My recovery from manic depression has been an evolution, not a sudden miracle. – Patty Duke
What is Bipolar Disorder?
Bipolar Disorder is a mood disorder sometimes called manic-depression that involves cycles of sadness and extreme happiness. The moods can shift from happy to sad quickly, or over the course of days or weeks with normal moods in between.
Symptoms of Bipolar Disorder:
There are two main phases of Bipolar Disorder, depression and mania.
Signs of Depression:
- Tired all the time
- Increased anxiety
- Feeling guilty, hopeless, or worthless
- Stuff you once enjoyed isn't any fun
- Harder to concentrate
- Uncontrollable crying
- Hard to make decisions
- Sleeping all the time
- Not sleeping much
- Gaining weight
- Losing weight
- Thoughts of death or suicide
- Trying to kill yourself
Signs of Mania:
- Extreme happiness, elation and excitement
- Feeling like a super-hero or like you have special powers
- Need for little to no sleep for days
- Mood swings
- Speaking really, really fast
- Difficulty with words
- Easily distractible
- Racing thoughts
- High sex drive
- Making huge, impractical plans
- Impulsivity, like deciding to quit a job
- Huge spending sprees
- Impulsive sexual indiscretions
- Abuse of alcohol or drugs
- Other bad decisions
Signs of Hypomania:
Hypomania is similar to the signs of mania but probably less extreme. This is more of a "had too many cups of coffee" feeling, whereas true mania is far more severe.
Still, hypomania may include:
- Periods of time with an especially energetic mood.
- Feeling more self-confident than normal.
- Being very talkative or speaking faster than usual.
- Feeling hyper.
- Having a hard time concentrating.
- Being more irritable or angry.
- Needing less sleep than normal.
- Having more interest in sex.
- Uncharacteristic spending sprees.
Bipolar Disorder doesn't follow a set pattern and can be harder to identify in teenagers, who are more prone to sleep, weight, and mood changes.
Types of Bipolar Disorder
Bipolar I Disorder:
Bipolar I is when manic or mixed episodes last at least seven days, or manic symptoms are so severe they require immediate hospitalization. Generally, someone with Bipolar I also has depressive episodes lasting two or more weeks. Think of it as a light switch being flipped. When the switch is aimed up, the teen is dangerously manic. When the switch is aimed down, they are just as dangerously depressed. The symptoms of depression and the symptoms of mania must be a major change in the teen’s normal behavior.
Bipolar II Disorder:
Bipolar II Disorder is a mood disorder characterized by one or more periods of depression and at least one episode of hypomania, which is a milder high than the mania experienced with Bipolar Disorder.
Because they’re milder, hypomanic episodes may be unrecognized. As a result Bipolar II Disorder is often misdiagnosed as depression. This is especially true when the symptoms are present at an age where streaks of hyperactivity aren't unusual and are even sometimes downright normal.
The risk for suicide is higher for those with Bipolar II than Bipolar I Disorder, probably because it’s often not diagnosed and not treated properly.
Rapid-Cycling Bipolar Disorder - four episodes of major depression, mania, hypomania or mixed symptoms within a year. Some people with Rapid-Cycling Bipolar Disorder have one or more episodes a week or even a day. This seems to be a more common form of bipolar disorder in those who have severe bipolar disorder and may be more common in those who were diagnosed with bipolar disorder at a young age.
Cyclothymic Disorder - mild form of bipolar disorder, in which two episodes of hypomania alternate with episodes of mild depression for at least two years. The symptoms of a person with Cyclothymic Disorder do not meet the diagnostic criteria for other types of bipolar disorder.
Bipolar Disorder - Not Otherwise Specified (NOS)
Bipolar Disorder may not always follow a particular pattern. It can include reoccurring hypomanic episodes without any signs of depression or rapid swings between mania and depression. In these cases it’s called Bipolar Disorder: Not Otherwise Specified (NOS).
How Often Do People With Bipolar Disorder “Cycle?”
Some people can cycle from depressed to manic in a matter of hours but for most part, the cycle is a few weeks apart. Every person is different and the cycles and signs/symptoms are different from person to person.
How Does Teen Bipolar Differ From Adult Bipolar?
Bipolar episodes that start in youth are diagnosed as early-onset bipolar disorder. Due to teens already having intense emotions as their brains and emotional growth mature, symptoms of bipolar can be much more severe at this age and the switches in mood can be more frequent. Patients with early-onset bipolar disorder are also at a higher risk for suicide with some studies showing that as many as 1/3 of these patients make at least one serious attempt.
What Causes Bipolar Disorder?
Doctors aren't entirely positive what causes bipolar disorder. We do know that bipolar disorder often runs in families - children with a parent or sibling with bipolar disorder are 4-6 times more likely to develop bipolar disorder. There's growing evidence that environmental and lifestyle choices may also have an effect on bipolar disorder.
Diagnosis of Teen Bipolar Disorder:
The best way to be diagnosed with bipolar is by talking with your doctor, therapist, or psychiatrist. They will do a screening and work-up to determine if you have bipolar disorder. Keeping track of patterns in your mood and talking about how you have been feeling are the most critical diagnostic tools.
Treatment of Bipolar Disorder:
Once a diagnosis of bipolar disorder has been made, a treatment plan will be formed. Generally treatment for bipolar disorder involves medication (typically a "cocktail" of medications of various types) and talk therapy will typically help bring some sense of normalcy. Learning coping mechanisms is invaluable.
It's very important to get proper treatment, as it can help control mood swings and other symptoms. Bipolar disorder is a life-long illness, so treatment will be long-term to help you manage and control your symptoms. Starting treatment early will help you form healthy habits and coping mechanisms to use later in life.
Medications to Treat Bipolar Disorder:
Many people with bipolar disorder have to try a number of medications before a combination is found that controls the symptoms. These may include:
- Mood-Stabilizers - Doctors often choose these first to help balance your moods, and you may be taking them for a long time.
- Atypical Antipsychotic Medications are occasionally used to treat some of the symptoms of bipolar disorder and often combined with other medications.
- Antidepressants are often utilized to treat the symptoms of depression, and are often combined with mood stabilizers.
What differs here, though, between adults and teenagers, is that doctors may be more hesitant in what they prescribe due to teenage brains handling these chemicals differently than the adult brain. The same drugs treating the same symptoms in a teen may have far different effects than they would in an adult. The drugs may not take effect as quickly or may need to be changed when you get older. Your doctor will determine what medication is safe for you to try, weighing the risks of the medication against the benefits to you.
My Loved One Has Bipolar Disorder:
Even though 3% of the population is diagnosed as bipolar, chances are you'll know someone who is. If your loved one has bipolar disorder, remember that they have brain chemicals that aren’t exactly lined up right. As long as they are not a harm to themselves or anyone else, simply treat them as you would another person.
That said, the highs and lows can be difficult for people in daily contact with the person. There are support groups and books to help the coping skills for partners and friends of bipolar patients. A good therapist for caregivers is never a bad thing.
Resources for Teen Bipolar Disorder:
Mood Tracker is a great tool for tracking shifts in moods as well as monitoring how much sleep the patient is getting, medications taken, and levels of anxiety and irritability.
The National Institute of Mental Health has a highly informative brochure that can be found online that details the specifics of bipolar disorder in children and teens.
National Alliance on Mental Illness - dedicated to improving the lives of individuals and families affected by mental illness.
“How to Survive When They’re Depressed: Living and Coping with Depression Fallout” by Anne Sheffield – A must-have book for someone living with a spouse or partner who battles depression and/or bipolar disorder. This book will completely change your outlook on life and how life should look when living in the house with someone with mental illness.
Child and Adolescent Bipolar Disorder Foundation: EXCELLENT site that advocates for youth with depression and bipolar and is highly respected for its scientifically credible information.
Depression and Bipolar Support Alliance has education and research materials, information about steps to recovery, tools for managing mental illness, and tips for family members.