndrome that is usually
characterized by serious and persistent difficulties resulting in inattentiveness
or distractibility, impulsivity, and hyperactivity.
Males and females are affected equally, although females are more likely to experience
more depressive and less manic symptoms. Bipolar disorder often begins in adolescence
or early adulthood. Bipolar disorder is beginning to be better recognized in young
children. However, diagnosis may still be difficult.
Bipolar disorder is likely to run in families. In some cases, is believed to be hereditary.
Researchers are still seeking to identify a gene (or genes) that may be responsible
for this disorder.
What are the symptoms of bipolar disorder?
The following are the most common symptoms of bipolar disorder. However, each individual
may experience symptoms differently.
Depressive symptoms may include:
Lasting feelings of sadness
Feeling hopeless or helpless
Having low self-esteem
Feelings of wanting to die
Loss of interest in usual activities or activities once enjoyed
Difficulty with relationships
Sleep disturbances (for example, insomnia or hypersomnia)
Changes in appetite or weight
A decrease in the ability to make decisions
Suicidal thoughts or attempts
Frequent physical complaints (for example, headache, stomachache, or fatigue)
Running away or threats of running away from home
Hypersensitivity to failure or rejection
Irritability, hostility, aggression
Manic symptoms may include:
Overly inflated self-esteem
Decreased need for rest and sleep
Increased distractibility and irritability
Excessive involvement in pleasurable and/or high-risk activities that may result in
painful consequences. This may include provocative, aggressive, destructive, or antisocial
behavior (for example, sexual promiscuity, reckless driving, reckless spending, abuse
of alcohol and/or drugs.
Increased talkativeness (may include increase in rate of speech, changes topics quickly,
cannot be interrupted)
Excessive "high" or euphoric feelings, at times grandiose
Severe, unpredictable mood changes including unusually happy or silly, or unusually
angry, agitated, or aggressive
Increased sex drive
Increased energy level
Uncharacteristically poor judgment
Some teenagers in a manic phase experience psychotic symptoms including hallucinations
For a diagnosis of bipolar disorder to be made, an individual must exhibit both depressive
and manic symptoms to a varying degree, depending on the severity of the disorder.
The symptoms of bipolar disorder, especially in a teenager, may resemble other problems.
These include drug abuse, attention-deficit/hyperactivity disorder, or delinquency.
Always talk with your adolescent's healthcare provider for a diagnosis.
How is bipolar disorder diagnosed?
Seeking early diagnosis and treatment is crucial to recovery. A diagnosis is often
made after a careful psychiatric exam and medical history performed by a psychiatrist
or other mental health professional.
Treatment for bipolar disorder
Specific treatment will be discussed with you by your adolescent's healthcare provider based
Your adolescent's age, overall health, and medical history
Extent of your adolescent's symptoms
Your adolescent's tolerance for specific medicines or therapies
Expectations for the course of the condition
Your opinion or preference
Mood disorders, including bipolar disorder, can often be effectively treated. Treatment
should always be based on a comprehensive evaluation of the adolescent and family.
Treatment may include one, or more, of the following:
Medicine (for example, mood-stabilizing medicines and/or antidepressants)
Psychotherapy (most often cognitive-behavioral, supportive, psychoeducational, and/or
Consultation with the adolescent's school
Parents play a vital supportive role in any treatment process.
Recognizing the varied and extreme mood swings associated with bipolar disorder is
crucial in obtaining effective treatment, and avoiding the potentially painful consequences
of the reckless, manic behavior.