What does a teen with bipolar disorder feel like?

Nicole, 15, has been extremely irritable lately. Her moods seem to change at the drop of a hat. One moment, she’ll be loud and boisterous, and the next minute she’ll darken into silent sadness. She has outbursts during which she throws or breaks things, and she throws temper tantrums almost like those of a small child. She has been having increased trouble concentrating in school and while doing homework, and her parents have started to consider getting her tested for a learning disability. Sometimes her mother can hear her moving around the house at three in the morning, but she doesn’t seem tired when she gets up for school at 6:30 a.m. Later, she’ll crash for several days and sleep away almost all of her free time. It seems more severe than typical teenage behavior.

Nicole has bipolar disorder (BPD). Bipolar disorder, or manic depression, is characterized by cycling between episodes of mania and depression. While once thought to be very rare in teenagers, it is now thought that it can occur during the teenage years, although it is hard to diagnose because a lot of teens don’t have the same symptoms as adults. Initially the symptoms are mistaken for typical teenage behaviors, and sometimes the symptoms are mistaken for other disorders such as attention deficit hyperactivity disorder, conduct disorder, and even schizophrenia. The basic symptoms of bipolar are:

Mania:

• severe changes in mood
• overly-inflated self-esteem
• increased energy
• decreased need for sleep
• increased talking, talking very fast, changing topics quickly, inability to be interrupted
• distracted easily
• increased goal-oriented activity or physical agitation
• disregard of risk, increased involvement in risky behaviors without regard to consequences

Depression:

• persistent sad or irritable mood
• loss of interest in activities once enjoyed
• difficulty sleeping or oversleeping
• loss of energy
• physical slowing
• significant changes in appetite or body weight
• difficulty concentrating

In teenagers, other symptoms might occur. In contrast to adults, teenagers are more likely to be irritable or have destructive outburst rather than display elation or euphoria during a manic episode. There might be complaints of headaches, muscle aches, stomach discomforts, and tiredness, and the teen might experience unexplained crying and social isolation as well. When the illness begins soon after the onset of puberty, it might manifest as a rapid-cycling and continuous state of irritability and mixed-symptoms with ADHD-like behaviors. If a teen appears to be depressed, displays severe ADHD-like symptoms, and has excessive outbursts of temper and mood changes, they might have bipolar disorder. Other warning signs include frequent absences from school, poor academic performance, and talking of running away from home.