Adolescent Bipolar Symptoms

Bipolar disorder is a lifelong disease that is diagnosed in 1 percent of all teenagers. It is extremely disabling and disrupts all aspects of life, yet it is frequently misdiagnosed. Recognizing the symptoms as early as possible, then seeking professional help to receive an accurate diagnosis, is the key to improving the outcome.

Two Major Symptoms

• Bipolar disorder used to be called manic depression, which describes the two major symptoms: mania and depression. To be diagnosed with bipolar disorder, there must be recurring changes in mood, repeatedly cycling between mania and depression. The severity and length of the manic and depressive episodes may vary but the mood swings must be evident. The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the medical manual that professionals use to define the symptoms and make a diagnosis.

Manic Phase

• According to DSM the symptoms of mania are persistent, elevated, expansive euphoric or irritable moods for at least one week and with at least one of the following: inflated self-esteem, decreased need for sleep, extreme talkativeness, racing thoughts, distractibility, increased activity or agitation, and daring behaviors.
  Mania affects feelings, thinking patterns, and biological functions. Teens with mania often describe themselves as feeling more active, creative, and intelligent. The teenager with bipolar disorder may experience so many ideas flying through their head that they can't even manage to express what they're thinking. Their energy is so high that they may be unable to remain still for very long or to sleep. They may begin to believe they are invincible, causing them to engage in unsafe activities including substance abuse. At its most severe, those in a manic episode may become delusional or paranoid.

Depressive Phase

• DSM states the symptoms of depression. At least five of the following must be seen the majority of the time for at least two weeks: depressed or irritable most of the time; insomnia or too much sleep; lack of or increased appetite; slow movement or agitation; poor concentration; inability to think; indecision; lack of energy; feeling worthless; and suicidal thoughts.
  On the flip side from mania, the depressive phase is characterized by extremely low energy. Teenagers may be unusually sad and stop engaging in activities that once were normal. Their mind works so slowly that they can't make decisions and they are filled with negative thoughts -- they are not good enough, they are ugly, or they believe they are unable to perform tasks. Teenagers with depression feel extremely hopeless and may decide they no longer want to live. Depression is often accompanied by real physical complaints such as stomachaches or headaches.

Subtypes of Bipolar Disorder

• The different subtypes of bipolar disorder demonstrate the variation that can be seen in symptoms: Bipolar I - typical swings in mania and depression; Bipolar II - slightly less intense mania (hypomania) but with typical mood swings; Bipolar Mixed - mania and depression occur simultaneously; Bipolar Rapid Cycling - many periods of mania and depression; Bipolar with Psychotic Features - classic mood swings plus hallucinations or delusions; and Cyclothymic Disorder - hypomania and mild depression.

Normal versus Symptomatic

• Given the fluctuation of feelings and moods that normally accompany the journey through adolescence, it can be difficult to discern where the issues become symptomatic of a serious disorder. The key is to gauge how much the symptoms interfere with daily functioning. Consider the age, what is typical for the individual, and what triggers the mood. Is their behavior reasonable considering the circumstances? Are they able to control their own behavior when it becomes extreme? Pay attention to the intensity and duration of symptoms, keep records and look for consistent cycling between depression and mania.

Obtaining a Diagnosis

• An awareness of the symptoms is the first step. Following up with a professional to get an accurate diagnosis is the next. It is critical to obtain professional help because bipolar disorder is frequently misdiagnosed. It can be masked by, or confused with, other disorders, such as schizophrenia, major depression, ADHD, oppositional defiant disorder, Asperger's syndrome, and anxiety disorders. Another reason to seek a diagnosis is that the sooner treatment is started, the better the chances are of improving ability to function and the quality of life. Your general practitioner or pediatrician may be the first stop, but don't hesitate to find a mental health professional if symptoms continue.