Bipolar disorder often starts in teens—but goes undiagnosed for years.
Like many mental health conditions, bipolar disorder often begins in the teenage years, but goes undiagnosed until young adulthood. This may mean that teens may suffer with symptoms for years. It can sometimes be harder to treat mental illness if many years have passed with the symptoms. To make it worse, untreated bipolar disorder can often result in risky behaviors that have serious consequences. For this reason, it's important to identify the symptoms of bipolar disorder in teens.
Symptoms of Bipolar Disorder in Teens
Although the symptoms in teens are similar to those of adults, they may be harder to identify. Sometimes, parents mistake the symptoms for teenage moodiness and rebellion.
The majority of people with bipolar disorder spend more time in a depressive state (as opposed to a manic episode). Symptoms of a depressive episode in teens include:
- Low mood and energy
- Loss of interest in things they usually enjoy
- Slowed speech and movement
- Feelings of guilt and worthlessness
- Sleeping more or less than usual
Note that teens may be less able than adults to identify what they’re experiencing. When you ask them what's wrong, they may have a hard time putting their thoughts into words. For some teens (especially boys), the symptoms of depression may manifest as anger and irritability. (Learn more here about how depression symptoms vary by gender.)
Contrary to myths, people with bipolar disorder don't bounce rapidly from depression to mania. You only need one manic episode in your medical history to get a diagnosis of bipolar disorder (as opposed to unipolar depression). Symptoms of a manic episode in teens include:
- High mood and energy levels
- Exaggerated sense of importance (grandiosity)
- Rapid speech
- Being easily distracted
- Sleeping less without feeling tired
- Impulsive actions
- Risky behaviors
- Increased goal-directed activity
Grandiosity means having an inflated sense of talent, power, or importance that is out of touch with reality. It is different than just being arrogant or confident because manic grandiosity is a departure from their usual personality. You might hear a teen in a manic episode brag that they are the best in a sport, tell authority figures what to do, or report having superpowers.
Goal-directed activity refers to purposeful activity, such as homework, chores, or creative endeavors. Adolescents in a manic episode may spend an increased amount of time painting or drawing, multitasking, or completing household chores.
Hypersexuality refers to increased sexual activity that is inappropriate for their age. In adolescents, it may look like drawing or looking at nudity, engaging in sexual acts, or masturbation.
Helping Your Child or Teen
You’re never too young to get help for a mental health condition. It can be scary to suspect that your child has bipolar disorder, but visiting a doctor or mental health professional can help your child get an accurate diagnosis and start treatment, if needed. Early treatment may help prevent the condition from worsening and minimize the consequences of risky decisions. That way, they can enter adulthood with confidence and control over their disorder.
If you or someone you know is thinking about suicide, you can call the National Suicide Prevention Lifeline at 1-800-273-TALK for free and confidential help 24 hours a day.
Marc Lener, MD, is a psychiatrist and founder of the Singula Institute in New York City