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Bipolar Depression Treatment for Teens

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Around 3% of adolescents have bipolar disorder, and over 2.5% of these teens struggle with the effect the condition has on their lives. 

Bipolar I disorder is a serious mental health condition that involves extreme mood shifts, especially during manic episodes, often making life difficult for anyone living with the condition. Yet bipolar I disorder in teens and young adults can be particularly challenging, as it often interferes with many pivotal aspects of their developing life, including school and friendships. 

Since bipolar I disorder can have such a big impact on teens’ lives, it’s important to address the condition head-on, with professional treatment. If you’re a teen who’s struggling with bipolar I disorder, or a parent or caregiver who wants the best support for your child, know that the right support is out there.

Signs of Bipolar I Disorder in Teens

If you’re worried about a teen who’s struggling with bipolar disorder, understanding the symptoms of bipolar I disorder in youth can really help you support them. Manic episodes, which are elevated mood states, are the main symptom of bipolar 1 disorder. Signs of mania in teens include:

  • Being intensely happy, or on the flip side, very irritable 
  • Making poor decisions
  • Talking very quickly about a variety of different topics
  • Being unable to sleep but not feeling tired
  • Feeling as if one’s thoughts are racing
  • Believing oneself to be extremely powerful or knowledgeable 

While manic episodes are the foundational feature of bipolar I disorder in teens, these are not the only type of mood episode that can occur with this condition. Teens with bipolar I disorder may also experience hypomanic episodes, which are typically less severe than mania. 

To be classed as a “manic episode,” mania must last at least 7 days. They may also require hospitalization. On the other hand, hypomanic episodes do not interfere as much with how you live your everyday life.

In addition to mania and hypomania, some teens may experience depressive episodes with bipolar I disorder. Signs of a depressive episode include:

  • Persistent feelings of sadness
  • Extreme irritability or anger
  • Sleeping more than usual
  • Struggling to concentrate
  • Feelings of hopelessness and worthlessness
  • Eating more or less than usual
  • Losing interest in usual activities
  • Having low energy levels
  • Experiencing recurrent thoughts of suicide or making a plan for suicide 
  • Moving more slowly than usual, or alternatively, feeling restless

The mood episodes we’ve spoken about can disrupt a teen’s ability to make and keep strong friendships, excel academically, and tackle adolescence successfully. 

Manic episodes can interfere with their focus and rational decision-making at school, and depressive episodes can lead to social withdrawal and lack of interest in school and other activities. 

In some cases, a teen’s manic episodes can result in dangerous or psychotic behavior, which can make it difficult to function in daily life. 

Bipolar I vs. Bipolar II in Teens

The primary difference between bipolar I and bipolar II in teens is that bipolar I involves manic episodes, which are more severe and debilitating. A teen only needs to experience symptoms of mania to be diagnosed with bipolar I disorder. On the other hand, bipolar II disorder involves both hypomanic and depressive episodes. 

Hypomanic episodes do not interfere with daily life the same way that manic episodes do. Given this, bipolar I is typically the more severe of the types of bipolar disorder in youth. However, it’s important to say that bipolar II disorder is still a classified mental health disorder, and teens with this condition benefit from support and treatment. 

How Bipolar I Disorder is Diagnosed in Teens and Young Adults

So, how is bipolar I diagnosed in teens? Diagnosis requires a thorough evaluation by a licensed mental health professional, such as a psychologist or psychiatrist. This process often includes:

  • Clinical interviews with the teen and their family to gather information about their symptoms and history. 
  • Standardized diagnostic tools to confirm diagnostic criteria are met. 
  • Medical assessments to rule out other conditions.

Accurate diagnosis is critical to designing a tailored treatment plan that addresses the teen’s unique needs. So, seeing a professional is necessary. A professional will make a youth bipolar disorder diagnosis based on criteria in the Diagnostic and Statistical Manual of Mental Disorders – a tool mental health professionals use to help them diagnose. The diagnosing clinician will ensure that the youth meets the criteria of having at least one manic episode lasting at least 7 days. They may also assess for a history of hypomanic and depressive episodes—however, these aren’t needed to get a diagnosis.

Inpatient and Residential Treatment for Teen Bipolar I Disorder

Youth bipolar disorder can interfere with functioning in daily life, but treatment is available. Residential and inpatient bipolar disorder programs for youth provide structured, 24/7 support for teens with this mental health disorder. These settings cater to their educational, emotional, and social needs while offering:

  • Intensive therapy sessions.
  • A safe environment to manage mood episodes.
  • Access to medical staff, including providers who can prescribe medication.
  • Collaborative family involvement to support long-term recovery.

Therapy in Residential Programs for Bipolar I Disorder

Residential programs for teens with bipolar I disorder offer a comprehensive approach to mental health care, incorporating a variety of therapy modalities. These therapies can be offered in individual, group, or family formats. The following forms of talk therapy are typically offered in bipolar I treatment programs for youth.  

Individual Therapy:

  • Cognitive Behavioral Therapy (CBT): Helps teens challenge negative thought patterns and manage co-occurring challenges like academic stress.
  • Dialectical Behavior Therapy (DBT): Focuses on emotion regulation, mindfulness, and distress tolerance, making it particularly useful for managing impulsivity during manic phases.
  • Trauma-Focused Therapy: Addresses past trauma that may influence symptoms of bipolar I disorder, providing a safe environment for processing emotions and healing. 

Group Therapy:

  • Peer Support Groups: Teens share experiences and learn from peers, fostering community and reducing isolation.
  • Skill-Building Workshops: Teach practical strategies for managing mood swings and enhancing social skills.
  • Creative and Expressive Therapies: Art, music, and drama therapy provide emotional outlets and boost self-esteem.

Family-Focused Therapy:

  • Psychoeducation for Families: Educates parents and siblings about bipolar I disorder and effective communication strategies.
  • Family Counseling Sessions: Improve relationships and equip families to recognize and respond to mood episode triggers.
  •  

These are not the only types of bipolar disorder therapy for teens, but they are commonly used in treatment. They can be highly effective for managing symptoms of bipolar disorder in this age group.

Medication for Teen Bipolar I Disorder

Medication can play a key role in stabilizing a teen’s mood and preventing mood episodes, so some teens with bipolar I disorder may take medications in addition to participating in therapy. Common medications include:

  • Mood Stabilizers: These are used to manage manic and depressive episodes.
  • Antipsychotics: These address severe manic symptoms or co-occurring psychosis.
  • Antidepressants: These are carefully prescribed for depressive episodes, often in combination with other medications.

Close monitoring by a child and adolescent psychiatrist ensures the medication the teen is taking is effective, while also minimizing their side effects. 

Where medication is concerned, it’s important to support teens to take them exactly as prescribed, as this can have an impact on the treatment’s effectiveness and side effects. 

If you notice a teen struggling to take their medication correctly, or they are still finding it tough to manage their bipolar I, even with medication, speak to a psychiatrist. They can help you find an alternative medication.

Lifestyle Changes for Teens with Bipolar I Disorder

Managing bipolar I in teens often involves a combination of medication and therapy. However, lifestyle changes can also be helpful and necessary.  

Lifestyle adjustments can significantly improve life for teens with this mental health condition. Some helpful bipolar disorder lifestyle changes for youth include: 

  • Developing a Routine: Consistent schedules for sleep, exercise, and schoolwork help regulate mood.
  • Managing Stress: Techniques like mindfulness apps and relaxation exercises can reduce triggers.
  • Building Support Systems: A nurturing family and supportive social environment are crucial for any teen’s emotional stability, but especially a teen with bipolar I.

Why Residential Therapy Works for Teens

Residential therapy for teens with bipolar I disorder is helpful for several reasons. Residential programs offer comprehensive care tailored to teens’ needs, providing the following benefits: 

  • Holistic Focus: These programs address mental health, as well as academic challenges and life skills development, supporting a teen’s whole life. 
  • Constant Support: Around-the-clock care ensures immediate intervention when mood episodes are taking a toll.
  • Peer Interaction: Living with others facing similar challenges helps build understanding and connection, potentially developing friendships that can last a lifetime. 
  • Focus on Long-Term Success: Residential therapy prepares teens to reintegrate into home and school life with confidence, so they’re able to live their lives independently.  

Residential treatment provides a safe setting for recovery, away from the stressors of daily life. Residential care can be a lifeline for teens who don’t show improvement with outpatient treatment and bipolar disorder medications, as it offers a more intensive level of care. 

Immediate Help for Teen Bipolar I Disorder

Teens with bipolar I disorder may require emergency treatment in crisis situations. Recognizing when immediate care is needed is vital. Crisis help for bipolar I in youth may involve taking the adolescent to a hospital or enrolling them in inpatient care. Situations requiring emergency intervention include:

  • Suicidal thinking, or making plans for suicide. 
  • Severe manic episodes causing harm or danger.
  • Symptoms of psychosis, in which the teen is out of touch with reality. 

If you’re facing a crisis situation with a teen with bipolar I and you’re unsure of what to do, a crisis outline can provide direction. Teen Line (call 800-852-8336 or text 839863) or YouthLine (call 877-968-8491 or text teen2teen to 839863) are two of the best support services for teens in crisis. 

In case of immediate danger, staff in a hospital emergency room can provide care and referral to resources. At Mission Prep, we offer inpatient treatment for teenage bipolar disorder. Contact us today at 866-990-7769 for support. 

References

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787

Goldstein, T. R., Fersch-Podrat, R. K., Rivera, M., Axelson, D. A., Merranko, J., Yu, H., Brent, D. A., & Birmaher, B. (2014). Dialectical Behavior Therapy for Adolescents with Bipolar Disorder: Results from a Pilot Randomized Trial. Journal of Child and Adolescent Psychopharmacology, 25(2), 140–149. https://doi.org/10.1089/cap.2013.0145

Kowatch, R. A., Fristad, M., Birmaher, B., Wagner, K. D., Findling, R. L., & Hellander, M. (2005). Treatment guidelines for children and adolescents with bipolar Disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 44(3), 213–235. https://doi.org/10.1097/00004583-200503000-00006

Miklowitz, D. J., & Chung, B. (2016b). Family‐Focused therapy for Bipolar Disorder: Reflections on 30 years of research. Family Process, 55(3), 483–499. https://doi.org/10.1111/famp.12237

National Institute of Mental Health (NIMH) (n.d.). Bipolar disorder. https://www.nimh.nih.gov/health/statistics/bipolar-disorder

National Institute of Mental Health (NIMH) (n.d.). Bipolar disorder in children and teens. https://www.nimh.nih.gov/health/publications/bipolar-disorder-in-children-and-teens

National Alliance on Mental Illness (NAMI) (n.d.). Types of medication. https://www.nami.org/about-mental-illness/treatments/mental-health-medications/types-of-medication/

Özdel, K., Kart, A., & Türkçapar, M. H. (2021). COGNITIVE BEHAVIORAL THERAPY IN TREATMENT OF BIPOLAR DISORDER. Nöro Psikiyatri Arşivi. https://doi.org/10.29399/npa.27419

Simjanoski, M., Patel, S., De Boni, R., Balanzá-Martínez, V., Frey, B. N., Minuzzi, L., Kapczinski, F., & De Azevedo Cardoso, T. (2023b). Lifestyle interventions for bipolar disorders: A systematic review and meta-analysis. Neuroscience & Biobehavioral Reviews, 152, 105257. https://doi.org/10.1016/j.neubiorev.2023.105257

Yuan, Z., Li, B., Ye, X., & Zhu, X. (2021). Systematic review and meta-analysis of the effects of group painting therapy on the negative emotions of depressed adolescent patients. Annals Of Palliative Medicine, 10(10), 10744-10755. https://doi.org/10.21037/apm-21-2474

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