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COULD MY TEEN BE BIPOLAR?

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by Karen Kaufman, Ph.D.

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Many bewildered parents of teenagers ask this question when they feel at a loss understanding and dealing with their child’s mood swings and behavioral fluctuations. For most teens, this is a normal phase that centers on healthy emotional separation from parents and the development of individual identity — culminating in well-adjusted young adults.


 
   According to Freud, the years leading up to adolescence are referred to as the latency stage, during which time mental and physiological processes remain dormant and will become activated during puberty.  From the early adolescent years, for some children as young as 10 (depending upon individual development), many intense changes begin to take place and to have a profound effect upon behavior. 

   Rapid physical growth and the developing reproductive system result in hormonal fluctuations that can affect everything from mood to skin blemishes.  When added to social and peer pressures, academic demands, athletics, and the myriad of enrichment activities offered to youngsters, many parents report that their once agreeable, pleasant children are suddenly displaying mood swings, irritability, low frustration tolerance, and contempt for their family members. Is it possible that my child is bipolar? is a commonly asked question of parents of teenagers because they are unprepared for the changes brought by this normal developmental stage.

   Similar to the toddler years, beginning with the favored word no at approximately age 2, adolescence is a powerful time in which the child’s individual sense of self, identity and autonomy take root in what culminates in the loud statement to parents: I’m not you.  In being themselves, it is almost a requirement for adolescents to like different music, clothes, movies, and to reject many things that their parents represent.

   How does a parent distinguish between the normal difficulties inherent in this stage with actual bipolar disorder, given the similar appearance.  Bipolar disorder is a serious mental illness characterized by uncontrollable mood swings, the degree dependent on the severity of the illness.  There are typically periods of profound depression; and at the other end of the spectrum, mania, which can be displayed in euphoric expansiveness or aggressive and irritable behavior.  As with many emotional problems, the degree of disturbance is the key factor.

What parents should look for:

—Is your child functioning well academically, socially, and in extracurricular activities? Serious depression would impede these functions.

—Does your child look forward to normal activities or suddenly avoid them?  Depression causes loss of interest in previously enjoyed activities and a general loss of the experience of pleasure.

—Are there suicidal thoughts or gestures, preoccupation with death, is death glorified?  These are signs of dangerous depression.

—Are emotional outbursts irrational or are they exaggerated responses to perceived slights or upsets?  With emotions running high in adolescence, when one looks closely enough, the stressor can often be located. 

—Is there highly impulsive, reckless or potentially dangerous behavior present?  The connection between actions and consequences should be firmly entrenched by the teenage years.  Self-harm is never a normal response to stress or disappointment.

—Is there undue pressure on youngsters to succeed, possibly beyond their personal capabilities?  All youngsters are aware of their parents’ disappointments.  This adds another layer in addition to the pressures they put on themselves to succeed.  Excessive parental pressure may contribute to depression and feelings of worthlessness rather than to high achievement.

—Are there significant changes in eating, sleeping and other personal habits?  The normal teenage body needs more sleep and more calories, and most youngsters are concerned about personal appearance.  When they sleep through important activities or commitments, show sudden weight fluctuations, or allow personal hygiene to deteriorate, this may be a sign of more serious problems. 

   In the end, most parents survive this inherently difficult stage and go on to delight in their children’s accomplishments.  Parental tolerance and acceptance will promote a smoother process.

KAREN KAUFMAN, Ph.D., L.C.S.W., works in private practice in New Rochelle and on the Upper East Side of Manhattan. She is on the faculty of Fordham University Graduate School of Social Service in Tarrytown.


How to Identify Childhood Depression
   While most adults can identify the signs and symptoms of depression, in children and adolescents it may appear as the following:
—Increased somatic complaints — aches, pains, feeling a vague sense of illness
—Irritability
—Social withdrawal
—Changes in sleep patterns
—Changes in appetite and eating patterns — failure to meet expected weight gain, or excessive weight gain
—Distractible behavior and poor concentration that may appear similar to ADHD
—Decreased energy and motor retardation
 


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