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Teen Health

More Than Mood Swings: Bipolar Disorder in Teens

Parents are often exasperated by their moody teenagers. After all, teens are known to be irritable, to sleep a lot and to resist authority figures. So how can a concerned parent determine when a teenager is just being a typical teen and when their child has a mental illness such as bipolar disorder?

Bipolar teenagers can have dramatic mood changes within a single day and may have different symptoms than adults. Below, Dr. Barbara Geller, a professor of psychiatry at Washington University in St. Louis, discusses how to recognize and treat bipolar disorder in adolescents.

What is bipolar disorder?
The specific definition for bipolar disorder includes certain symptoms that patients must have to make a diagnosis. Bipolar people have to experience both depressed and manic episodes. For example, to fit the depressed part, a teen would need to be sad, to lose enjoyment in usual activities, to have trouble sleeping and eating, to be guilt-ridden or suicidal. To fit the manic part, they'd have to have elation: a mood of being happy as if the most wonderful thing in your life is happening except it's on a day that's like any other day. Parents will often see their child get suddenly silly, giddy, joking without an apparent reason.

How can parents distinguish between a moody teenager and a mood disorder?
It's extremely important for parents to get a professional evaluation if they have any suspicion. If it is not evaluated, and you let it go on, it can devastate a child's life. The consequences for a lack of treatment can be great: suspensions from school, sexually transmitted diseases, depression and even suicide. So it's very important, especially in families with a history of bipolar disorder or depression, for parents to seek professional help at the first sign of any suspicion.

When does bipolar disorder usually first appear?
It's really only been in the last decade that people have started to pay attention to bipolar disorder in young children and early adolescents. So many adults looking back realize that they had the illness, but it may not have been recognized at that time. It's estimated from current studies that maybe as many as half of adults who have bipolar disorder had it before they were 17 years old.

How is the bipolar disorder different in younger children?
In adults, what people are used to thinking is that there will be a discrete episode with a clear onset and a clear offset. You generally have mostly a high or a low, and people function somewhat better between episodes.

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