What about bipolar disorder?

Bipolar disorder in young people under 18

by beyondblue Clinical Advisor and psychiatrist Associate Professor Michael Baigent

Bipolar disorder is a rare and often serious mental health disorder that is mostly seen in people aged over 18. It affects less than 1 per cent of the population.

Like many other mental illnesses, bipolar manifests during late adolescence and in the early 20s.  There are occasions when bipolar develops in earlier adolescence, but it is highly controversial as to whether it occurs in children.

There is only poor quality research in the area of bipolar disorder in children and based on my own experience as a clinician, I think it is very unusual for it to arise in a child under 14-years-old, if indeed it does occur at all. The youngest person I have treated for bipolar disorder in my career was 15-years-old, which was very unusual.

For this reason, Youthbeyondblue does not have any specific information on bipolar disorder for children or young people.

I urge parents and carers whose child or young teenager has been diagnosed with bipolar disorder to seek the advice of a reputable psychiatrist.

Why? Because bipolar disorder can be notoriously difficult to diagnose in teenagers.

It requires assessment in the first instance from a psychiatrist. Psychiatrists have more experience in diagnosing this disorder than a psychologist or other mental health professional. It is also advisable to seek the opinion of a clinician who is experienced with young people.

Bipolar disorder involves prolonged periods of abnormally elevated or ‘high’ mood and associated changes in behaviour, known as mania. Then, during other times, the person can experience depressive episodes. In between these highs and lows, the person usually doesn’t have any symptoms.

In teenagers, it is very hard to diagnose because it can be normal for many teens to have ‘ups and downs’ and sometimes even dramatic mood swings. These sudden changes in mood can make people wonder if the young person might have bipolar disorder.

It’s worth noting that bipolar disorder is much more serious than occasional mood swings. Mania involves persistent elevated moods and associated unusual behaviour.

It can be a dangerous condition. People with bipolar disorder often have suicidal thoughts during phases of mood disturbance.

Treatment usually requires medication such as mood stabilisers, which can play an important role in managing the condition. During manic phases, people frequently require hospitalisation.

My advice is to make sure young people get a proper assessment and referral to a psychiatrist if there is concern that bipolar disorder may be an issue. It is a disorder that requires careful diagnosis (often over time) and supervised treatment.

People aged over 18 should refer to the beyondblue website to download the bipolar disorder fact sheet for adults.