Mental Health

Bipolar Disorder

Teen Bipolar Disorder

Bipolar disorder is an illness that can have serious impacts on teens and their families. Teen bipolar disorder, also known as manic-depressive disorder, causes teens to experience extreme moods, known as mania and depression. Mania causes a teen to feel overly energetic and irritable, while teens suffering from depression feel sad, tired, and unable to do anything. Scientists do not yet fully understand teen bipolar disorder, but it seems to be caused by chemical imbalances in the teen’s brain. Teen bipolar disorder cannot be cured, but it can be treated with therapy, and sometimes medications.

Teens with bipolar disorder experience intense moods, often without a clear cause. They may change rapidly from mania to depression, or experience one extreme or the other with long periods of normal or less extreme moods in between. These mood changes are more severe and extreme than the normal ups and downs that every teen experiences. Sometimes stress, medications, or environmental factors can trigger a manic or depressive episode, but the exact causes of bipolar disorder are not yet known. Bipolar disorder seems to have a genetic component, and teens whose close family members have bipolar disorder are more likely to develop bipolar disorder.

Commons signs of mania include:

  • High energy
  • Irritability
  • Violent outbursts
  • Excessive, rapid talking, often jumping from one topic to another
  • Inability to concentrate
  • Little need for sleep
  • Poor judgement, sometimes leading to spending sprees, drug use, or sexual promiscuity
  • Obsession with sexuality
  • Grandiosity, which is an unrealistic sense of one’s abilities, such as thinking one has special powers. Many young people like to imagine having special abilities, have trouble evaluating risk, or exaggerate their own unique talents and skills; this generally only becomes a symptom if the teen tries to act on the ability, like trying to fly. 

Episodes of depression can cause:

  • Prolonged sadness or boredom
  • A feeling of emptiness
  • Loss of interest or energy
  • Headaches and body aches
  • Changes in sleeping or eating habits
  • Fatigue
  • Feeling worried, hopeless, guilty, or anxious
  • Suicidal thoughts or behavior 

Some teens with bipolar disorder show signs of mania and depression in the same day, sometimes even at the same time, such as feeling depressed, but engaging in manic activities. Other teens with bipolar disorder never have severe manic episodes, only minor episodes known as hypomania. Teens who suffer from bipolar disorder may deny that they have a problem, especially while experiencing mania. Some other signs of teen bipolar disorder can include:

  • Poor performance in school
  • Talking or thinking about running away
  • Using drugs or alcohol
  • Engaging in self-destructive behaviors, such as fighting
  • Becoming isolated
  • Being overly sensitive
  • Delusions or hallucinations
  • Thinking about or attempting suicide 

Because doctors are just beginning to understand teen bipolar disorder, they are not yet sure of the number of teens who suffer from it, but about 10 million Americans have bipolar disorder. Many adults who develop bipolar disorder begin to show symptoms in their late teens, but researchers believe that bipolar disorder may begin much younger in some individuals.

A teen who may have bipolar disorder should visit a doctor, who can make sure the teen does not have another medical condition such as attention deficit hyperactivity disorder (ADHD), conduct disorder, or substance abuse problems. A doctor or therapist can recommend and provide treatments for teen bipolar disorder. Treatment may consist of counseling, often combined with a mood stabilizing medication. The use of medication by teens should be monitored carefully; while it helps many people, it may cause suicidal thoughts and behavior in teens.

Families can help teens with bipolar disorder by:

  • Understanding, and helping the teen to understand, that he or she has an illness, and that this illness is not the teen’s fault, but that he or she can do things to feel better.
  • Enrolling in family therapy.
  • Seeking help for any other untreated mental illnesses in family members, such as depression or anxiety; this sets a good example and reduces stress in the family.
  • Providing a quiet environment for the teen, with a regular schedule, especially for sleep.
  • Being patient; avoid telling your teen to “snap out of it” or “get over it.”
  • Always taking talk of suicide seriously and seeking immediate medical help for suicidal teens; be especially alert after a traumatic event like moving, divorce, death in the family, or loss of a friendship or boyfriend or girlfriend. 

Some things teens with bipolar disorder can do to reduce symptoms include:

  • Follow any treatments prescribed by your therapist or doctor
  • Consider keeping a daily journal of your thoughts and feelings
  • Learn ways to manage stress, such as yoga, deep breathing exercises, going for walks, or listening to soothing music
  • Exercise, eat a balanced diet, and get enough sleep
  • Avoid drugs, alcohol, and caffeine, which is found in coffee, tea, energy drinks, chocolate, and many sodas
  • Ask for help when you feel you need it 

Teens with bipolar disorder are at increased risk for suicide. A teen who is having suicidal thoughts or actions should get medical help immediately, or call 911 or a suicide prevention hotline, such as 1-800-SUICIDE (1-800-784-2433); check your phone book for local suicide prevention hotlines or mental health centers.

National Institute of Mental Health, “Bipolar Disorder” [online] and Healthwise, “Bipolar Disorder in Childhood” [online]
National Alliance on Mental Illness, “Bipolar Disorder” [online]
Nemours Foundation, TeensHealth, “Bipolar Disorder” [online]
Kowatch, et. al., “Treatment Guidelines for Children and Adolescents With Bipolar Disorder,” Journal of the American Academy of Child and Adolescent Psychiatry, 44:3, March 2005 [online]

Emotional Problems

Teen Stress

Stress is a natural feeling when something important is on the line. In such circumstances, stress can assist with focus and provide energy for the task to be done or the situation to be dealt with. With the situation resolved, the stress dies out.

But not all stress is healthy stress: stress can get out of hand. Understanding teen stress can help identify and help a teen whose stress has gotten out of control.

Causes of Teen Stress

Teen stress can come from many different areas: it depends on what contexts the child moves in and what the expectations are for him or her. Here are some causes of teen stress.

• The Changes of Adolescence—Developing faster or slower than most of one’s friends can cause tensions because the teenage years are a time when being like others and liked by others is so important. As the teen transitions and hormone changes take place, teens can be stressed by feeling out of control and losing a sense of self.

• Family Issues—Tensions between parents, separation or divorce, parental infidelity, alcoholism or drug abuse in the family, poverty, or parents who are not involved with their children’s lives may all cause stress for teens. If a child is being verbally or physically abused or is a victim on incest, stress will be only one facet of a much larger set of issues.

Another family issue that causes teen stress is parents living vicariously through their children. When children have to not only fulfill their own dreams but have all their family’s hopes resting on their shoulders, this can weigh heavily on them.

• School—For students who have difficulty in school, whether or not they have a learning disability, school can cause a lot of stress. For students who aspire to goals beyond school that depend on excellent grades may also feel very pressured.

• Social Issues—The ins and outs of friendship and dating often cause stress for teens. Hoping for acceptance, and even love, and trying to balance one’s own developing personality with other teen’s perceptions and expectations is challenging. Teens worry not only about their own problems, but about their friends’ problems, and this can cause stress. If a teen is bullied, whether in person or via cyberbullying, this is likely to cause both stress and distress. Having an argument with someone can also cause stress.

• College Applications—The whole future lies open before the teen graduating high school, but so does the task of persuading a college to help the teen get there. This is a critical activity, and one for which many teens feel unprepared. The long waiting period for replies causes stress for both teens and their parents.

• Transition—All the transitions of adolescence can cause stress. From making the transition to high school to learning to drive to holding down one’s first job to—in many cases—sharing a room with a stranger when starting college and dealing with the increased responsibility to moving to a different city or town to the pile of responsibilities that fall on a teen’s shoulders when they turn 18 even the normal, expected transitions of adolescence can cause teen stress.

• Fear—Living in a neighborhood with a high crime rate or a drug problem, or living in a generally safe neighborhood, but having been mugged or robbed can cause fear, and fear causes stress.

• Sorrow—The loss of a loved person or a pet can lead to both grief and stress.

• Responsibility—Having to care for others when one is still growing up oneself can cause stress. This can result from caring for younger siblings, a disabled or substance abusing parent, or a failing grandparent.

Signs and Symptoms of Teen Stress

People young and old react differently to stress. Some get physical symptoms like diarrhea and tension headaches, while others show it in their mood, growing snappy or withdrawn or angry. Teens may develop healthy coping strategies on their own or need help to direct their activities when they feel stress. For example, temporary avoidance of something that is stressful could be taking a break from a difficult problem set in math to shift focus. Long-term avoidance may lead to failing to hand in the assignment on time. Even though the same strategy is employed, in the first case it is useful, but in the second, detrimental.

Other signs of teen stress include withdrawal; crying; picking fights; loss of focus and diminishing accomplishment;, change in eating or sleeping patterns, particularly loss of appetite and disturbed sleep; moodiness or anger. Extreme stress can lead to thoughts of suicide.

Help for Teen Stress

The first level of help for teen stress is simply having a way to express what is going on. This means both having language to name the feelings and having a safe place to vent one’s feelings. The first can be gained most easily from parents who discuss their feelings openly, telling their children when they feel stressed and, as appropriate why, and what they do about it. The second can be provided by a parent, sibling, friend, mentor, or even a journal or diary that the teens knows is a private place for reflection.

Certain activities may help relieve stress. Playing a sport can help, but so can other physical activities that one can do alone, like practicing a tennis serve, or just throwing a ball against a wall. Distraction can also help, whether playing a video game or something else that requires concentration, like chess.

Sometimes professional help is needed. This may start with the child’s pediatrician or school guidance counselor. For stress issues that are not responding, a therapist may be the next step.


Confronting Teen Stress

Mental Health

Teen Depression

What is Teen Depression?

Most of us feel sad or unhappy at various times in our life, but teenage depression that extends for a longer lengths of time (usually more than 2 weeks) and that interferes with our daily life is considered to be major depression. This type of teen depression is one that isn’t to be taken lightly and should be treated as early as possible to prevent further problems.

Studies and statistics show that approximately 1 in 8 adolescents may be suffering from depression, a very scary statistic. Even more frightening is that only about 30% of these children who are suffering emotional/mental turmoil are receiving any treatment for it.(1)

Many teens have mood swings or are quick to express anger, but how do you distinguish between normal teenage angst and a more serious problem?

Teenage Depression Warning Signs

Although at times teens will normally go through some of these following signs, when they occur alone for extended periods of time and/or occur in conjunction with each other it’s important to look at what may be causing them.

  • Sadness or hopelessness
  • Low self-esteem
  • Sluggishness (less active)
  • Substance abuse
  • Spending more time alone (this includes time alone from you as parents and time away from their regular friends)
  • Decrease in desire to do things they used to like to do (sports, activities, hobbies)
  • Physical ailments (headaches, appetite problems, sleeping problems)
  • Problems in school (falling grades, getting into trouble, not paying attention in class)
  • Talking about death or suicide (never to be taken lightly)
  • Not caring about appearance
  • Running away from home
  • Blaming self for things that are not their fault
  • Unable to concentrate and/or make decisions

Who’s At Risk for Teen Depression? 

Every teen is at risk in developing major teen depression, but there are certain groups of individuals that are more prone to this type of disorder.

  • Females are more likely to develop adolescent depression than males (about 2x more often)
  • Abused/neglected individuals
  • Children that have or have had long-term/chronic illnesses
  • Teens that have a family history of depression or other mood disorders
  • Teens with family disruptions at home (divorce, death in family, etc)
  • Teens with low self-esteem

Adolescent Depression Treatment Options

Depending on the degree of depression your teen is determined to have, there are several forms of treatment that are available. Only a mental health professional is qualified to determine what would be the best course of treatment for your child. All types of treatment can take place either at home and/or in a residential setting.

  • Medicine (anti-depressants – usually used in addition to other forms of therapy)
  • Individual Therapy -Cognitive Behavioral Therapy – helps to teach healthy ways of thinking
  • Interpersonal Psychotherapy – helps to determine interpersonal issues/situations that may be the cause of the depression
  • Group Therapy – individuals with the same affliction meet together to discuss their problems and in turn help each other through their situations

Major adolescent depression, if left untreated, will rarely go away on it’s own. Relapses are extremely common and should always be prevented. Other forms of mental health illnesses are more common as well in depressed teens. If teens are left without help, they may decide to take things into their own hands. They can turn to alcohol and/or drug abuse to help make their pain go away. At it’s worst, teen depression can lead to suicide. According to, teen suicide is the 3rd leading cause of death among young people ages 15-24. We must all do our part in preventing these outcomes as best we can. Early intervention is key. Watch for those warning signs and if observed, seek the necessary help right away.

Teen Depression Sources: