Someone with Bipolar Disorder will usually experience a depressive episode before experiencing a manic episode, and may even have several depressive episodes prior to a manic episode. This is why some people with Bipolar Disorder are originally diagnosed with Depression.
Bipolar Disorder, and other mental disorders, should only be diagnosed by a medical doctor, clinical psychologist, or other trained health provider who has spent time with the teenager and has conducted a proper mental health assessment. Diagnoses are complicated with many nuances. Please do not attempt to diagnose someone based on the symptoms you read in magazines or on the internet. If you are concerned, speak to a trained health professional.
There are two types of Bipolar Disorder:
- Bipolar I Disorder: The teenager must experience at least one manic episode, although he or she will likely also experience depressive episodes.
- Bipolar II Disorder: The teenager must experience at least one depressive episode and one hypomanic episode. A hypomanic episode is a less-severe version of a manic episode. See below for further details.
These look similar to the depressive episodes experienced when someone has Depression. They occur nearly every day for at least two weeks and can include:
- Feeling sad and low most of the day
- Losing interest and pleasure in most activities
- Losing or gaining a considerable amount of weight
- Eating a lot more or a lot less than usual
- Difficulty sleeping or sleeping all the time
- Restlessness or a sense of moving in slow motion that is noticeable to others
- Fatigue or lack of energy
- Feeling worthless or guilty for no reason
- Difficulty thinking or concentrating
- Recurrent thoughts of death or suicide
These occur most of the day, nearly every day for at least one week. They can include:
- Inflated self-esteem or grandiosity (e.g., acting like he or she is superior to others)
- Little need for sleep (e.g., feeling rested after only 3 hours of sleep)
- Need to continue talking – rapid and sometimes confused speech
- Having too many thoughts at once, feeling a pressure of thoughts in his or her head
- Acting distracted or unable to focus
- Increase in goal-directed activity (e.g. either socially, at school or work) or restlessness, although the goal he or she is working toward may not make sense or be logical
- Excessive involvement in risky activities with painful consequences (e.g., expensive shopping sprees, foolish business investments, drug use, sexual promiscuity)
- In severe cases, people can experience hallucinations (i.e., hearing or seeing something that isn’t actually there) or delusions (i.e., believing something that isn’t true even when confronted with proof)
These are similar to manic episodes and last for four consecutive days or longer, but don’t significantly interfere with the person’s ability to live his or her life. Because hypomanic symptoms are less severe, they don’t always seem problematic to the person, even though they’re an obvious departure from his or her usual behaviour. Although a person may be very productive and accomplish many tasks when experiencing Hypomania, he or she also may become involved in risky behaviour or activities that result in painful consequences.
These symptoms are much more severe and last longer than the regular ups and downs of life. Although most people’s moods change when they experience positive or negative events, the moods swings of someone with Bipolar Disorder occur without any external provocation and are not easily controlled by the person. Some individuals will experience a ‘mixed state’, which is Mania and Depression at the same time.
For many people with Bipolar Disorder, there may be periods of time (lasting from days to years) where the mood is under better control and more likely to stay within “usual” limits. This is especially true if the person is being successfully treated for the illness.
* Statistics are sourced from the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition.
Remember, you cannot diagnose someone with Bipolar Disorder without a proper mental health assessment conducted by a properly trained health provider.