Adolescent mental bipolar disorder often doesn’t display the classic extreme highs and lows immediately.
Behavior
Bipolar disorder in teens
Adolescent mental bipolar disorder often doesn’t display the classic extreme highs and lows immediately.
Instead, teens may seem to be experiencing a depressive episode. This can appear as extreme tiredness and exhaustion, confusion and brain fog, and feeling like they have failed. During these initial episodes, suicidal ideation may occur. As these symptoms are so clearly associated with major depression, treatment may be given for depression only. A manic episode leading to a bipolar disorder diagnosis may not happen for weeks, months, or even years after this point.
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What are the symptoms of bipolar disorder?
Aside from the initial symptoms, there are many other signs of bipolar disorder. These can include:
Depression
As we have mentioned, a low mood that seems like severe depression is the first and most prominent symptom. This can also occur as part of bipolar disorder at any time. Bipolar depression is subtly different from depression alone. While a person may feel irritated, sad, and tired, they may also show exaggerated and untrue beliefs. These can include feelings of failure not associated with fundamental failures, unexpected or disproportionate guilt, confusion, and brain fog. Those with bipolar depression may feel extreme fatigue and move or speak much more slowly than usual.
Mania
Mania is not a slow process that can be easily missed. A manic episode can be highly disruptive and dangerous. This is especially true for teens, who might engage in risk-taking behaviors. Teens may talk or behave grandiosely (making grand plans, seeming to have a sudden increase in self-esteem), and may feel euphoric. You might notice that they speak, move, and think more quickly than usual, and are also more irritable.
Not sleeping or eating can be expected during these episodes, causing further erratic behavior, and they can result in hospitalization.
Hypomania
Hypomania is still mania but is less evident than outright mania. Because hypomania has less extreme symptoms, it can often be missed or seen as someone getting “back on track” after a depressive episode. With hypomania, a person may seem chatty and upbeat and show great productivity and focus. They may also be a little irritable, but nothing that would raise alarm bells – especially in teens who often display these tendencies anyway. Teens experiencing hypomania usually don’t find that their lives are being disrupted and may not see anything out of the ordinary with their behavior.
Mixed episode
A mixed episode is when someone experiences both different sides of bipolar disorder. Mania and depression symptoms will both be evident at the same time. For example, someone may feel very low and have feelings of guilt or failure but will also speak highly quickly and jump from one thought to the next. They may feel irritated, jittery, and anxious.
Psychosis
In extreme cases of depression or mania, psychotic features may be evident. These might include delusions and incorrect beliefs. A person may also experience hallucinations which can impact any sense. Such breaks from reality can occur during or after the first bipolar episode but can also be present during subsequent episodes.
How is bipolar disorder diagnosed in teens?
Due to the slow emergence of bipolar disorder, family observation is a powerful tool in diagnosis. Teens should be monitored and described over time to reach an accurate conclusion. That said, an expert in the mental health field is necessary to diagnose and treat bipolar disorder. An accurate diagnosis needs to be reached as quickly as possible, as leaving bipolar disorder untreated can lead to higher risks to the person’s well-being.
It is worth noting that in some cases, it is believed that disorders, children, and teens can find themselves with the wrong diagnosis and treatment plan. Initial symptoms can be depression, whereas the euphoria and impulsivity of mania or hypomania might be diagnosed as attention-deficit hyperactivity disorder (ADHD) in teens and younger children. Those who display psychotic features may also face misdiagnosis with schizophrenia. Anxiety diagnoses can be common for teens displaying some milder symptoms.
Of course, in some cases, less obvious bipolar disorder may be reduced to hormones and teenage misbehavior and not treated at all.
Risks associated with bipolar disorder
Without proper treatment, bipolar disorder can increase risks to a teen’s health and well-being, as well as the well-being of those around them. They may not partake in self-care activities needed to keep them healthy and might fall behind in school. This can lead to lifelong consequences to their success and trigger worse self-esteem and confidence in the future. There are also substantial risks during manic or psychotic episodes, where teens may engage in hazardous behavior. Getting into fights, being arrested, and putting themselves in dangerous situations can all occur. Just one instance of this can have devastating consequences.
In the long term, those with untreated and unmonitored bipolar disorder are more likely to turn to substance abuse and are at a higher risk of suicide. Early intervention is essential to mitigate these risks and establish coping strategies for patients, educators, family members, and friends.
Myths and misinformation
While misdiagnosis can occur, finding an accurate diagnosis is another severe issue. Bipolar disorder can be entirely misunderstood, with inflammatory portrayals in popular media and a general lack of knowledge surrounding it. Some adolescents may believe that bipolar disorder only impacts adults or that bipolar disorder needs to have a root “cause.” Bipolar disorder may be more likely to occur if a teen has a close relative with bipolar disorder, and symptoms can worsen due to trauma – but trauma is not a straightforward cause. Therefore, those who cannot pinpoint a traumatic event or series of events should still be assessed if displaying signs of bipolar disorder.
Others might think that bipolar disorder is as simple as being “moody” and that they can snap out of it. However, this isn’t the case. Nor should treatment for bipolar disorder be considered a “cure,” and that medication and therapy will only be temporary. Talking to a professional is the best way to dispel these myths and understand the reality of bipolar disorder.
Is bipolar disorder curable?
Bipolar disorder is a lifelong diagnosis. As it is a chronic disorder, it is not considered curable. Those who are undiagnosed or do not seek the correct treatment options may struggle throughout their lives. However, bipolar disorder can be successfully managed with medication and therapy-based treatment options.
Treatment for bipolar disorder
There are many well-established treatment options for adolescents and adults with bipolar disorder. In most cases, the best treatment plan includes medication and therapy on an ongoing basis.
Medication for bipolar disorder
Medication has proven to be highly effective for teens with bipolar disorder. Mood stabilizers are used to help mitigate and manage symptoms. These can include lithium and anticonvulsants. Mood stabilizing medication is utilized to treat the manic episodes associated with bipolar disorder and can also reduce the depressive episodes experienced. However, antidepressants may be necessary for conjunction with mood stabilizers. Finding the correct balance can be challenging, and this will be closely monitored by a medical and psychiatric professional. In teens mainly, atypical antipsychotics may be used to help manage symptoms. It is essential to consider that medication may need to be changed throughout a person’s lifetime as their body and mind are trauma. The focus is reducing trauma and anxiety associated with the disorder at home.
Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy (CBT) focuses on the individual and gives them the resources to change their negative and false thought patterns. It can build an internal understanding and recognition of episodes and support healthier thinking. This is exceptionally important for teens struggling with exaggerated feelings of guilt or shame around their disorder.
Interpersonal and Social Rhythm Therapy (IPSRP)
Interpersonal and Social Rhythm Therapy (IPSRP) is excellent for teens struggling with executive dysfunction. Bipolar disorder can make it hard for teens to practice self-care and stick to routines; this therapy helps them build a schedule. This can include self-care like sleeping regularly, ensuring they attend school, and making time for their social life. As bipolar disorder can disrupt regular routines, IPSRP provides a robust framework that can reduce stress and lower the number of episodes a teen experiences.
Bipolar disorder is a severe and chronic disorder steeped in negative myths. This can be upsetting and difficult for newly diagnosed teens, but it is essential to understand that bipolar disorder can be managed. With the correct treatments, those with bipolar disorder can live healthy and happy lives throughout adulthood and even thrive. Both medication and therapy can be used to achieve these positive outcomes.
If you suspect that your teen or a child in your classroom may have bipolar disorder, the most important thing is to begin the diagnosis and treatment process early. This means that they and you have the tools to understand and care for their mental health.
