Everyone experiences a range of emotions and feelings in their
lives. They can be influenced by the things going on around them,
the people in their lives, or sometimes by nothing at all. The way
that someone is feeling at any one time is called their mood.
Ups and downs in a person's mood are normal, and young people in
particular can experience 'mood swings' as part of normal
adolescence. This can make it difficult to know when changes in
your child's mood are becoming a problem and might need treatment
from a health professional.
What is Bipolar Disorder?
Bipolar disorder is a mood disorder in which people have
episodes of low mood(major depression) and periods of 'high' or
elevated mood (mania or hypomania).These episodes last at least a
week and affect the person's life, interfering with their thoughts,
emotions, behaviours, relationships, activities and day-to-day
The pattern and severity of bipolar disorder is different for
everyone. Some people might have episodes that are close together,
while others may have long periods between episodes when they have
no symptoms and function well. Some people have one or two
episodes, then never have another one.
What is a manic episode?
A manic episode is period of elevated ('high') or irritable mood
which lasts at least one week and severely disrupts the young
When a young person is manic they may experience:
- Elevated mood - feeling euphoric, 'high', or 'on top of the
world' or very irritable
- Less need for sleep - sleeping very little without feeling
- More energy and activity - having lots of projects or plans,
walking long distances, being always 'on the go'
- Racing thoughts and rapid speech - thoughts jumping around from
topic to topic, speech that is difficult for others to follow
- Being uninhibited - not caring about what others think, not
thinking about the consequences of their behaviour
- Inappropriate behaviour - behaviour that is out of character
and potentially harmful, including sexual risk-taking, driving too
fast, abusing alcohol or other drugs, or spending large amounts of
- Grandiose beliefs -believing they have special powers or
talents, or that they are someone famous
- Psychotic symptoms - not being in touch with reality, and
having hallucinations, delusional ideas, or disorganised thinking
These experiences can feel very confusing and frightening, but for
some people they can also be enjoyable, and the person experiencing
them may not even think there is a problem.
What is a hypomanic episode?
A hypomanic episode is a milder form of mania. The symptoms are
less severe and might last for a shorter period of time. People do
not have psychotic symptoms during hypomania, and often manage to
What is a depressive episode?
A depressive episode is a period of lowered mood, with changes
in thinking and behaviour that last at least two weeks.
Typical symptoms of depression include:
- Feeling low in mood - sadness, irritability, tearfulness
- Losing interest in things that used to be enjoyable
- Changes in appetite and weight - eating more or less than
usual, gaining or losing weight rapidly
- Changes in sleeping patterns - trouble falling or staying
asleep, or sleeping much more than usual
- Lowered energy levels and lack of motivation
- Feelings of hopelessness and worthlessness
- Poor concentration and memory problems
- Thinking about suicide
Types of bipolar disorder
There are two main types of bipolar disorder: bipolar I
('bipolar one') and bipolar II ('bipolar two'). These categories
are based on the symptoms reported by the young person as well as
the observations of others including family, friends or health care
A person withbipolar Idisorder will have had at least one episode
of mania. They will usually have had depression at some time as
A person with bipolar II disorder will have had at least one
episode of hypomania, as well as at least one depressive
Bipolar disorder and families
Bipolar disorder can cause a huge amount of stress for parents
and family members. It can have a significant impact on family
life, especially if the young person is living at home. Watching
your child experience severe changes in mood and behaviour can be
distressing and confusing, especially if their behaviour is out of
character or dangerous. Families can provide vital support for
young people with bipolar disorder, but they can also experience a
lot of stress of their own.
Bipolar disorder often develops at a time when young people are
becoming independent from their families and taking on adult
responsibilities. For example, they might be moving out of home and
finding a job. When they become unwell they might have to move back
home, stay at home for longer than they were planning, or need to
be cared for by their parents. This can sometimes be humiliating,
frustrating and demoralising for a young person.
High levels of stress in a household can lead to more conflict and
unhelpful interactions, with a negative impact on everyone's mental
There are some strategies that might help you communicate with
your child without increasing everyone's stress:
- Try to listen to their point of view and understand why they
feel the way they do
- Avoid shouting, criticism or other inflammatory language
- Take 'time out' if a situation is escalating and come back to
it at a later time
- Keep language specific and clear, especially if they have been
having difficulties concentrating or remembering things
- Try to solve problems together with your child,rather than
telling them what to do
- 'Pick your battles' - try to raise only the important issues,
and don't argue about things that don't really matter
It can be very helpful if you can work with your child to find a
local doctor (general practitioner- GP) or psychiatrist with whom
they feel comfortable. If your child has had a positive experience
with a family GP in the past, then that's a good place to start.
Local community health centres and headspace centres can also
Expert medical care will help your child's recovery. Early
treatment can reduce the effect of the disorder on their life,
reduce the risk of future episodes, and improve the chance that
treatment will be effective.
Appropriate medication is a key part of treatment for bipolar
disorder. Psychological treatments are also important in order to
address negative thoughts and feelings, encourage adherence to
treatment, manage anxiety, and importantly, identify ways to
improve overall health and wellbeing.
Other strategies that can helpto manage bipolar disorder and stay
- Having regular patterns of sleeping and eating.
- Learning to manage stress.
- Avoiding alcohol and other substances.
- Keeping in contact with friends and other supportive
- Getting a good balance between rest and activities.
Black Dog Institute http://www.blackdoginstitute.org.au
Macneil, C. A., Hasty, M. K., Conus, P., Berk, M. & Scott, J.
(2010), Bipolar Disorder in Young People: A Psychological
Intervention Manual, Cambridge: Cambridge University Press .