More than a mood swing: Do teens really suffer from bipolar disorder?

A psychiatrist from the Montreal Children's Hospital separates fact from fiction

MONTREAL, Sept. 20, 2012 /CNW Telbec/ - Many teenagers experience periods of sadness that quickly morph into a better mood, but these mood swings are often just the usual ups and downs associated with growing up. Bipolar disorder is something far more serious and now researchers know the disease can manifest itself in children and adolescents as well.

"Bipolar disorder is not just an adult disease," says Dr. Lila Amirali, psychiatrist at the Montreal Children's Hospital (MCH) of the McGill University Health Centre and director of the hospital's Pediatric Psychiatric Care Program. "Now that we understand much more about it, we're able to diagnose it more accurately in teenagers."

Some people may think that bipolar disorder is a constant series of manic behaviour and depressive behaviour but according to Dr. Amirali, that's not the case. "We only need to see one manic episode, even if all other episodes are depressive. In adolescents, the first episode they experience is usually depressive, but if they experience a manic episode that lasts for a week or more then they qualify for a diagnosis of bipolar disorder."

Recognizing the symptoms
What defines a manic episode? Dr. Amirali says it can appear in many forms but the most common symptoms are the following:

  • Feelings of grandiosity
  • Decreased need for sleep
  • Flight of ideas
  • Pressured speech or being very talkative
  • Easy distractibility
  • Agitation and increased activity
  • Poor judgment and impulsively engaging in activities with bad outcomes
  • Underestimation of risk

Dr. Amirali also points out that teenagers who are experiencing a manic episode won't necessarily show signs of being happier. "People tend to think that being manic means being happy but that's definitely not the case across the board. We very often see excessive irritability and even psychotic symptoms such as delusions or loss of touch with reality."

Over the course of a lifetime, 2.5 to 3 per cent of the general population will have bipolar disorder, and males and females suffer from it in equal numbers. It is extremely rare in children under the age of 12. The disorder tends to run in families and it is the highest inherited psychiatric disorder. Parents who have bipolar disorder or know that there is a history of bipolar disorder in their families should be aware of the signs and symptoms and what to watch out for.

Effective treatments give families hope
"Bipolar disorder in teens didn't even exist as a diagnosis 20 years ago," says Dr. Amirali, "but now we know so much more about diagnosing and treating the condition, and parents have every reason to be hopeful about the outcomes." At the bipolar disorder clinic at the Montreal Children's Hospital, medication, psycho-education and psychotherapy are used to help patients manage their symptoms. Dr. Amirali emphasizes that treatment and optimal follow-up are of utmost importance in helping a teenager live with bipolar disorder. "We teach our patients as well as their families about the importance of lifestyle hygiene—that is, keeping regular routines especially when it comes to sleep, and minimizing stress factors in the child's life." School consultation and support also play an important role in helping an adolescent live with bipolar disorder.

Often, teenagers who experience a manic episode are brought to Emergency at the hospital. Once diagnosed, they are referred to a psychiatrist for follow-up. Other patients are referred to the Montreal Children's Hospital through their doctor or CLSC. Dr. Amirali points out that whether or not the teenager has a dramatic episode that may require hospitalization, they will be referred to psychiatry. "Families should know that there are resources in place to help them if they suspect bipolar disorder, and they should not hesitate to ask for help."

Dr. Amirali will be giving a talk on bipolar disorder during the English edition of Mini-Med at the MCH. Registration has begun and seating is limited. Mini-Med is offered in English starting October 9 and in French starting October 10. The cost is $65.00 for adults and $45.00 for seniors and students. People interested in attending can register online at or obtain more information by calling 514-412-4307.

For further information:

To interview Dr. Amirali please call:

Stephanie Tsirgiotis
Communication Officer
Public Relations and Communications
The Montreal Children's Hospital, MUHC