How to Spot Bipolar Disorder in Teens And What to do About It

Bipolar disorder, a mental illness of two extremes, is difficult to spot in teenagers because even healthy teens are volatile. The disease typically develops in the early 20s.  But the symptoms are often misdiagnosed, especially in teens. What does bipolar disorder look like in a teenager, and how does a parent spot it?

Let‘s dig in.

Bipolar disorder is characterized by “highs” (called mania), and “lows” (called depression). Bipolar patients also have hypomanic episodes. Hypomania means “below mania,” and is considered a lesser form of mania. There are also mixed episodes, where a bipolar patient suffers a form of mania and depression at once.

Three teenage boys playing on a guitar. Credit to flickr.com user chiesADIbeinasco.
Used with permission under a Creative Commons license.

Common Symptoms

Teen-onset bipolar disorder is similar to adult-onset. Adolescents suffer similar symptoms to adults. Here are the symptoms of manic, hypomanic, and depressive episodes in teens:

Mania	Hypomania	Depression
Racing speech and thoughts Increased energy Decreased need for sleep Elevated mood and excessive cheerfulness Increased physical and mental activity Hypersexuality Reckless and risk-taking behaviors Drop in grades Irritability, aggressive behavior, and impatience Excessive spending Difficulty concentrating Grandiosity	Productivity Exuberant and elated mood Decreased need for sleep Elevated mood and excessive cheerfulness Unusual confidence Hypersexuality Reckless and risk-taking behaviors Extreme focus on projects at work or at home Increased creativity	Anhedonia – loss of interest or pleasure in normally enjoyable activities Sadness or irritability Fatigue Shame or guilt Sleeping too much or insomnia Drop in grades Loss of appetite or overeating Anger, worry, and anxiety Difficulty concentrating Thoughts of death or suicide

But there is one crucial difference between teenagers and adults who suffer bipolar disorder: teenagers tend to be rapid cyclers, which means they suffer mood episodes more frequently than adults. Adults typically vacillate between defined episodes of hypomania, mania, and depression, with periods of wellness in between lasting from weeks to years. But teenagers vacillate between extreme mood states within hours to days, with very few periods of wellness in between. Teens are similar to children with regard to rapid cycling.

Irritability and Rage

Teens who suffer from bipolar disorder can exhibit irritability during both manic and depressive phases, just like children and adults. For teenagers, irritability can be a constant issue during the manic phase. Like children, teens are more likely than adults to become irritable. Unlike most children and adults, however, adolescents who present with irritability are more likely to be hostile, and even violent.

Slamming doors, yelling, and even telling parents that they hate them is normal for many teenagers, and they recover quickly. But a bipolar teen’s rage is much more extreme. He or she might not be able to calm down for days to weeks. They may hit themselves or others, or break possessions. Adolescents suffering from mania may think their parents are out to get them, to the point where the teens hide in their rooms or throw away their phones. In extreme cases, teens may end up psychotic, where they engage in delusions, hear voices, or see things that aren’t there. If your teen is acting paranoid or psychotic, he or she may need to be hospitalized.

Issues with School

School may be more difficult for teenagers with bipolar disorder than those without. High school forces teens to keep a very rigid schedule, and there is a lot of pressure to perform. If hospitalized, they may miss school and must catch up, resulting in more stress due to missed workload. 

Social navigation can also trouble teens. For teenagers, explaining their bipolar disorder to their friends may be next to impossible. Teens with bipolar might suffer guilt or shame after an episode, which makes dealing with their illness even more difficult, and may impact their friendships.

Solutions/Taking Action

If you can’t tell if your teen suffers from bipolar disorder and you have doubts, it’s okay to consult a doctor. Get a referral from your child’s pediatrician to a behavioral therapist or child psychologist. Refer to the symptom chart, and describe your teen’s manic and depressive symptoms to the doctors. There’s no neon sign over your child’s head that will tell you definitively that your teen has a mood disorder. But if you have suspicions, getting a psychiatric evaluation for your teen is the best step you can take. A diagnosis may help both you and your teen as you parent during his or her adolescence. For more on what to do if your child is bipolar, click here.

Parenting a bipolar teen may be extra difficult. You need to teach him or her how to manage extreme emotional states, and how to deal with his or her rage in a constructive manner. But don’t give up. Dig in now and keep looking for help. There used to be few resources for dealing with mood disorders; now there are plenty.

Even with help, these are going to be difficult years. Finding a balance may be tricky. But there is hope for teenagers with bipolar disorder. Bipolar is one of the most treatable disorders. With talk therapy, and possibly medication, your teen can live a healthy and fulfilling life. You can raise a successful bipolar adults, but first you need to get through the teen years.

I wish you luck in your journey.

Related:

• Interview With My Parents: On Raising A Bipolar Child
• Children at High Risk for Bipolar Disorder Genetically Vulnerable to Stress
• How to Get a Psychiatric Evaluation

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