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Teenagers and Bipolar Disorder

What All Parents Need to Know

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If you’re reading this page you likely have a teenager with bipolar disorder. If your teen has been newly diagnosed, you may be frightened. They may have ended up in the hospital due to a manic episode, or they may have threatened or even attempted suicide. The behaviors of teenagers with bipolar disorder can be extremely challenging for everyone in a family. Help, however, does exist. There are excellent medications that help keep symptoms in check, and with parental assistance and a good management program, teenagers with bipolar disorder can live healthy, normal lives. Here are the most important facts parents need to know:

  • Bipolar disorder is a biological illness having nothing to do with parenting style.
  • Bipolar disorder is a lifelong illness. There is no known “cure.”
  • Medication is essential, but is not enough. A comprehensive management program is necessary. There are no magic pills.
  • With proper management, people with bipolar disorder can live happy, productive lives.
  • Teenagers are capable of managing the illness, but they absolutely need the help of parents and health care professionals.

Having an early diagnosis is a tremendous help. Teens who are diagnosed with bipolar disorder at an early age are more likely to manage their illness successfully during the rest of their lives. A proper diagnosis also allows parents to better understand their teenager’s behaviors so they can help when symptomatic behaviors occur. The main goal for parents of a bipolar teen is to learn the difference between typical teenage behavior and bipolar-influenced behavior. Once they do, they can recognize the signs that a mood swing is starting, and learn the best ways to communicate with and ultimately help their teen successfully manage the illness.

Typical vs. Bipolar Teenage Behavior

There is a huge difference between typical teenage behavior and behavior that is symptomatic of bipolar disorder. A bipolar teenager will display both, and it may be difficult at first for parents to tell the difference. As a rule, it is usually a matter of extremes. For example, it is normal for teenagers to feel sadness and heartbreak after a break-up. They may cry, call their friends and perhaps even believe for a while that they may never be happy again. Yet they bounce back in a reasonable amount of time. A teenager with bipolar disorder, on the other hand, might fall into a deep depression, isolating themselves and crying for weeks or even months on end. They might turn their unhappiness on themselves and say things like, “I’m worthless and unlovable” or “I would be better off dead.” They may even try to commit suicide.

The same is true for irritation and anger. During an argument it is normal for teenagers to yell, slam their door and even tell their parents, “I hate you!” But they will usually come out for dinner a few hours later feeling better. A teenager experiencing a bipolar disorder mood swing, however, might not be able to calm themselves down for a very long time, and their response can be much more extreme. They may become paranoid or psychotic, think their parents are out to get them, or even end up in the hospital.

The beginnings of mania are often missed in teenagers, as manic symptoms can be confused with typical teenage behavior. Dating, drinking, staying up all night studying, talking back to parents, getting excited about a project, etc., are all typical teenage behaviors. But when a child is manic, these behaviors always go too far. Once again, it is the extreme nature of the emotions and behaviors that spell the difference. A mania treatment plan is essential for anyone with bipolar disorder—especially teenagers—as it can come on quickly and spiral out of control in a matter of days.

Teenagers and the “Bipolar Conversation”

Bipolar disorder is a compulsive illness, and until a teenager with bipolar disorder learns to recognize their symptoms and differentiate between when they are experiencing a mood swing and when they are healthy, they can and often will make decisions that have dangerous consequences. These include decisions around sex, relationships, school choices, drugs and alcohol, etc. A parent can help their teenager learn to recognize their symptoms, but they must first learn how to communicate effectively with a teenager with bipolar disorder. The first step is to understand that when a teenager is in the midst of a bipolar disorder mood swing—whether it’s psychosis, mania, depression, anxiety, etc.—they will often say things they don’t mean, don’t believe and would never say when healthy. It’s important during these times not to react as though they were healthy, and get caught up in what I call the “bipolar conversation.”

The bipolar conversation happens when the person you care about is sick and the bipolar disorder is doing the talking, but you react to what they’re saying as though everything is normal. This leads to a lot of problems, as the conversation typically becomes circular—the ill person keeps saying what bipolar disorder is making them say and you keep reacting by trying to get them to see that they’re making no sense. For example, a typical response by a parent to hearing their teenager say they are a failure and want to die might be, “You’re not a failure! Why are you so unhappy? So many people love you.” Etc., Talking this way simply doesn’t work, as it doesn’t address the real problem, which is the illness itself. Rather, a more appropriate response might be, “I hear you and I know you’re depressed. You have bipolar disorder and this is normal. I’ve seen you like this before. Let’s do X, which we know helps you when you are feeling this way.” This response addresses the real issue and leads to great progress in communicating with your child and managing the illness successfully.

Teenagers, Bipolar Disorder and School

Besides relationships, school is the main problem for teenagers with bipolar disorder. School is basically a microcosm of work. It has a very rigid schedule. There is a lot of pressure to perform, and there are many social requirements. The pressures can be enormous during exams and for those who miss school due to a mood swing or hospitalization. There can be shame and embarrassment after an episode. It’s hard enough to talk when you’re a teen, and having to explain bipolar disorder at school may feel impossible. Many teens have their first episode in high school, or when they go off to college. As a parent, you may worry that your child will not be able to get a degree and a good job, or that they will have to miss school if they have a serious mood swing. This is not necessarily true. A strong management plan makes it very likely that a teen can finish high school and move on to work or college. The goal should be to find stability before taking on a new college or job.

High school is actually a great time for teenagers to learn what they can and can’t do regarding bipolar disorder. They must understand that things will not get better just because they are out of school. The illness remains and will respond to other, new triggers.

My Health Cards System teaches parents how to work with their teenager to identify specific symptoms and know when a mood swing is present. It also provides step-by-step instructions for creating effective plans to deal with each symptom as it arises. I promise you there is no better system for parents and teenagers available anywhere else.

A Final Note

Teenagers with bipolar disorder can get better, but they absolutely need help from others. As a parent, teacher or anyone who cares about a bipolar teenager, you will first need to learn as much as you can about the illness, including the various bipolar medications and how they work. You will also need to learn to distinguish between the teenager’s natural behaviors and those that can be attributed to bipolar disorder. And you will need to learn effective ways to communicate with them, especially when they are in a mood swing. The goal is to help them learn how to talk about bipolar disorder in order to better understand themselves and what they need to stay healthy.