Typical Teen Behaviour or Something More?

Typical Teen Behaviour or Something More?

Summary:
Adults
– Bipolar Disorder
– Swings from Sophia states of depression to states of either mania or hypomania (less severe mania)
– A full manic episode usually lasts at least 1 week (But it can be several)
– Person becomes elevated in mood or extremely irritable
– They feel grandiose – Have all sorts of ideas about accomplishment or powers they have
– They sleep very little or not at all – They do not feel tired the next day
– They are loaded with energy – they speak fast
– They are impulsive – Spending, sex
– When they swing to the other extreme – depression – they lose interest in everything
– They become very fatigued
– Are often suicidal

Adolescent (15 to 19 years)
– They have long periods with sub-threshold symptoms than adults
– There is more frequent switching between depression and mania (called mixed periods)
– They can be irritable & say “there’s no point in the world and my life is terrible” while talking rapidly and smiling
– Often described as a “tired but wired” feeling
– Accompanied with depression and anxiety – we also worry about suicide because adolescents can be impulsive
– Some typical teen behaviour such as unstable moods and risky behaviour with drugs or sex can also be expressions of bipolar disorder
– Keep a record of moods

Bipolar disorder has a strong genetic component
– Among women who have bipolar disorder the rate of the disorder in their children is up to 15%
– What is thought to be inherited is a vulnerability to mood swings when under stress
– it is most likely a combination of genes, environment & changes neurologically

Common triggers for mood episodes:
– Change in sleep wake cycles
– Negative life events (break-ups, loss of a loved one , criticism)
– Positive life events (These can trigger mania)
– Stimulant drugs
– Alcohol (depression)
– Watch for hiding food under the bed
– Watching TV to see if their name is called
– Calling relatives they haven’t spoken to in years
[note: it is not simply down to trauma]

Treatment:
– family-FOCUSSED treatment – Which involves three components:
– Psychoeducation
– Adolescent explains what episodes alike
– Parents are asked the same (From their perspective)
– Discussion of issues in the family playing a role in the mood of the teenager
– Safety plan / Relapse prevention plan – Knowing the signs
– Communication training
– Listen actively
– Make requests
– Balance positive feedback with negative
– Disagreements – Three volley approach
– First volley – Setting some sort of limit
– Second Volley – If teen responds “that’s not fair”
– Third volley – Let me explain again why I think this is fair
– More complaint/ argument – i Explained myself – we can discuss it some other time – for now the discussion is over – stop talking
– Problem-solving skills training
– Problems which are not being solved in the family
– Cleanliness | Money | Caring for family pets | Going to school
– Good to set up an IEP – Individualised educational program
– Classroom setup | Classes to be attended | Length of the school day etc.,
– Think about stigma – for the teen suffering as well as the teen telling peers

Source: Brain & Behaviour Research Foundation – The Quarterly, September 2016 – Miklowitz, D.

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