Bipolar disorder in teens has not been as well researched, nor received as much attention as has bipolar disorder in children. This may be because people tend to either group teens with children or with adults. Unfortunately, this is not helpful as each developmental stage presents different manifestations of the illness. This page will first discuss issues that teens specifically face when dealing with bipolar disorder and then will some tips that may be helpful to parents of teenagers who struggle with bipolar disorder (and other mood disorders generally). It also links to pages on children and adults with bipolar disorder.
Treatment for the bipolar teenagers must balance the need for the child to have individuality and confidentiality with the need to include the family. Well intentioned families of teens think teens require their own space and time with a therapist. Bipolar teens, however, often need the support, involvement, and understanding of the entire family. Treating a bipolar adolescent without family involvement is usually unsuccessful. In therapy, bipolar teenagers frequently tell me their parents don’t understand how much help they need. Many feel their parents and others expect them to be an adult and that they are not ready to handle any of these responsibilities. They feel they need more help from their parents then the normal teen, and they often want them to participate in therapy.
Bipolar teenagers, even when stable, have a hard time managing stress. They are vulnerable to stressful situations, but also struggle with self-awareness about the impacts of stress on their wellbeing. They need assistance recognizing the physical signs of stress in their bodies, coping with that stress, and reaching out to others to communicate that stress. Therapy can focus on assisting them in acquiring these skills.
Bipolar teenagers often “bite off more than they can
chew." They seem to have no concept of what they can handle and what they
can't. In realizing, they are overwhelmed by a task, they often shut down
completely. Parts of this may be because when they are experiencing mania they
think they can handle more than they can. Therapy teaches kids to take small
steps towards their goals, thus allowing them to experience success.
The bipolar adolescent struggles with acceptance of
peers and with understanding the opposite sex. Their judgment is often
impaired. They may choose friends who are not healthy for them or put
themselves in situations with peers where they are treated badly. Treatment must focus on these issues. These
need help to realize their value as a person (self-esteem), setting boundaries
for themselves, and setting standards for how they will allow themselves to be
Despite repeated education about signs of mania and
depression, bipolar teenagers often seem unaware of when they are experiencing
symptoms of mood states that may influence them. They need psycho education to
assist them in understanding the signs and symptoms of each mood state, and how
that may make them vulnerable
Bipolar teenagers must learn the connection between
sleeping, eating healthily, and their mood stability. In therapy I will often suggest they log their sleep, so they
can see directly how the lack of sleep impacts their ability to handle stress.
A sleep log is
also helps them to see when they are experiencing mania (little need for sleep high
energy) or depression. These days there are some apps on their phones that can
help with this kind of tracking
Families of bipolar teenagers often expect too much from them. Bipolar disorder disrupts emotional regulation, coping skills, and problem-solving skills. Don’t compare your bipolar adolescent to other adolescents. Many of the bipolar teenagers I work with are incredibly artistic and talented and feel emotions at a depth that most of us will never understand.
These teens may seem sophisticated because of these special traits. However, they still need a tremendous amount of help with their day to day existence. They require patience and support from their family and they need constant attention, care and monitoring.
Adolescence carries with
it many challenges that make it an especially difficult developmental period.
The bipolar adolescent has a compromised ability to face all these stresses and
Adolescence is a time when kids:
· Assert their individuality
· Separate from their parents
· Look to their peers for more guidance than their family
· Struggle for social acceptance
Often, the bipolar teen is not ready for these challenges. Bipolar disorder may cause them to be dependent on their family for basic daily functioning, and although they want to separate, that dependence can make it difficult.
What can you do as a parent to better help your Bipolar Adolescent?
As the parent of a bipolar adolescent you need to have an incredible amount of patience. A bipolar teen needs parents who are skilled at:
· Modeling good problem-solving skills
· Practice solving conflict peaceably
· Utilizing assertiveness to express thoughts and feelings
Parents need to learn these skills and therapy can help with that. Parents may need to process their feelings of grief and anger over the illness their child has. Frequently, parents have a diagnosis of depression or anxiety as well, often from the stress of raising a bipolar teen.
Insisting on parenting a bipolar disorder in teens teen the way you would any other teenager is ineffective and can be harmful for your child. Normal parenting techniques just don't work with kids who are bipolar.
Bipolar disorder in teens causes an everyday struggle for control. Bipolar teens struggle with regulating sleep , appetite and moods. Work to give them a sense of control by teaching, accepting and creating safety and stability. Insisting a bipolar teenager does what you want when you want it doesn’t work and will drive you crazy.
It is important to understand that there are normal developmental stages that children pass through as they grow up. Each stage is marked by the acquisition of new skills (hopefully) and a greater maturity level. If your child is bipolar it may be that their illness has disrupted this process of normal development. If your child is 15 but has been unstable in their illness for three years, they will not have the skills of a normal 15 year old. It may take them three years to catch up. Be reasonable about your expectations.
Teen bipolar disorder is a serious illness. Your child can be fine and go on to live a productive and stable life- if they get the right help and stay on the right path. Don't waste your time worrying and arguing with your child about unimportant things. All parents want their children to be productive adults who can have a job, friends, a family, and happiness - and the parents of bipolar teens are no different. And, all teenagers want to express themselves in ways that may be somewhat at odds with what their parents would desire. With the personal expression of an adolescent bipolar teenager, however, it is generally best to give some leeway. If your bipolar teenager gets a nose ring or a tattoo, it's not the end of the world. If they try suicide, on the other hand, it's much more serious. Parents need to identify and weigh the relative seriousness of any situation.
A bipolar teen often has an incredible amount of feelings and thoughts that they are struggling to make sense of. Create opportunities for them to express themselves, especially if they are writers or artists. Build on any strengths or interests they have, the more successes they have the more likely they are to be functional adults.
If you and your teen get into an argument, do not give them the silent treatment afterwards. They need help learning how to problem-solve and resolve conflict. When things are calm, discuss what happened and how you can move on from a serious incident
Bipolar teens are at risk for suicide. This constantly needs to be monitored. Parents must communicate with their child's therapist and psychiatrist about any signs of depression or concerns they have about their child.
Bipolar disorder in teens is a serious risk factor for drug use. Many adults with bipolar disorder have substance abuse problems.
During healthy and normal development, kids learn emotional regulation. They learn how to identify and tolerate painful emotions, and they learn how to cope with them. Bipolar teens are often overwhelmed by the intensity of their emotions and are at a complete disadvantage in trying to handle them. Parents must create a dialog with their child about what is happening with his or her emotions. Depending on the severity, duration, and age of onset, a 15-year-old may need to be treated like a three-year-old in understanding and managing their emotions. A parent needs to teach them about what they are feeling because the reality of the situation is that they themselves don't know. Parents often must read cues about how their child is feeling until they can do it themselves. Bipolar teens may not have the infrastructure necessary to regulate their emotions and so parents must create it for them with a lot of patience and repetition.