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Your child is going through the usual ups and downs of being a teenager. But then you begin to notice that their behavior is a bit more erratic than usual and seems to swing from extreme irritability to extreme sadness every few days.
You may start to think that maybe it’s more than teenage angst — that maybe your teen has bipolar disorder. Read on to learn what symptoms to look for, how bipolar disorder is diagnosed, and how this mental health condition is treated.
Bipolar disorder is a chronic and serious mood disorder that affects about 2.6 percent of American adults. The condition usually appears in the late teens or early adulthood.
Typically, people with bipolar disorder experience periods of extreme happiness or high energy and activity. These are known as manic episodes.
Before or after a manic episode, a person with bipolar disorder may experience periods of intense sadness and depression. These periods are known as depressive episodes.
While there’s no cure for bipolar disorder, treatment can help people manage symptoms and better cope with their condition.
Symptoms of a manic episode are very different from those of a depressive episode. Although teens with bipolar disorder experience mood changes in much the same way as adults, one difference is that teens tend to be more irritable than elated during their manic episodes.
A teen with bipolar disorder who’s having a manic episode may:
- have a very short temper
- talk excitedly and quickly about a lot of different things
- be unable to focus
- rapidly jump from task to task
- be unable to sleep but not feel tired
- feel incredibly happy or act silly in an unusual way
- do risky things like drinking while driving
- do compulsive things like binge shopping
- become overly sexual or sexually active
During a depressive episode, a teen may:
- feel worthless, empty, and guilty
- feel very down and sad
- complain about stomachaches, headaches, or other aches and pains
- sleep too much or too little
- have little to no energy
- have a loss of concentration
- be indecisive
- have no interest in activities or socializing with friends
- overeat or not eat at all
- think a lot about death and suicide
Doctors are unsure of what causes bipolar disorder. It’s believed that a mix of family genes, brain structure, and the environment contributes to this disorder.
Teens with a family history of bipolar disorder have an increased risk of developing the disease. For instance, if your child has a parent or sibling with bipolar disorder, they’re much more likely to develop the condition. However, keep in mind that most people with relatives who have bipolar disorder do not develop it.
Although doctors can’t use brain scans to diagnose bipolar disorder, researchers have found subtle differences in brain size and activity in people who have the condition. Scientists also believe concussions and traumatic head injuries can increase a person’s risk of developing bipolar disorder.
Doctors say that traumatic or stressful events, such as a death in the family, can trigger the first bipolar episode. Stress hormones and how your teen handles stress can also play a role in whether the disease emerges.
Teens with bipolar disorder may also experience other disorders and behavioral problems. These can overlap with mood episodes.
These other disorders or behavioral problems can include:
- drug addiction
- alcohol addiction
- conduct disorder, which can involve long-lasting disruptive, deceitful, and violent behaviors
- attention deficit hyperactivity disorder (ADHD)
- post-traumatic stress disorder (PTSD)
- panic attacks
- separation anxiety
- anxiety disorders, such as social anxiety disorder
Teens with bipolar disorder are at an increased risk of suicide, so watch out for signs of suicidal thoughts and tendencies. Warning signs include:
- giving away cherished possessions
- having intense feelings of sadness and hopelessness
- withdrawing from friends and family
- losing interest in regular activities or activities they love
- thinking or talking about being better off dead or what it would be like if they died
- being obsessed with death
Talk to your teen if you’re worried that they’re contemplating suicide. Don’t ignore these symptoms. If you think your teen is at immediate risk of self-harm or hurting another person:
- Call 911 or your local emergency number.
- Stay with the person until help arrives.
- Remove any guns, knives, medications, or other things that may cause harm.
- Listen, but don’t judge, argue, threaten, or yell.
You can also get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.
Your teen’s doctor may perform a physical exam, an interview, and lab tests. Although your doctor can’t diagnose bipolar disorder through a blood test or body scan, it helps to rule out other illnesses that mimic the disorder. These can include hyperthyroidism.
If your doctor finds that no other diseases or medications are causing your teen’s symptoms, they may suggest that your child see a psychiatrist.
A psychiatrist will conduct a mental health assessment to determine if your child has bipolar disorder. There are six types of bipolar disorder diagnoses recognized in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition), which doctors use to diagnose mental health disorders. These types are:
- bipolar I disorder
- bipolar II disorder
- cyclothymic disorder (cyclothymia)
- substance/medication-induced bipolar and related disorder
- bipolar and related disorder due to another medical condition
- unspecified bipolar and related disorder
With bipolar I disorder, your teen experiences at least one manic episode. They may also have a depressive episode before or after the manic episode. However, bipolar I disorder doesn’t always cause depressive episodes.
With bipolar II disorder, your teen experiences at least one depressive episode and one hypomanic episode. A hypomanic episode is a less intense manic episode that doesn’t significantly impact your teen’s life.
If a doctor diagnoses your teen with bipolar disorder, you, your teen, and their doctor can work on creating an effective treatment plan.
After the doctor has evaluated your teen, they may recommend psychotherapy, medication, or both to treat the disorder. Over time, though, your doctor may change the treatment and management plan to better fit your teen’s needs.
Your teen may benefit from going to therapy. Talking with a therapist can help them manage their symptoms, express their feelings, and have better relationships with loved ones. There are a number of different types of therapy treatments:
- Psychotherapy, also known as talk therapy, can help your teen work out the stress associated with bipolar disorder. It can also help them identify issues they can address during sessions. Teens with bipolar disorder can have individual sessions or go to group therapy sessions.
- Cognitive behavioral therapy can help your teen learn problem-solving skills and ways to turn negative thoughts and behaviors into positive ones.
- Interpersonal therapy is also known as interpersonal and social rhythm therapy. It focuses on minimizing family disputes and disruptions in daily routines or social rhythms that might trigger new episodes.
- Family-focused therapy helps families work through intense emotions and stresses. It also promotes family problem solving and conflict resolution. It’s considered the best type of therapy for children.
Your teen’s doctor will discuss medication options to help you find the medications that may be most appropriate for your teen. Doctors most commonly prescribe drugs called mood stabilizers and atypical antipsychotics to treat bipolar disorder.
Depending on how complex their disorder is, your child may take more than one type of medication. The National Institute of Mental Health recommends that children take the fewest medications and smallest doses possible to manage their symptoms. This treatment philosophy is often referred to as “start low, go slow.”
You should talk to your teen’s doctor about the medication treatment plan they’re prescribing so that you’re as informed as possible. Be sure to ask:
- why they’re recommending a certain medication
- how the medication should be taken
- what the short-term and long-term side effects are
- what over-the-counter drugs your teen cannot take while on the medication
If your child has just been diagnosed with bipolar disorder, you probably want to know what you can do to help. Parents and loved ones can help their teen cope by following these steps:
- Educate yourself about bipolar disorder. Read articles and journals, as well as books, such as The Bipolar Teen: What You Can Do to Help Your Child and your Family by David Miklowitz and Elizabeth George. Reading about bipolar disorder can help you learn more about what your teen is experiencing and how you can effectively help.
- Be patient and kind. You may get frustrated with your teen, but be sure to be calm and patient so that they feel supported.
- Encourage your teen to open up. Let them know that it’s alright to talk about what they’re going through and that your home is a judgment-free zone. This can help strengthen your relationship.
- Listen to your teen carefully and with compassion. Your teen feels loved and supported when they know you’re listening to their feelings with an open heart.
- Help keep track of their moods and symptoms. You and your teen can work together to keep track of how your teen feels and the intensity of their moods. This can help you, your teen, and their therapist better understand the disorder and make necessary changes to their treatment.
- Help them develop a daily routine and a healthy lifestyle. Eating right, sleeping well, and avoiding drugs and alcohol helps your teen better manage their disorder. And establishing a daily routine helps your teen develop that healthy lifestyle. You can help your teen by encouraging them to:
- keep a daily schedule
- prepare what they need for each day
- develop healthy eating habits
- develop healthy sleep habits
- socialize with friends and family
- spend at least 30 minutes per day working out to enhance overall health
Teen Mental Health, an advocacy and resource group, provides a detailed checklist your teen can reference as they work to create a routine to improve their mental and physical health.
Teens with bipolar disorder benefit greatly from a safe and nurturing support system. It helps them cope as they learn to live with their mood disorder. In addition to providing support at home, you can help your teen by getting involved with the following types of programs.
Individualized education programs (IEPs)
Teens with bipolar disorder can suffer in school if their symptoms are left untreated or are poorly managed. Developing an IEP helps the faculty at your teen’s school make the right changes to help your teen deal with their symptoms. Having an action plan helps your teen receive a full education.
Your plan should include effective learning methods and what to do when your teen has certain symptoms. Talk to your teen’s school for more information on putting together an IEP.
Being able to connect with other teens who have bipolar disorder can bring a sense of relief and comfort to your teen. You can facilitate this by finding a core peer group for your teen.
With a core peer group, your teen can confide in people who experience similar stresses, pressures, and stigmas associated with their disorder. Help your teen find peers online and in your community by reaching out to local advocacy nonprofits or searching through Facebook for peer support groups.
Caring for a teen with bipolar disorder can also cause stress for parents and loved ones. You have to cope with your teen’s erratic behaviors and other challenging problems.
As a caregiver, you also need to take care of yourself. Join caregiver support groups for support or attend family therapy sessions so you can share your feelings with your teen in a safe space. You can be a better caregiver when you’re honest about your needs and emotions.
If you think your teen might have bipolar disorder, talk to their doctor right away. The sooner your teen starts treatment, the sooner they can start to manage their symptoms.
And if your teen has recently been diagnosed with bipolar disorder, try to look at it as an opportunity. You now have a better understanding of your teen’s behavior, and with that comes the chance to help your teen learn to manage their symptoms and start to build a stronger, healthier life.