Teens and Bipolar Disorder

By STEVE BRESSERT, PH.D.

Teenagers with bipolar disorder have an ongoing combination of extremely high (manic) and low (depressed) moods. Highs may alternate with lows, or the person may feel both extremes at close to the same time. Bipolar disorder usually starts in adult life, before the age of 35. Although rare in young children, it does occur in teenagers. This illness can affect anyone. However, if one or both parents have bipolar disorder, the chances are 5-10% greater that their children will develop the disorder. Bipolar disorder may begin either with manic or depressive symptoms. The manic symptoms may include:

• severe changes in mood compared to others of the same age and backgroundùeither unusually happy or silly, or very irritable
• unrealistic highs in self-esteem — for example, a teenager who feels specially connected to God
• great energy increase and the ability to go with little or no sleepfor days without feeling tired
• increased talkingùthe adolescent talks too much, too fast, changes topics too quickly and cannot be interrupted
• distractibility — the teen’s attention moves constantly from one thing to the next
• high risk-taking behavior, such as jumping off a roof with the belief that this will not cause injury

The depressive symptoms may include:

• persistent sadness, frequent crying, depression
• loss of enjoyment in favorite activities
• frequent complaints of physical illnesses such as headaches or stomach aches
• low energy level, poor concentration, complaints of boredom
• major change in eating or sleeping patterns, such as oversleeping or overeating

Some of these signs are similar to those that occur in teenagers with other problems such as drug abuse, delinquency, attention-deficit hyperactivity disorder, or even schizophrenia. The diagnosis can only be made with careful observation over an extended period of time. A thorough evaluation by a child and adolescent psychologist or psychiatrist can be helpful in identifying the problems, manic-depressive or other, and starting specific treatment.

Teenagers with bipolar disorder can be effectively treated. Effective treatment for this disorder usually includes education of the patient and the family about the illness, medication such as lithium, andpsychotherapy. Lithium often reduces the number and severity of manic episodes, and also helps to prevent depression. Psychotherapy helps the teenager understand himself or herself, adapt to stresses, rebuild self-esteem and improve relationships.