Facts About Bipolar Disorder
“There's a tremendous amount of progress in understanding bipolar
What is Bipolar Disorder?
Bipolar disorder (also known as manic-depression) is a brain disorder marked by bouts of extreme and impairing changes in mood, energy, thinking, and behavior. Symptoms may emerge either suddenly or gradually during childhood, adolescence, or adulthood.
A teen with untreated bipolar disorder (BPD) will experience mania (highs) and depression (lows). These highs and lows usually occur in cycles, varying in length from hours, days or weeks. However, bipolar disorder does not affect everyone in the same way.
The frequency, intensity, and duration of symptoms as well as response to treatment vary dramatically. There is presently no cure for bipolar disorder but there are a lot of treatment options, including medication, therapy and lifestyle choices. Seeking help and adhering to a treatment plan can make a big difference in the life of a teen with BP. Genetic discoveries are expected to lead to more accurate diagnosing, better treatments, and perhaps a cure.
Symptoms of mania may include:
- Elevated mood—silliness or extreme happiness that is inappropriate
- Grandiosity—inflated sense of importance
- Racing speech and thoughts
- Talking more than usual
- Irritability or hostility
- Excessive distractibility
- Decreased need for sleep
- Reckless behavior or poor judgment (daredevil acts, hypersexuality)
- Hallucinations and psychosis
Symptoms of depression may include:
- Lack of pleasure in life
- Withdrawal from favorite activities
- Agitation and irritability
- Persistent feelings of sadness and/or crying spells
- Sleeping too much or inability to sleep
- Drop in grades or inability to concentrate
- Thoughts of death and suicide
- Fatigue or loss of energy
- Significant weight loss, weight gain or change in appetite
Is it Bipolar Disorder, Something Else, or a Mixed Bag?
Bipolar disorder is often accompanied by symptoms of other psychiatric disorders, which can make the initial diagnosis difficult. Diagnoses that mimic, mask, or co-occur with bipolar disorder include:
- Attention-deficit hyperactivity disorder (ADHD)
- Oppositional-defiant disorder (ODD)
- Conduct disorder (CD)
- Pervasive developmental disorder (PDD)
- Generalized anxiety disorder (GAD)
- Panic disorder
- Obsessive-compulsive disorder (OCD)
- Tourette's syndrome (TS)
- Seizure disorders
** A significant proportion of the millions of children and adolescents with depression may actually be experiencing the early onset of bipolar disorder, but have not yet experienced the manic phase of the illness.
Should I Get Help?
The rationale for getting help for bipolar disorder is compelling. Common results of untreated bipolar disorder are problems maintaining normal social relationships, truancy, school problems, aggression, substance abuse, problems with the law, and suicide attempts and completions. Suicide is the third leading cause of death among teens.
With appropriate treatment and support at home and at school, a diagnosis of bipolar disorder does not have to mean that you cannot live a “normal” life. Most teens who take their meds and follow their treatment guidelines go on to graduate from high school or college and are able to live productive, independent lives.
Teens with concerns about their mental health should consider the following steps:
- Confiding in a trusted adult about how you’re feeling.
- Finding a qualified psychiatrist who you trust (with the help of your parents)
- Starting a mood chart today. Make daily notes of your mood, behavior, sleep patterns, and events. Share your notes with the professional who evaluates and eventually treats you.
- Educating yourself about bipolar disorder.
- Reducing stress, exercising, and maintaining a regular sleep schedule
- If you are using drugs or alcohol—Stop!! They will only make your symptoms worse.
There are many components to a good treatment plan. Ideally, your plan will include:
- Taking the medications prescribed for you, and monitoring any side effects
- Monitoring your symptoms—be aware of how your feel.
- Educating yourself about your illness.
- Psychotherapy for you and perhaps your family.
- Getting help with school, including special accommodations
- Reducing your stress. Don’t try to do too much.
- Eating right and exercising regularly
- Sticking to a regular sleep schedule and a consistent routine. This is very important!!
Medication is an essential part of treatment for any patient with bipolar disorder. No one medication works for everyone. There may be a lengthy trial-and-error process as the doctor works with you to find the right medication - alone or in combination. It is very common that a medication regimen that works might have to be changed as you grow and the disorder presents differently. Remember, your illness is as biological as diabetes. You need to keep taking your meds unless your doctor advises you otherwise!
It’s very important to have an unbiased, non-judgmental person with whom you can talk about your feelings and problems. Individuals with bipolar disorder almost always benefit from regular sessions with a therapist. In addition, it is often helpful for the whole family to meet with a therapist.
Sleep and Exercise
Maintaining a regular sleep pattern is one of the most important things you can do to help yourself feel better. “All-nighters” can cause episodes of mania or depression. Teens who fall into a weekend pattern of staying up late and then sleeping in, find that by Monday morning their biological rhythms are out of kilter. It is best to keep to a regular sleep routine even in the summer. It can help to schedule a fun activity in the morning as motivation to get up early. Even a few missed wake/sleep cycles can have unfortunate consequences.
Exercise combats depression and stress. Exercise will help you let go of anger, anxiety and tension. The naturally-occurring beta endorphins that the brain releases during exercise have a calming effect on the body. Exercise is crucial to feeling better.
You can’t “catch” bipolar. It is a complex genetic illness, and can run in families. If someone in your family has been diagnosed with bipolar disorder or a mood disorder, your chances of having the illness increases dramatically. But BP can also appear in individuals who have no family history of the disease. Here are the stats:
- Bipolar disorder in its most severe form is thought to affect at least 1% to 2 % of the general population.
- Less severe forms likely affect up to 6% of the population.
- When one parent has bipolar disorder, the risk that his or her child will have bipolar disorder is 15% to 30%.
- When both parents have bipolar disorder, the risk increases to 50% to 75%.
- If a brother or sister has bipolar disorder, the sibling’s risk is 15% to 25%.
- If an identical twin has bipolar disorder, there is approximately an 85% chance the other twin will also develop it.
The family trees of many teens with bipolar disorder often include individuals who suffered from substance abuse or mood disorders, or both. Because previous generations were less likely to diagnose bipolar disorder, affected family members may have been written off as the “crazy Auntie,” with troubling behaviors such as alcoholism, frequent periods of unemployment, dysfunctional personal relationships, bankruptcies, or imprisonment. Interestingly, the family tree might also have many members who are highly-accomplished, creative, charismatic and extremely successful in business, politics, or the arts.
Bipolar disorder and the medications used to treat it can have a significant impact on a teen's education. Bipolar disorder can affect school attendance, alertness and concentration, sensitivity to light, noise and stress, motivation, and energy available for learning.
A teen needs and is entitled to school accommodations necessary to ensure his or her education. The special education staff, parents, and mental health professionals should form a team to determine your educational needs.
The Balanced Mind Foundation's online pamphlet, Educating the Child with Bipolar Disorder, describes accommodations and strategies that may be helpful.
Learn all you can about bipolar disorder. Read, join support groups, and exchange ideas. Not surprisingly, other teens are often a good source of ideas and strategies for coping with bipolar disorder. Sharing your problems and concerns with others really does help.
TREATMENT SAVES LIVES. DON’T LET IGNORANCE OR FEAR OF WHAT OTHERS MAY THINK STOP YOU FROM GETTING HELP.
The Balanced Mind Foundation, 2007
 McGuffin P, Rijsdijk F, Andrew M, et al. The heritability of bipolar affective disorder and the genetic relationship to unipolar depression. Arch Gen Psychiatry. 2003 May;60(5):497-502.