Bipolar disorder is a mental health disorder that can cause dramatic changes in mood and energy levels. Symptoms can first appear during the teenage years and affect daily life severely. Spotting the early signs of bipolar disorder and getting an accurate diagnosis can help your teen receive the right treatment.

The extremes of mood are known as manic episodes and depressive episodes and diagnosis is dependent on the duration of each. Mania in both Bipolar I and Bipolar II (less severe manic episodes) does not always present with feelings of elation, sometimes it presents as extreme and extended irritability, anger, or agitation. Because these symptoms can be confused with teen moodiness, teens with Bipolar Disorder II can be misdiagnosed as depression only.

Because mood swings are less obvious than with bipolar I, diagnosing bipolar disorder II remains a challenge. Patients often suffer from depression as well and that is why so many are treated only with antidepressants.

Misdiagnosis of bipolar disorder as attention deficit hyperactivity disorder[ADHD] and major depressive disorder is common, leading to the use of stimulants and antidepressants, which might worsen the course instead of mood-stabilizing agents.

Patients who show symptoms of what appears to be depression should be evaluated for manic or hypomanic symptoms. If bipolar disorder is diagnosed, treatment should include mood-stabilizing drugs like lithium, with or without antidepressants.

The widespread use of antidepressants alone in patients with mixed depression may explain the reported increase in suicides among teens on these drugs.

The suicidality sometimes related to antidepressants is probably not caused by the drug itself, but by clinicians using only antidepressants to treat mixed depression.

The primary symptoms of bipolar disorder are periods of elevated or irritable mood accompanied by dramatic increases in energy, activity, and fast thinking. The illness has two (bi) strongly contrasting phases (polar): 1) bipolar mania or hypomania and 2) depression.

Bipolar mania or hypomania symptoms include:

Bipolar depression/major depression symptoms include:

Some people with bipolar disorder become psychotic when manic or depressed - for example, hearing things that aren't there. They may hold onto false beliefs, too. In some instances, they see themselves as having superhuman skills and powers - even considering themselves to be god-like.

Answer questions briefly, calmly and honestly. Avoid being drawn into long conversations or arguments with a manic individual, as these can be overstimulating and upsetting. People with elevated moods are vulnerable despite their apparent confidence, and they tend to take offense easily.

Be cautious about becoming swept up in an individual's hypomanic or manic mood. If the person starts to argue, try to remain detached. Consider postponing the discussion, saying something like, "I can see this means a lot to you and we need to discuss it, but I am upset and tired now. Let's discuss it in the morning when my head is clearer."

In order to prevent risky or inappropriate behavior associated with bipolar disorder (e.g. reckless spending, unrealistic projects, gambling, promiscuity and reckless driving) discuss with the person precautions (s)he can take to prevent these activities and negative consequences during manic episodes (e.g. give his/her credit cards to you temporarily to prevent reckless spending, give his/her car keys to you to prevent reckless driving, or staying at home if promiscuity or socially inappropriate behavior is a problem).

If you suspect your teen may have bipolar disorder, begin mood charting. Keep a daily record of his/her moods, behaviors, sleep patterns and other factors that could help with diagnosis and finding the right treatment. Key to correct diagnosis is the duration of manic and depressive episodes.

If your teen screened "red flags" of bipolar disorder on the Wellify Teen screening, a thorough assessment and diagnostic testing is needed immediately (see Assessment & Diagnosis section).

Treatment is best guided by a medical doctor who specializes in diagnosing and treating mental health conditions (psychiatrist) who is skilled in treating bipolar and related disorders. You may have a treatment team that also includes a psychologist, social worker and psychiatric nurse.

Bipolar disorder is a lifelong condition. Treatment is directed at managing symptoms.

The primary treatments for bipolar disorder include medications and psychological counseling (psychotherapy) to control symptoms, and also may include education and support groups.