top of page
  • Writer's pictureDr. Samantha Brustad

Adolescent Bipolar Disorder: Effective Strategies for Parents and Caregivers

Bipolar disorder is a complex mental health condition that presents a unique set of challenges when it surfaces in adolescents. Characterized by alternating periods of depression and mania, this disorder can profoundly affect a young person's mood, energy levels, and behavior. 

Adolescence is a critical time of emotional and mental development. This period is further complicated by the fact that symptoms may first become noticeable during these years. Effectively managing this condition necessitates a comprehensive understanding of its manifestations and a tailored approach to treatment that considers teenagers' unique needs.

Due to the natural emotional fluctuations that occur during the teenage years, it can be difficult to distinguish between typical adolescent behavior and the signs of bipolar disorder. However, the impact of untreated bipolar disorder can be profound, affecting academic performance, social relationships, and overall well-being. 

Parents, caregivers, and mental health professionals are vital in recognizing the symptoms and providing support. We will explore the basic guidelines you need to know in this guide. If you or a loved one are currently managing bipolar disorder or want to get assessed for symptoms, we highly recommend reaching out to a mental health professional.

Our team at Balanced Minds here in Tampa Bay provides therapy, assessments, and psychological evaluations. We specialize in working with children and teens, providing a warm and safe environment to help them navigate life's journey.

adolescent bipolar disorder

Understanding Bipolar Disorder in Adolescents

Bipolar disorder in adolescents is a complex mental health condition that presents with emotional and behavioral fluctuations. Its management requires an intricate understanding of its symptoms, treatment, and impact on young people's lives.

Many instances of first-time onset of bipolar disorder come during adolescence, making it a crucial age window to manage symptoms in the long term. Unfortunately, the time between onset and diagnosis can sometimes average from 5 to 10 years due to the overlap of symptoms with Bipolar and other conditions.

Identifying Symptoms and Diagnosis

The diagnosis of bipolar disorder involves recognizing a pattern of both depressive and manic symptoms. Diagnosing bipolar disorder can pose a challenge, as many of the symptoms overlap with other conditions. Working with a mental health professional is crucial to rule out other causes. 

Symptoms during manic episodes can include excessive happiness, irritability, and rapid speech, whereas depressive episodes may involve sorrow, guilt, and a feeble sense of self-worth. Diagnostic criteria are used to influence clinical interviews and assessments to determine the severity and duration of mood episodes.

Prevalence and Risk Factors

Bipolar disorder typically emerges in adolescence or early adulthood. It is estimated around 27% of cases first show under the age of 13, increasing to around 37% until age 18. These rates contribute to anywhere from 1 to 4% of the adolescent population presenting with the disorder.

This is due to many risk factors. Genetics play a significant role, as adolescents with a parent or sibling that has the disorder are at a higher risk of developing it themselves. The disorder is also more prevalent in adolescents with environmental stressors, including trauma or substance abuse, which increases the odds of triggering an onset.

Type I and Type II Bipolar in Adolescents

Bipolar Disorder is a blanket term that encompasses two main sub-conditions. While both types of bipolar present with the same cycle of manic and depressive episodes, each of them has unique symptoms that must be considered during treatment.

Type I bipolar is characterized by more severe manic episodes. A critical thing to note is that this directly leads to higher rates of substance abuse in those with Type I (61%) compared to those with Type II (48%), as mania has a higher level of risk.

Type II bipolar can be identified by more hypomanic and depressive episodes. Hypomania is generally less severe than hypermania, lacking the presence of psychotic symptoms.

It is vital to ensure that a psychological evaluator is experienced in assessing and treating each type of Bipolar disorder to avoid any misdiagnoses. 

For example, because Type 2 bipolar is characterized by more depressive episodes, it can often be misdiagnosed as major depressive disorder. If a Type II patient is then prescribed antidepressants rather than stabilizers, it could lead to rapid symptom cycling and a higher risk of the condition remaining chronic.

Coexisting Conditions

Adolescents with bipolar disorder often have coexisting conditions that can complicate the symptom profile and treatment. This can range from other mental health conditions, like anxiety, substance abuse, or eating disorders, as well as physical health symptoms, like migraines, diabetes, and thyroid illness.

It is estimated at least 50% of patients meet the criteria for another psychiatric diagnosis. It is critical to find a mental health professional who can manage all of a patient’s comorbidities to provide a holistic treatment plan.

The Impact on Adolescent Development

The onset of bipolar disorder often coincides with the critical stages of adolescent development, further complicating the experience. Adolescence is marked by significant physical, cognitive, and emotional changes that can interact with and exacerbate the symptoms of bipolar disorder.

For example, the hormonal fluctuations and heightened emotional sensitivity of adolescence may contribute to more frequent and severe mood episodes. Additionally, the impulsivity and risk-taking behaviors common in adolescence can lead to poor decision-making and increased substance abuse, further exacerbating bipolar symptoms.

Living with Bipolar Disorder

Individuals living with bipolar disorder navigate daily challenges related to mood regulation and stress management. There are several therapeutic and medicinal interventions to consider, which healthy support systems should complement. Support groups and psychoeducation are vital for patients and families, as they will help those with bipolar disorder find healthy and productive ways to live with the condition in the long term.

Treatment Approaches and Options

Effective treatment often consists of a combination of medication and psychotherapy. The goal of treatment is to stabilize mood swings and help the young person develop coping mechanisms to manage their symptoms. Therapeutic approaches such as cognitive-behavioral and social rhythm therapy have been found to complement the stabilization medications provide.

Mood stabilizers, antidepressants, and antipsychotics such as lithium and aripiprazole are common pharmacological treatments. Adolescents may have varied reactions to bipolar medicines, so it is critical to work closely with their medical providers to find a treatment that is suitable and effective.

Professional and Family Support

A robust support system is crucial to helping adolescents manage bipolar disorder.

Supporting an adolescent with bipolar disorder involves providing a stable environment, ensuring medication adherence, and fostering open communication. It is also vital for parents and caretakers to educate themselves about the disorder to better understand and empathize with the adolescent's experiences.

Psychoeducation is also essential in managing the condition, equipping adolescents with the knowledge to understand their disorder and the skills to navigate its challenges. Treatment plans must be flexible and adaptable to the patient's changing needs as they progress through therapy.

Healthy Ways to Manage Bipolar Disorder

Adolescents may sometimes adopt counterproductive coping strategies such as substance abuse or self-isolation. Recognizing and redirecting these behaviors towards healthier outlets is essential for long-term management.

Understanding education law and special education services is crucial. Adolescents may require academic accommodations to support their learning and help manage their condition within the school environment.

Navigating Transitions to Adulthood

Adolescents with bipolar disorder face unique challenges as they navigate the transition to adulthood. This period can be particularly turbulent, as they must manage both the typical developmental changes of adolescence as well as the symptoms of their mental health condition.

Bipolar disorder also makes it difficult for adolescents to establish their independence and identity. This is because the mood swings and impulsivity associated with the condition can make it challenging to maintain healthy relationships and achieve educational or vocational goals.

For example, bipolar disorder often causes people to set increasingly higher goals. This can cause children to aim for progressively more difficult standards over time. If an adolescent then swings back from a manic state to a euthymic or depressive mood, they may become discouraged by being unable to reach their goals.

Proper treatment and support are crucial during this time to help them develop healthy coping mechanisms and build a strong foundation for the future.


Overall, Bipolar disorder can be a challenging journey, especially for adolescents and their parents or caretakers. The cyclical nature of the disorder and the presence of any comorbidities can make it tricky to diagnose, so it is crucial to find a trained psychiatric evaluator to ensure the right treatment plan is in place.

If you or a loved one are currently struggling with cyclical depression and mania or otherwise believe a bipolar evaluation would help, we highly recommend reaching out to a mental health professional. 

Because bipolar disorder can present a wide range of symptoms and is prone to onset early into the adolescent years, receiving an official evaluation and diagnosis is crucial to managing symptoms and developing healthy strategies.

If you are in the Saint Petersburg or Tampa Bay area and want help managing and evaluating cyclical depressive symptoms, check out Balanced Minds! Our team of friendly, licensed mental health professionals has been helping kids, teens, and adults in the area navigate life’s challenges by combining evidence-based therapy and a compassionate approach.

Contact our team by email or phone to learn more about how we can help today!


bottom of page