Although it can be difficult to definitively diagnose bipolar disorder before adulthood, many people experience an onset of symptoms during adolescence. Adolescence is by nature a time of intensity and mood fluctuations; however, adolescents with a bipolar disorder exhibit discrete periods of irritability, grandiosity, and/or pressured speech and behavior, alternating with depressed mood, apathy, anhedonia, and hopelessness. Adolescents may be more susceptible to high-risk behavior during both manic and depressive episodes, and the number of untreated episodes is correlated to the number of episodes in later life. Many adolescents with untreated bipolar disorder also self-medicate with alcohol or drugs, leading to high rates of comorbidity with substance abuse disorders. Mood episodes can take a toll not only the teen, but on the entire family.
For most adolescents, effective management of bipolar disorders involves client and family psychoeducation, medication management, behavior therapy (CBT or DBT), and relapse prevention.