How To Identify Bipolar Disorder In Teens

Though changes in personality, lifestyle and behavior can all be typical parts of a teen’s journey to adulthood, severe symptoms that affect daily life generally are not. Knowing how to recognize potential signs of a mental health disorder, including bipolar disorder, can help you learn when it may be time to seek help for your teen. In teens, bipolar disorder can lead to significant challenges related to school, mental and physical health, and relationships.  

Around 50% of all chronic mental conditions can begin at the age of 14. Many parents and other caregivers wonder whether their child’s symptoms signal the presence of bipolar disorder. If you suspect your teen may be experiencing symptoms of bipolar disorder, it may help to familiarize yourself with what treatment options are available—and what you can do to act as a system of support.

What is bipolar disorder?

Bipolar disorder is generally considered to be a mental illness that can be characterized by intense mood swings between extreme highs (mania) and lows (depression).

When someone is living with bipolar disorder, their symptoms can often interfere with their ability to function or feel in control of their emotions. This can affect their mood, energy level, behavior and relationships with others. Bipolar disorder typically develops during adolescence or early adulthood.

Causes of bipolar disorder in teens

Doctors and scientists aren't generally sure exactly what causes bipolar disorder. Like other mental health disorders, it can run in families. This may suggest that there may be a genetic component in which someone with a certain gene can be more likely to have bipolar disorder than someone without it.

Experts also believe that environmental factors may trigger the onset of symptoms. Traumatic or significant life events, exposure to substance use, instability at home, and other similar circumstances may lead to the development of bipolar disorder. It can also be possible that some individuals may be biologically predisposed to bipolar disorder. However, environmental factors can be the missing link that can lead to its manifestation.

What are the symptoms of bipolar disorder in teens?

Even healthy children will likely experience ups and downs while learning to navigate the world around them. Teenagers often undergo significant changes in their moods, thoughts, and behaviors as they transition through adolescence and into adulthood. However, when these fluctuations are severe, they can signal the existence of mental health concerns. If a teen feels extreme depression or develops an unusually elevated mood, their symptoms may rise to the level of bipolar I, bipolar II, or cyclothymia. 

Teens living with bipolar disorder may have manic episodes that can feature intense happiness or euphoria, impulsive behavior, and overly inflated self-esteem. A teen’s symptoms may also include changes in sleep patterns, difficulty focusing, and abnormal mood swings.

They may also experience manic episodes that can have the same characteristics but are less severe, which are generally known as hypomanic episodes. Finally, it can also be possible to experience depressive episodes in which they express intense sadness, disinterest in activities, frequent bodily complaints, and irritability (among other things). 

Symptoms of manic episodes

Mania is generally thought to have symptoms that can be related to changes in a person's energy and mood. If mania is severe, a teen can experience psychosis, which is characterized by hallucinations, delusions, and disorganized thinking. Some possible symptoms of mania can include:

• Elation

• Excessive energy

• Increased activity

• Feeling jumpy or uneasy

• Irritability

• Having an exaggerated sense of self-confidence

• Experiencing urges to engage in risky behaviors

• Rapid and disjointed speech

• Racing thoughts

• Heightened sex drive

• General poor judgment

• Hallucinations (all types) 

• Insomnia 

Symptoms of depressive episodes

During depressive episodes, your teen might seem disconnected, often sad or disinterested, and have very little energy. They may have low self-esteem, feelings of hopelessness, or decreased motivation. Depressive symptoms can be clinically significant if they happen about every day for two weeks. During episodes of extreme depression, teens can experience symptoms of psychosis.

Here are some of the symptoms you might notice during a depressive phase:

• Feeling sad or down

• Sleeping more or less than usual

• Eating more or less than usual (and experiencing changes in weight as a result)

• Losing interest in previously enjoyable activities

• Experiencing difficulty concentrating

• Forgetfulness

• Feeling tired or “slowed down”

• Feelings of extreme guilt 

• Experiencing trouble making decisions

• Experiencing low self-esteem

• General relationship problems

• Isolation

• Suicidal ideation or attempts

• Frequent bodily complaints

Other types of episodes

Two other types of episodes that can happen in bipolar disorder are hypomania and mixed episodes. 

Hypomanic episodes generally last at least four days in a row. The symptoms can be similar to mania, but might be less severe overall. They may not seem to cause any problems for the teen at all, at least in the short term. In fact, some teens can get a lot accomplished during hypomanic phases. However, if they engage in risky behavior, hypomania can lead to long-term concerns like unplanned pregnancies and STDs, car accidents, injuries and more. 

In a bipolar episode with mixed features, the teen may have symptoms that fall into both the depressed and manic categories. For example, they might have an extreme amount of energy but feel very sad at the same time.

Related conditions and problems

Teens living with bipolar disorder can face other challenges that may be directly or indirectly related to their condition. They may, for instance, live with other mental health disorders that can exacerbate or trigger their symptoms. For example, bipolar disorder can co-occur with attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder, and panic disorder. Additionally, symptoms of bipolar disorder are similar to those of several other disorders, including persistent depressive disorder, disruptive mood dysregulation disorder, and generalized anxiety disorder. Behavior common to these conditions can make it hard to know which, if any, are the diagnosable disorders.

If your teen is exhibiting signs of a manic or depressive episode, you may have questions, including How is bipolar disorder diagnosed in teens? If they are diagnosed, how will my teen’s bipolar disorder be treated? Below, we’re discussing the mental health care options available to teens who might be living with bipolar disorder. 

How is bipolar disorder diagnosed?

The first step to dealing with possible bipolar disorder in teens can be to seek help from a medical or mental health provider. There are several types of professionals who can diagnose bipolar disorder, including psychiatrists, psychologists, and primary care physicians. The teen’s healthcare provider will likely need to interview them to make an evaluation. The process might start with a rundown of the teen’s health history, as well as the medical history of their family—including discussions about mental health disorders. 

Next, a doctor might make referrals for medical testing and treatment (if needed). They may have the teen take a diagnostic screening quiz to help them to determine the right next step for their needs. 

After this, your teen’s doctor may compare everything they learn from the interview with the diagnostic criteria from the DSM-5. They then might be able to provide a diagnosis themselves, or they might refer your teen to a specialist who can. While you cannot prevent bipolar disorder, an accurate diagnosis and early intervention can help increase the chances of positive treatment outcomes. 

How is bipolar disorder treated?

If a teen’s mental health provider makes a diagnosis of bipolar disorder, treatment can come in many forms. Medications may be prescribed to regulate mood or help with other aspects of bipolar disorder. Treated correctly, symptoms of mania or depression can become more manageable so that a teen can focus on developing strategies for living with bipolar disorder in the long term. Always consult with your child’s healthcare provider prior to starting or stopping any medication. 

A psychologist or social worker may also work with your teen's school to find out how bipolar disorder is affecting the teen there. They might also be able to make accommodations to help the child succeed in school despite any challenges they may face.

A teen’s treatment plan may also involve talk therapy. There are several different therapeutic modalities a mental health professional might utilize when addressing bipolar disorder in a teenager. A teen who is experiencing the effects of bipolar disorder can benefit from family interventions, such as family-focused therapy. Talking about the realities and experiences that stem from living with bipolar disorder can help the family come together to provide better support for the teen, and can help the teen feel validated in their experiences. Additionally, in family therapy the teen can learn to communicate their needs more effectively with their family. When you request a family therapy consultation, consider asking the therapist about their experience working with teens, the modalities they typically utilize, and the disorders they primarily address.  

How can online therapy support a teen living with bipolar disorder?

Psychotherapy can help your teen learn to live with the ups and downs that can come with this mental health disorder. Your teen can then learn to make better decisions and take better care of themselves. Additionally, getting the right help can reduce their chances of experiencing serious side effects or consequences down the road.

No matter what sort of therapy you think your teen may benefit from the most, online therapy options can make receiving professional support fast, easy and convenient for most. Not being limited to professionals local to your area can help you find someone who meshes well with your teen and truly understands their needs. Additionally, online therapy may make finding someone to talk to yourself a more straightforward process, as there’s no need to commute to and from in-person appointments. This can save you time and money.

Is online therapy effective? 

Online therapy can be just as effective as traditional options for managing mental health symptoms. In fact, one 2022 study found that online cognitive behavioral therapy could successfully treat symptoms of depression and anxiety disorders in adolescents aged 11 to 19 years. 

Getting started with treatment sooner rather than later may help your teen develop the skills they may need to navigate life successfully and can support them as they learn to manage the range of possible  symptoms that can be associated with bipolar disorder.