Bipolar Disorder

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  • Young men's version of this guide

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Everyone has ups and downs in their mood or feelings of “moodiness” once in a while. When these ups and downs involve extreme emotions and begin to interfere with normal everyday activities such as school, work, and relationships, there may be a problem. A person with Bipolar Disorder experiences unusual and extreme shifts in mood, energy levels, and behaviors all at one time. These changes are called “manic episodes,” and they usually last for days at a time. The National Institute of Mental Health reports that about 2.9% of adolescents are diagnosed with bipolar disorder.

What is Bipolar Disorder?

There are two main types of Bipolar Disorders – Bipolar I and Bipolar II. With both types, there are manic episodes and depressive episodes. There may be mixed episodes with both mania and depression but this is not as common. Symptoms occur every day and last at least one to two weeks and often last longer. If a person experiences depression and no manic episodes, they do not have Bipolar Disorder.

What is not Bipolar Disorder?

We all experience moodiness at times, especially when we are stressed. Being a teenager is a challenging time, as there are changes in academic expectations, peer relationships, and parent-child relationships. As a person struggles with all of these transitions, it’s normal to have emotional ups and downs; however, moodiness by itself is not the same as Bipolar Disorder.

What is a manic episode?

A manic episode is the opposite of depression. We all have periods of high energy and happiness, but a manic episode is a more extreme experience of emotions and gets in the way of everyday activities. According to the DSM-V (the manual that providers use to diagnose emotional disorders), someone who is having a manic episode will have some of these symptoms:

  • Feelings of extreme happiness or ecstasy – feeling like you can do or say anything, such as feeling that one has supernatural powers
  • Extreme irritation with a short temper
  • Not sleeping very much, but not feeling tired, and having an unusual amount of energy
  • Having racing thoughts and difficulty focusing on anything
  • Talking very quickly and feeling pressure to keep talking or jumping from one subject to another
  • Doing too many activities at once without realizing that it’s too much
  • Dangerous or risky behaviors (for example: increased or an unusual amounts of sexual activity, drug use, buying expensive things without the money to pay for them) without thinking about possible consequences
  • Unusual thoughts or beliefs that others would not agree with

In a manic episode, these behaviors are extreme and serious enough to interfere with a person’s school, work, and home life.

What is a depressive episode?

A person experiencing a depressive episode may have some of the following symptoms:

  • Extreme sadness or emptiness that makes it hard to get out of bed or do normal daily activities
  • No interest in fun activities at school, home, or with friends
  • Eating too little or eating more than usual
  • Sleeping too much or too little
  • Extreme low energy and feeling tired all of the time
  • Feeling hopeless or guilty
  • Having an extremely hard time thinking or focusing at school, work, or at home
  • Thinking about hurting themselves, death, or suicide

Symptoms typically last all day every day for at least two weeks.

Do a lot of people have Bipolar Disorder?

According to the National Institute of Mental Health, approximately 2.9% of adolescents and 2.8% of adults are diagnosed with Bipolar Disorder in the United States. In other countries, Bipolar Disorder is less common, ranging from  0.1% to 2.4%. It’s unclear why Bipolar Disorder is more common in the U.S. than in other countries. It is even less common in children under 13 years of age.

Who is more likely to have Bipolar Disorder?

Bipolar Disorder is more common in young adults and adults than in children and teenagers. Research shows that the diagnosis of Bipolar disorder isn’t influenced by ethnicity or gender. Having family members with the disorder increases risk for developing a disorder (but does not guarantee it).

How do I know if I have Bipolar Disorder?

Someone with Bipolar Disorder will have unusual and extreme changes in mood, behavior, and energy levels every day that last most of the day, for at least a week at a time. This change in mood and behavior would be noticeable to family, friends, co-workers, and teachers. A person with Bipolar Disorder may have a lot of trouble sleeping and being calm, may have unusual and extreme behaviors or may have trouble feeling good enough to do every day things.

What problems can Bipolar Disorder cause?

People who struggle with Bipolar Disorder may have some of these problems:

  • Relationship problems – Extreme mood changes can make it hard to get along with family, friends and partners
  • School and work problems – Extreme mood changes and unusual thoughts can make it hard to concentrate well in school or at work
  • Self-harm behaviors – Some people have thoughts of hurting themselves or attempting suicide
  • Substance abuse – Some people start using drugs and alcohol. Drugs and alcohol make the mood changes worse and the disorder harder to diagnose.
  • Legal problems – During periods of mania, People may do things that they would not normally do, including illegal activities that may cause them to get into trouble with the law.

How do I get help?

Talk with a parent or adult that you trust if you are concerned that you might have Bipolar Disorder. They can help you find a mental health clinician who is experienced in treating it.

What is the treatment for Bipolar Disorder?

There are many kinds of treatment for Bipolar Disorder, including:

  • Medication: Different types of medication are usually helpful in treating Bipolar Disorder. A psychiatrist will likely prescribe a medication called a mood stabilizer. This will help keep moods level, preventing too much excitement or depression. There are other medications, like antidepressants, that may be helpful as well.
  • Cognitive Behavioral Therapy (CBT): is a type of therapy that can help manage symptoms of manic and depressed episodes by helping someone understand how their way of thinking about things can impact their behaviors and mood.
A combination of psychotherapy and medication is usually the most effective treatment. A mental health clinician can recommend the best type of therapy for you.

Our health guides are developed through a systematic, rigorous process to ensure accuracy, reliability, and trustworthiness. Written and reviewed by experienced healthcare clinicians from Boston Children's Hospital, a Harvard Medical School teaching hospital and consistently ranked as a top hospital by Newsweek and U.S. News & World Report, these guides combine clinical expertise, specialized knowledge, and evidence-based medicine. We also incorporate research and best practices from authoritative sources such as the CDC, NIH, PubMed, top medical journals, and UpToDate.com. Clinical specialists and subject matter experts review and edit each guide, reinforcing our commitment to high-quality, factual, scientifically accurate health information for young people.