Bipolar disorder typically begins in the adolescent years. However, the signs are often chalked up to typical teen hormones or moodiness, or misdiagnosed as depression, anxiety, or ADHD. Therefore, it’s essential for parents and healthcare professionals to become familiar with the symptoms of bipolar disorder in teens.
Research shows that bipolar disorder impacts up to 3 percent of teens. And the majority of those individuals start experiencing symptoms as teens or young adults.
- There are two main types of bipolar disorder: Bipolar I disorder and Bipolar II disorder. Each includes manic episodes and depressive episodes.
- Causes of bipolar in teens include brain function, genetic factors, and childhood experiences.
- Bipolar disorder in teenagers is often mistaken for other mental health conditions or dismissed as typical teen behavior.
- Cognitive Behavioral Therapy and family therapy are effective components of treatment for bipolar disorder in teens.
Am I Bipolar or Am I Depressed?
Adolescence is a tumultuous time. Therefore, the extreme mood swings of a teen with bipolar disorder may be mistakenly classified as normal teen behavior or as other teenage mood disorders like depression. That’s why it’s so important for the adults in a teen’s life to pay close attention to shifting moods that seem unusual or out of control. This will help them to identify early signs of bipolar disorder.
The biggest difference between depression and bipolar disorder is that bipolar in teens also includes manic episodes. People with bipolar disorder, formerly known as manic depressive disorder, shift between “high” periods of mania and “low” times of depression. Each individual with teen bipolar disorder experiences the condition differently. The nature, speed of onset, and duration of symptoms can vary from person to person. In addition, signs of bipolar in teens may be different than adult symptoms.
Prevalence of bipolar disorder is about equal in males and females. However, in males, the first bipolar episode is more often a manic one. And females are more likely to have a depressive episodes as the first sign of bipolar. Therefore, bipolar in teenage girls may be mistaken for major depression. Moreover, early signs of bipolar disorder in young adults may resemble symptoms of Borderline Personality Disorder. Both disorders may include symptoms such as impulsive behavior, intense emotions, and suicidal thoughts.
Types of Bipolar Disorder
There are two main types of bipolar disorder: Bipolar I disorder and Bipolar II disorder. A teenager’s specific diagnosis depends on the nature of their type of bipolar and their mood fluctuations.
Bipolar I is characterized by manic periods interspersed with times of either depression or relative emotional stability.
Also known as “episodes,” the cyclical ups and downs experienced by an individual with bipolar disorder may occur over a span of days, weeks, or even years.
However, the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition) identifies four additional types of bipolar disorder:
- Cyclothymic disorder (cyclothymia): diagnosed after one year of bipolar in teens (two years in adults) of multiple periods of hypomania and periods of moderate depression
- Substance/medication-induced bipolar and related disorder
- Bipolar and related disorder due to another medical condition
- Unspecified bipolar and related disorder
What Age Does Bipolar Start?
In general, when is bipolar disorder diagnosed? According to the National Institute of Mental Health, bipolar disorder symptoms start during late adolescence or early adulthood. The average age of onset is debated among researchers. The DSM (Diagnostic and Statistical Manual of Mental Disorders, 5th ed.) lists the average ages of onset for bipolar disorder as 18 years old for bipolar disorder I and mid-20s for bipolar disorder II.
However, experts say that symptoms of bipolar disorder in teenagers can show up as early as age 14 or even younger. While it can be difficult to diagnose bipolar disorder in children, early identification and treatment can be extremely helpful in managing a teen’s symptoms as they age. Parents who think their child may be showing bipolar teenager symptoms should schedule a mental health evaluation.
The effects of bipolar disorder are cyclical rather than constant. Therefore, teens with bipolar disorder may experience extended periods of time—sometimes as long as years—during which they enjoy relatively stable moods. With the right combination of therapeutic interventions, teens with bipolar disorder can learn to manage the condition and live healthier, more balanced lives.
Symptoms of Bipolar Disorder in Teens
Signs of bipolar in teens include both manic symptoms and depressive symptoms. Here are some of the signs of bipolar in teens during manic episodes and depressive episodes.
Generally, manic episodes last at least a week, with manic symptoms occurring on a daily or near-daily basis. Although feelings of intense energy and euphoria are typical markers of a manic episode, mania differs drastically from a typical good mood.
Manic episodes occur seemingly at random, uninfluenced by outside factors. Teens experiencing bipolar manic episodes may show signs such as:
- Exhibiting an inflated sense of self-esteem
- Engaging in risky behaviors
- Appearing more motivated to accomplish goals
- Acting immature and giddy
- Being irritable and short-tempered
- Speaking and moving rapidly
- Difficulty concentrating
- Having trouble sleeping but not feeling tired
While similar to manic episodes, hypomanic episodes are not as severe. Therefore, they are less likely to disrupt a teen’s daily life. Mental health professionals generally associate hypomania with periods of sociability and productivity. However, hypomania can be just as distressing as manic episodes. This is because hypomania is difficult to control and can lead teens to engage in dangerous or self-destructive activities, such as drug use, unprotected sex, or delinquent behavior.
A depressive episode of bipolar may resemble clinical depression. During depressive episodes, individuals with bipolar disorder feel atypically sad and low. Depressive symptoms associated with bipolar disorder in teens may include the following:
- Insomnia or oversleeping
- Eating too much or too little
- No desire to take part in activities that usually bring them joy
- Physical symptoms like headaches, stomachaches, or chronic pain
- Feelings of guilt or worthlessness
- Problems concentrating and making decisions
- Extreme sadness
- Suicidal thoughts.
Some individuals with bipolar disorder also experience psychotic symptoms, such as hallucinations, delusions, disordered thinking, and dissociation from reality.
Causes of Bipolar Disorder in Teens
Genetic, environmental, and neurological factors contribute to bipolar in teens. Here are some of the causes of bipolar determined by researchers.
Bipolar disorder occurs due to the brain’s inability to properly regulate one’s moods. Thus, experts believe that imbalanced levels of neurotransmitters can increase one’s risk of developing the disorder. One study compared the MRIs of 2,447 adults with bipolar disorder and 4,056 healthy controls. The results showed thinning of gray matter in the brains of patients with bipolar disorder when compared with the controls. Moreover, researchers believe that experiencing concussions or traumatic head injuries may increase the risk of developing bipolar disorder.
Furthermore, individuals whose immediate family members are bipolar have an increased likelihood of developing it as well. Teens with a parent who is bipolar have a 15 to 30 percent risk of developing the condition. However, if both parents have bipolar disorder, the risk that the child will inherit it increases to 50 to 75 percent.
A number of environmental factors can trigger and exacerbate symptoms of teen bipolar disorder. Stress, conflict, abuse, and other forms of trauma have been linked to bipolar. The research is clear that childhood trauma leads to more severe bipolar disorder with more frequent episodes. In one study, individuals with bipolar disorder who had experienced childhood maltreatment had an earlier age of onset and greater mania and depression severity, as well as a higher risk of suicide attempts. In addition, they were more likely to also have PTSD, anxiety, or substance use disorders.
How Is Bipolar in Teens Treated?
Treatment for bipolar disorder vary depending on the teen’s symptoms and other factors. However, treatment for bipolar disorder can include a combination of the following approaches:
- Talk therapy, both group and individual
- Medication, such as mood stabilizers
- Psychoeducation, so teens can understand the nature, cause, and management of their symptoms
- Cognitive Behavioral Therapy, to guide patients in transforming negative thoughts and behaviors into positive alternatives.
- Family therapy—an increasingly common component of treatment for bipolar disorder. Family-focused therapy provides an opportunity for a teen’s entire support network to play an active role in the healing process.
Treatment for bipolar disorder in teens may also include treatment for co-occurring mental health diagnoses, such as ADHD, anxiety, or substance use disorder. Scientists have found that approximately 57 percent of adolescents with bipolar disorder also have co-occurring ADHD.
Treatment for Bipolar Disorder in Teens at Newport Academy
At Newport Academy, we help teens build self-knowledge and process trauma that may be contributing to the severity of teens’ bipolar disorder. Our family therapy helps families build trust and stronger communication skills, so parents can serve as support systems for teens when they are struggling.
We also support teens to replace unhealthy coping mechanisms they may be using to deal with the symptoms of bipolar disorder. These might include alcohol and drug abuse, self-harm, and other self-destructive behaviors. Instead, adolescents learn new ways of thinking and new, healthy behaviors that support them to manage bipolar episodes.
Contact us today to schedule a mental health evaluation and get started on the path to healing.
Frequently Asked Questions
What are signs of bipolar in a teenager?
Early signs of bipolar in teens include extreme mood swings and periods of depression interspersed with periods of manic behavior.
What can be mistaken for bipolar disorder?
Bipolar disorder in teens is sometimes mistaken as clinical depression, ADHD, or anxiety. Early signs of bipolar disorder in young adults can resemble symptoms of borderline personality disorder.
What can trigger bipolar disorder?
Research shows that experiences of intense stress or trauma can catalyze bipolar episodes. People with bipolar who have experienced childhood trauma typically have earlier ages of bipolar onset. more extreme symptoms, and more frequent episodes.
At what age does bipolar start showing?
People typically develop bipolar in adolescence or young adulthood. Bipolar symptoms in teens usually manifest at age 14 or older.
How is bipolar disorder treated?
Treatment for bipolar in teens and young adults can include talk therapy, psychoeducation, and/or mood stabilizers. In addition, family therapy helps build a strong support system so teens can turn to their parents for help when they are struggling.
Int J Bipolar Disorder. 2021; 9(3).
Ther Adv Psychopharmacol. 2018 Sep; 8(9): 251–269.
Child Adolesc Ment Health. 2013 Sept; 18(3): 10.1111.
Psychiatry (Edgmont). 2008 Jun; 5(6): 34–42.