Bipolar Disorder: Teens versus Adults

Typically, euphoria, elation, racing thoughts, irritability, and substance use are common symptoms of a manic episode. The symptoms of depression that certain imbalances in the brain can cause are decreased energy, insomnia, fatigue, agitation, and suicidal thoughts.

According to the National Institute of Mental Health, Bipolar Disorder affects approximately 5.7 million American adults, or about 2.6 percent of the U.S. population age 18 and older in a given year. For children and teens, Bipolar Disorder will develop in about 1-5% of those under 18 years of old. However, when Bipolar Disorder develops in childhood or early adolescence, it is known as an early-onset form of the mental illness. Because, generally, the typical onset for this mental illness is 25 years of age. Bipolar can begin in childhood and develop as late as 40 years of age.

Bipolar is a mood disorder, meaning that of all the psychological illness, it is a disorder that affects mood, emotions, and perception. Characteristic of this disorder is a swing in moods from depression to mania. However, research now indicates that the difference in the experience of mood swings between teens and adults might be due to the differences in brain development. The teen brain is still developing, which may contribute to having different experiences of the disorder when being a teen versus being an adult. The grey matter of the brain, which contains most of the brain’s neurons and is known as the thinking part of the brain, is still growing in teens. However, for adults, the brain’s grey matter development is complete. Alongside this is the still developing frontal cortex, which completes its growth during ages 23-26. The frontal cortex performs reasoning, planning, judgment, and impulse control, necessities for being an adult. This might explain a teen’s tendency to make poor decisions and an inability to discern whether a situation is safe.

Increased Risk Behavior in Teens

These tendencies might contribute to significant risk factors in a teen’s experience of mania and depression. Typically, euphoria, elation, racing thoughts, irritability, and substance use are common symptoms of a manic episode. The symptoms of depression that certain imbalances in the brain can cause are decreased energy, insomnia, fatigue, agitation, and suicidal thoughts. Both of these experiences can lead to risky situations for teens. Severe depression can lead to suicide, and extreme mania can lead to substance abuse. It’s not surprising to know that approximately 40% of teens with Bipolar Disorder also have a substance abuse disorder. Cocaine use, for example, could help amplify a high while the use of marijuana could help with lowering mood if adolescents feel too hyper or manic. Some teenagers will also engage in other forms of self-harm, such as cutting or risky behavior as a way to take away their emotional pain and accelerate the highs.

For these reasons, it would be important that teens get treatment of their disorder as soon as possible. Treatment of Bipolar Disorder and minimizing mood swings includes the use of medication and therapy, such as Cognitive Behavioral Therapy, Rational Emotive Behavioral Therapy (REBT), Dialectical Behavioral Therapy, life skills training, psycho-education, and hospitalization, if necessary. When medication is combined with therapy, there is a greater chance of arriving at and maintaining mental health.


Mood stabilizers are a common treatment medication for Bipolar Disorder and can help prevent the swing from depression to mania or hypomania. However, not all mood stabilizers will equally manage the depression or mania. For instance, lithium more effectively works to treat the depression versus the manic episodes, while the medication commonly referred to as Depakote works well in treating mania. In fact, Depakote seems to be more effective in treating adolescents who have four or more mood episodes per year (known as rapid cycling). Finding the right medication, or a combination of medications, given the unique circumstances of your teenager is a necessary discussion to have with a psychiatrist. Additionally, as you might expect, lithium, Depakote, and other mood stabilizers come with side effects that are worthy of exploration before your teen begins any medication.

If any of these symptoms appear to be present for you or an adolescent you know, the next step is to seek the assistance of a mental health professional. Rather than attempting to restore the imbalances in the brain yourself  through drugs, drinking, excessive exercise, being assessed by a psychologist or counselor can facilitate finding the right long-term treatment and healing.

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