With the recent death of Carrie Fisher (RIP, General Organa), a vocal advocate for mental health, there has been a lot of discussion around bipolar disorder. There are several basic types of bipolar disorder; all of them involve clear changes in moods, energy, and activity levels. These moods range from periods of extreme emotional highs, feelings of elation, and energized behavior (known as manic episodes) to very sad, “down,” or hopeless periods (known as depressive episodes). It’s normal for people to have some moods swings between high and low, so what makes this psychiatric disorder such a big deal?
During manic episodes, one may have decreased need for sleep, have inflated self-esteem, feel “wired”, talk really fast about a large variety of topics, have racing thoughts, be irritable, and do a lot of impulsive (like shopping sprees) or risky behaviors (like high risk sexual behaviors). A person in a manic state may have delusions (“I’m a god!”) or hallucinations. A manic episode must last at least one week and cause significant difficulty at home/school/work/social settings to be considered diagnostic criteria for bipolar disorder. In a hypomanic episode (less severe than a manic episode), one may have similar change in mood/behaviors, but it does not cause significant difficulty with home/school/work/social settings. Although some aspects of a manic episode may sound appealing (you mean I get a lot of things done with little-to-no sleep and still feel euphoric?), the “high” does not stop at a good level. Moods can rapidly become more irritable, behavior more unpredictable, and judgment more impaired.
During depressive episodes, one will feel sad or hopeless, have decreased energy levels, changes in eating and sleeping habits, feelings of guilt or worthlessness, and lack interest in activities. Sometimes people in a depressive episode may be unable to get out of bed, or be incredibly overwhelmed making routine decisions. They may consider suicide. These episodes must last at least 2 weeks and cause difficulty at home/school/work/social settings to be part of bipolar disorder diagnosis.
The risk of suicide is very high in people with bipolar disorder (50% of people diagnosed with bipolar disorder attempt suicide), and can occur in either manic or depressive episodes. “Self-medication” with alcohol or other drugs is fairly common with these disorders. Although bipolar disorder can occur at any point in life, the average age of onset is 25. Every year, 2.6% of the U.S. population is diagnosed with bipolar disorder. It’s important to note that bipolar disorder does not get better on its own; it is treated with a combination of medications and therapy. Proper diagnosis is key!
If you’re concerned that your teen is showing signs of any mental health problems, including bipolar disorder, it is important to talk to a health care provider as soon as possible.