Bipolar disorder in Young People

Also known as: Bipolar Affective disorder; Manic Depression


Bipolar affective disorder is a mental health condition that affects men and women equally. It usually first develops between the ages of 18 to 24 years, but its symptoms are being recognised in younger people. The condition is characterised by mood swings between mania (feeling of elation or euphoria) and depression. If the manic part of bipolar affective disorder is milder and no admission to hospital is necessary, it is called hypomania.

There are usually periods of stable mood between episodes of bipolar disorder but, in the ‘rapid cycling’ form of the disorder, there may be few or no periods of stability between episodes. Occasionally, ‘mixed’ episodes occur, when symptoms of mania and depression can be observed at the same time.


Medical text written January 2013 by Professor Paramala Santosh.  Last updated May 2018 by Professor Paramala Santosh, Consultant Child and Adolescent Psychiatrist and Head of the Centre for Interventional  Paediatric  Psychopharmacology and Rare Diseases, Maudsley Hospital, London, UK.

Although great care has been taken in the compilation and preparation of all entries to ensure accuracy, we cannot accept responsibility for any errors or omissions. Any medical information provided is for education/information purposes and is not designed to replace medical advice by a qualified medical professional.

What are the symptoms?

Periods of mania may develop quite rapidly over a period of a few days and last for a week or longer. Aspects of mania may include a number (usually three or four) of the followingoccurring together:

  • unreal ideas of an individual’s importance
  • need for less sleep than normal
  • heightened energy
  • increased talkativeness
  • unrealistic new activities
  • inappropriate behaviour
  • distracted and agitated behaviour
  • mood change affecting personal and school or college life
  • risky behaviour leading to financial difficulties
  • possible alcohol and drug related misuse.

In bipolar affective disorder the depressive period lasts for at least two weeks and includes at least five of the following:

  • constant low mood for most of the day and nearly every day
  • sleep disturbance
  • weeping and extreme sadness
  • tiredness and lack of energy
  • lack of interest in most activities
  • inability to concentrate
  • feelings of guilt, worthlessness and suicide
  • appetite changes
  • problems in affection and personal relationships.

What are the causes?

The cause of bipolar affective disorder is not known, but it is thought that genetic and environmental factors are involved. Stress factors may play a part in the further onset of the disorder in previously diagnosed people.

How is it diagnosed?

A diagnosis of bipolar affective disorder type I describes an illness with one or more manic episodes or mixed episodes. People often have one or more major depressive episodes.

Bipolar affective disorder type II is characterised by the occurrence of one or more major depressive episodes accompanied by at least one hypomanic episode.

This usually requires a psychiatrist to complete an assessment to provide a diagnosis and treatment plan.

How is it treated?

Treatment with medication is either preventative or symptomatic (treating episodes of mania and depression when they occur). Medication is usually mood stabilising drugs such as atypical antipsychotics (eg aripiprazole, risperidone, olanzapine, lurasidone), lithium and antiepileptic mood stabilizers (eg carbamazepine, sodium valproate and lamotrigine). Sodium valproate should not be used in women of childbearing potential, or in post-pubertal girls, as it can be harmful to the unborn baby. It is often necessary to combine mood stabilisers in order to get good control of the symptoms. These medications can be taken as a long-term preventative measure or as a symptomatic medication.

Inheritance patterns and prenatal diagnosis

Inheritance patterns
It is thought that an individual’s genetic make-up might be involved as there is a higher than average chance of developing the condition if other members of the family are affected.

Prenatal diagnosis

Is there support?

Bipolar UK

Tel: 0333 323 3880

Bipolar UK is a Registered Charity in England and Wales No. 293340. It provides information and support to people affected by bipolar and associated illnesses. Offers support groups across the UK, an active eCommunity and a Support Line.

Group details last reviewed December 2022.

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