Understanding bipolar disorder in teens

Bipolar disorder is a condition that affects the brain’s ability to regulate moods. It can cause a teenager to experience intense mood swings, ranging from depressive episodes to extreme elation.

Teenagers often face a range of emotions during adolescence, from feeling excited and energised to feeling overwhelmed or irritable. It can be tricky to tell when a teenager is dealing with more than the normal range of emotions and whether professional help is needed.

It's important to pay close attention to the teenager's moods, as well as any changes in their behaviour that may indicate the need for additional support. If a teenager is showing signs of bipolar disorder, depression, anxiety, or other mental health issues, it's important to reach out to a mental health professional for help.

Bipolar disorder symptoms in teens

The signs of bipolar disorder in a teenager can vary significantly from one person to another, however, there are some common symptoms that are typically experienced. These symptoms can be grouped into three categories. These include:

• Depressive episodes
• Mania
• Hypomania

Bipolar disorder in teens can vary but will often include sudden and extreme shifts in mood, such as extreme highs (mania) or lows (depression), changes in sleeping patterns, changes in appetite, difficulty concentrating, impulsivity, irritability and changes in energy levels.

Additionally, some teens may also experience anxiety, periods of paranoia, and thoughts of suicide or self-harming behaviours. It's important for parents, teachers, and healthcare providers to be aware of these signs, as early detection and intervention is essential for treating bipolar disorder.

There are four types of bipolar disorder that a teenager can struggle with. These are:

• Bipolar type 1
• Bipolar type 2
• Rapid cycling bipolar
• Cyclothymia

Out of these four types, bipolar types 1 and 2 are the most common. The image below shows the differences in the symptoms a teen might experience depending on which type of bipolar disorder they're struggling with.

Depressive episodes

A teenager with bipolar disorder is likely to experience depressive episodes featuring low moods, lack of motivation, and difficulty concentrating, before they have an episode of mania or hypomania.

When they do have a depressive episode, you'll typically see the following signs:

• Low mood and intense sadness
• Lack of energy
• Lack of interest in activities they usually enjoy
• Changes in their appetite
• Changes in their sleeping pattern
• Feeling worthless, hopeless or guilty
• Lower levels of concentration
• Suicidal thoughts

You can read more about depression and teens here.

Manic episodes

During a manic or hypomanic episode, a teen may feel full of energy, have racing thoughts, or become impulsive or overly talkative.

Manic episodes typically last for at least 7 days. During this time, you may see the following signs:

• Euphoria
• Exaggerated optimism
• Less need for sleep
• Difficulty concentrating
• Noticeable increase in energy
• Risky or reckless behaviour
• Aggression and/or violence

Hypomanic episodes

Symptoms of hypomania can be similar to mania, but they'll be less extreme. Typically, a person will experience the following:

• Increased energy
• Less need for sleep

During a manic or hypomanic episode, a teenager may also become irritated with people around them.

Diagnosing bipolar disorder in teenagers

Diagnosing bipolar disorder can be a complex process and needs careful, extended and multiple observations. An expert diagnostician will need to carefully review symptoms and determine the treatment needed.

Priory has expert child and adolescent psychiatrists who are able to provide an thorough assessment and ongoing monitoring. Following a diagnosis, we can offer education about bipolar disorder to the young person and their family, which can be through family therapy. Family therapy can help bring out everyone's strengths to help the young person recover and stay well.

We can also offer individual therapy to teach the young person skills to manage their mood changes and prevent unhealthy thought processes that can exacerbate their condition; this may be in the form of cognitive behavioural therapy (CBT).

If necessary, we can also offer different types of medication for bipolar disorder, prescribed by our specialists. We'll also be able to monitor the young person's medication, mental health and risks.

Supporting a teenager with bipolar disorder

Life can change a lot during adolescence, from starting college or work, to making new friendships and possible romances. When you’re supporting a teenager with bipolar disorder, it’s important to try and find the right balance. This can mean avoiding being overly cautious, as this could potentially cause your teenager to become avoidant or isolate themselves.

If a teen is struggling to talk about how they’re feeling, suggest forming a communication system that involves less talking but allows you to keep an eye on them. You may want to use a traffic light system for communicating. Sit down with your child when they are calm and say to them: “If you say or text you are the colour ‘red’, what will that mean?” The young person may say: “’Red’ means I'm struggling.” You can then ask how the child would like you to react if they're in a ‘red’ frame of mind.

A teenager struggling with bipolar disorder might not want to be asked lots of questions but they might not want to be left alone either. It might be that they’d  like to watch a film or walk the dog with you until they feel they're at an ‘amber' level.

Parents can do the same if the child describes their mood as ‘amber’ (less high risk than ‘red’) and ‘green’ (low risk), and then there will be a plan in place for communication about risks that makes everyone feel safer.

Remind your child that you love them unconditionally and let them know that they can contact a supportive charity such as ChildLine or the Samaritans anonymously by telephone or via a web chat if they need a confidential discussion.

When your teenager has bipolar disorder, you might also find it useful to connect with others who are going through a similar experience. It’s important to find support for both your teenager and yourself to help you both learn how to cope with the condition. Bipolar UK and Mind are both charities that can provide you with peer support.