Identifying Bipolar Disorder In Teens: Why Early Treatment Is Important

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Moody behavior is a part of growing up. But if your teen’s mood swings become explosive, abrupt, and include sleep disruption, it could signal bipolar disorder, a serious brain disorder also known as manic depression.

“Bipolar disorder is a chronic, severe mood disturbance,” explains Mark Casdorph, DO,  with Upper Valley Outpatient Behavioral Health. It usually is diagnosed before age 18 and is recognized by behavior that is substantially different than that in other kids, he adds. 

How To Recognize Bipolar Disorder

Symptoms of bipolar disorder typically include explosive swings in behavior which last at least seven days:

Manic or “high” behaviors may include:

  • Inflated self-esteem
  • Grandiose thoughts
  • Acting very happy and silly
  • Talking very fast and changing subjects often
  • Lack of sleep, yet don’t feel tired
  • Increased activities
  • Risky behavior

Depressive or “low” behaviors may include:

  • Easily distracted
  • Extreme irritability
  • Anger outbursts
  • More sleep than usual
  • Restlessness
  • Sadness, thoughts of death
  • Complaints about pain

“Everybody gets irritable at times,” says Dr. Casdorph. “It's normal to have some irritability, but an abrupt change, like an extended period of profound irritability or anger outbursts, isn’t normal and could signal bipolar disorder.” He likens it to “a volcanic eruption of emotions that lasts an extended period of time.” Recent studies have found that anxiety and worry also are hallmarks of bipolar disorder.

Diagnosing Kids Can Be Tricky

A bipolar disorder diagnosis is sometimes difficult with kids, says Dr. Casdorph, “because they can't always explain that their thoughts are racing, or admit that they're doing certain behaviors that are inappropriate.” There’s also a lot of overlap between bipolar disorder and other conditions that you see in kids, he says. “Like ADHD. In fact, most kids who end up being diagnosed with bipolar disorder were first labeled with ADHD because hyperactivity and inattentiveness are common features in both conditions. One big distinction between the two is in bipolar disorder, you have a disturbance of sleep that's abruptly different. The teen may sleep less yet still has plenty of energy to go around. And bipolar kids are more explosive than ADHD, and they have more episodes of outbursts.”

One of the main risk factors for bipolar disorder is genetics, says Dr. Casdorph. “Chances are, there's somebody in the family that has had these kinds of problems. Because of that, many parents are at least aware of the concept.”

Treating Bipolar Disorder

There is no way to effectively treat bipolar disorder without medication, according to Dr. Casdorph. “A lot of parents are afraid the medication will zombify their child. We don't do that. That's absolutely not acceptable,” he says. “You can effectively treat people with bipolar disorder without having significant side effects, and that should be expected.”

In addition, anyone with bipolar disorder needs to be educated about properly caring for themselves. Maintaining a regular sleep-wake cycle, and avoiding certain things — including other medications that could make them manic — are two examples. “These are all easily learned, but you have to start early in the process. Using a combination of medication and education is the appropriate method for treating this,” explains Dr. Casdorph.

Early Diagnosis Is Best

According to Dr. Casdorph, researchers have found that the earlier the diagnosis and the sooner treatment begins, the fewer problems the child will have into adulthood. “There is no cure yet for bipolar disorder, but we’ve found that 90 percent of kids who are diagnosed with bipolar disorder as a child have a long and happy life if they use their medications properly and receive the proper education about their condition,” he says. 

Because bipolar disorder can be devastating to the entire family, Dr. Casdorph believes family counseling is necessary. “The entire family, especially parents, needs to know exactly what is going on and what to expect. They need counseling to understand the gravity of the situation and how best to manage it.”

With proper treatment, bipolar children and teens can have a normal life. They can have lots of friends, avoid trouble at school, get good grades, control their anger, sleep regularly, and avoid mood issues, says Dr. Casdorph. “Their minds can be at rest without the chaos they had before,” he adds.

To learn more about bipolar disorder, talk to your doctor or health care provider or search for a provider.

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