Bipolar Disorder and Manic Depressive Illness

It is often hard to detect bipolar disorder. What makes diagnosis particularly difficult are the manic phases associated with the disorder. When you are manic, you often feel invincible. Even if you are exhibiting classic symptoms of mania—feeling extremely uninhibited and excited—you likely won't believe anything is wrong with you.

Problems Diagnosing Teens

As we saw earlier, it is harder to detect bipolar disorder in children and teens than in adults. This is partly because adults believe it is normal for adolescents to act up, behave unpredictably, and experience mood swings. As such, symptoms of both mania and depression are often mistaken for normal teenage behavior.

Another problem is that most bipolar research is based on adult behavior, even though depressed adults often act differently than teens. While adults tend to express their depression openly, many teens hide, or repress, their depression. Often, most teens don't even know they are depressed. They just know that something is wrong. Their extreme behavior is a cry for help.

“I never imagined I had a real, biological prob lem,” admits Ralph, fifteen. “All I knew was that I would get angry at people for no reason. The smallest thing could set me off. Ultimately, I think my shoplifting was just to get attention. Well I got attention—from the cops who arrested and charged me. That's when I finally saw a psychia trist, who discovered that I was bipolar and that I had been experiencing manic episodes. It was a relief to know that there was an explanation for my problems, and ways to treat them.”

Sadly, many parents and teachers mistakenly view teens' manic-depressive symptoms as mere bad behavior. They end up punishing teens instead of looking for the real causes of such behavior. If you aren't comfortable talking to your parents about your depression, try opening up to another adult you trust: a relative, a teacher, a coach, a close friend's parents, a clergy member, a school guidance counselor, or a social worker. If the feelings are overwhelming and don't go away, you will need to get professional help. Although bipolar disorder is a biological disease, there are no laboratory tests or other procedures, such as blood tests or brain scans, that can detect it. Instead, a doctor makes a diagnosis based on the presence of a combination of symptoms. To do this, he or she will talk to you and your parents to compile a detailed history of your symptoms, both past and present. Doctors focus on five areas when making a diagnosis:

• Development: Did you have an easy birth? Were you a healthy baby who had no problems learning to walk or talk?
• Physical health: Were you a healthy child? Did you have any illnesses, acci dents, surgery, or medical conditions?
• Psychological health: As a child, were you relaxed or anxious, shy or aggressive? Did you act up?
• Education: Have you always done well in school or have you had difficulty? Do you have trouble paying attention in class?
• Family: How do you get along with your parents and siblings? Are there any cases of mood disorders, learning disabilities, or alcoholism in your family?

You should have a normal physical examination as well as blood and urine tests and an electrocardiogram so that a doctor can rule out any kind of medical reason for your symptoms of depression. Often, psychological tests can help give doctors additional information about your state of mind. You might be shown pictures or images, such as Rorschach inkblots, and be asked to give your interpretation of them. Your impressions may give doctors insights into your fears and concerns.