What is bipolar disorder in teens?

Bipolar disorder is a type of depression.

There are 3 main types of depression:

• Major depression (clinical depression)

• Bipolar disorder (manic depression)

• Persistent depressive disorder (dysthymia)

A teen with bipolar disorder often has extreme mood swings. These mood swings go beyond the day’s normal ups and downs. A teen may have times of great elation, happiness, elevated mood, or irritability. This is called mania. These episodes often alternate with periods of major depression. That is why this disorder has two poles or symptoms.

What causes bipolar disorder in a teen?

Experts don’t know the exact cause of bipolar disorder. But it does tend to run in families. So in some cases, it may be inherited.

Which teens are at risk for bipolar disorder?

A teen is at higher risk for bipolar disorder if another family member has it.  Researchers are still looking for the gene or genes that may cause the disorder.

The disorder often starts in the teen years or early adulthood.

What are the symptoms of bipolar disorder in a teen?

Teens with bipolar disorder often have abnormal mood swings. They shift between depression and mania. These episodes often last 1 or 2 weeks. But symptoms may be different for each teen.

Symptoms of depression may include:

• Lasting feelings of sadness

• Feelings of despair, helplessness, and guilt

• Low self-esteem

• Feelings of not being good enough

• Feelings of wanting to die

• Loss of interest in activities once enjoyed

• Trouble with close relationships

• Sleep problems, such as insomnia

• Changes in appetite or weight

• A drop in energy

• Problems focusing or making choices

• Suicidal thoughts or attempts

• Frequent bodily complaints, such as headache, stomachache, or extreme tiredness (fatigue)

• Running away or threats of running away from home

• Sensitive to failure or rejection

• Feelings of anger, hostility, or aggression

Symptoms of mania may include:

• Overly inflated self-esteem

• Less need for rest and sleep

• Easily distracted

• Very irritable

• Often taking part in high-risk activities that may have harmful results, such as reckless driving, gambling, excessive overspending, unprotected sex, or alcohol and drug abuse

• Very talkative, such as speaking quickly or changing topics a lot

• Very high or euphoric feelings, at times grandiose

• Severe, unpredictable mood changes, such as being abnormally happy or silly

• Heightened sex drive

• Heightened energy level

• Uncharacteristically poor judgment

• Seeing or hearing things that are not there (hallucinations), or believing things that are not true (delusions)

Symptoms of bipolar disorder, especially in a teen, may look like other problems. Make sure your teen sees their healthcare provider for a diagnosis.

How is bipolar disorder diagnosed in a teen?

Bipolar disorder can be hard to spot. That’s because it may look like other health problems, such as depression. A teen must have both depressive and manic symptoms to a varying degree to be diagnosed with bipolar disorder.   

A mental health provider will ask about your teen’s health history and symptoms. They will also do a mental health evaluation before making a diagnosis.

How is bipolar disorder treated in a teen?

Bipolar disorder is a life-long chronic health condition. Treatment will depend on your teen’s symptoms, age, and general health. It will also depend on how severe the condition is.

Treatment can often help a teen with bipolar disorder improve. But it will take time. Treatment may include one or more of the following:

• Mood-stabilizing medicines or antidepressants

• Consistent follow-up with professionals by teen and family

• Talk therapy (psychotherapy)

• Family therapy

• Consultation with your teen’s school

What are possible complications of bipolar disorder in a teen?

Teens with bipolar disorder are at risk for other problems. These include:

• Substance abuse

• Attention-deficit/hyperactivity disorder (ADHD)

• Anxiety disorder

• Behavior and conduct problems

• Suicidal thinking

• Suicide attempts

How can I help prevent bipolar disorder in my teen?

Experts don’t know how to prevent bipolar disorder. In some cases, it may be inherited.

Knowing the risk factors for bipolar disorder, spotting it early, and getting expert help for your teen can help ease symptoms and improve your teen’s quality of life.

How can I help my teen live with bipolar disorder?

Bipolar disorder has no cure. But over time, your teen’s symptoms will get better. Being supportive and patient can help. Here are things you can do to help:

• Keep all appointments with your teen’s healthcare provider.

• Take part in family therapy as needed.

• Secure prescription medicines in a locked cabinet

• If there are guns in your home, keep them unloaded and locked in a gun safe. Secure the ammunition in a locked, separate area. Don't let the teen know the safe combination or where the safe keys are located

• Talk with your teen’s healthcare provider about other providers who will be involved in your teen’s care. Your teen may get care from a team that may include school staff, counselors, therapists, social workers, psychologists, and psychiatrists. Your teen’s care team will depend on their needs and how serious the depression is.

• Tell others about your teen’s bipolar disorder. Work with your teen’s healthcare provider and schools to create a treatment plan.

• Reach out for support. Being in touch with other parents who have a teen with bipolar disorder may be helpful. If you feel overwhelmed or stressed out, talk with your teen’s healthcare provider about a support group for caregivers of people with bipolar disorder.

• Take all symptoms of depression, mania, and suicide threats very seriously. Get treatment right away. Suicide is a health emergency. Talk with your teen’s healthcare provider for more information. Find out who to contact, and what to do if your teen has suicidal thoughts. Have an emergency plan in place.

When should I call my teen’s healthcare provider?

Call your healthcare provider right away if your teen:

• Feels extreme depression, fear, anxiety, or anger toward him or herself or others

• Sleeps for extended periods of time, refuses to eat, isolates from peers

• Feels out of control

• Hears voices that others don’t hear

• Sees things that others don’t see

• Can’t sleep or eat for 3 days in a row

• Shows behavior that concerns friends, family, or teachers, and others express concern about this behavior and ask you to seek help

Call or text 988 if your teen has thoughts of harming themselves or others and the means to carry out the plan. You will be connected to trained crisis counselors at the National Suicide Prevention Lifeline. An online chat option is also available at www.suicidepreventionlifeline.org. You can also call Lifeline at 800-273-TALK (800-273-8255). Lifeline is free and available 24/7.

Key points about bipolar disorder in teens

• Bipolar disorder is a type of depression. A teen with this disorder often has abnormal mood swings that shift between depression and mania.

• The exact cause of bipolar disorder is unknown. But it tends to run in families.

• A teen must have both depressive and manic symptoms to a varying degree to be diagnosed with the disorder.

• A mental health provider makes a diagnosis after a mental health evaluation.

• Treatment may include medicine and talk therapy.

• Home safety is critical. Prescription medicines, firearms, and ammunition should be kept safe in separate, locked areas.

• Teens with bipolar disorder are at risk for suicidal thoughts and suicide attempts. All comments about suicide must be taken seriously and help sought immediately

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.

• Before your visit, write down questions you want answered.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.

• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.

• Ask if your child’s condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if your child does not take the medicine or have the test or procedure.

• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your child’s healthcare provider after office hours. This is important if your child becomes ill and you have questions or need advice.