Monitoring adolescents for early signs of bipolar disorder is crucial for timely intervention. The following list includes early indicators and warning signs across emotional, behavioral, cognitive, and physical domains. These signs may not confirm bipolar disorder on their own, but patterns or clusters of them—especially when they are severe, recurrent, or impairing—warrant professional evaluation.

Emotional Indicators

• Mood swings: Intense emotional shifts lasting hours to days, not just typical teen moodiness.

• Euphoria or irritability: Unusual happiness or silliness that seems out of context, or persistent anger and hostility.

• Depressed mood: Sadness, hopelessness, or emptiness lasting days or weeks.

• Low frustration tolerance: Becoming extremely upset over minor issues.

Behavioral Indicators

• Increased activity or energy: Hyperactivity or being “on the go” more than usual.

• Risk-taking behaviors: Engaging in dangerous or impulsive activities (e.g., reckless driving, substance use, unsafe sex).

• Decreased need for sleep: Feeling rested after very little sleep, without fatigue.

• Social withdrawal: Avoiding friends, family, or usual activities.

• Aggression or hostility: Physical or verbal aggression without clear provocation.

Cognitive Indicators

• Racing thoughts: A rapid flow of ideas or talking fast, jumping from topic to topic.

• Grandiosity: Unrealistic beliefs about one’s abilities or powers (e.g., thinking they can do things far beyond their age or skills).

• Poor judgment: Making decisions with little regard for consequences.

• Distractibility: Inability to focus or stay on task.

Academic and School-Related Indicators

• Drop in school performance: Sudden decline in grades or motivation.

• Behavioral issues at school: Disruptions, defiance, or disciplinary problems.

• Frequent absences: Due to sleep disturbances, mood symptoms, or social withdrawal.

Sleep and Appetite Changes

• Sleep disturbances: Insomnia during manic phases or hypersomnia during depressive phases.

• Appetite changes: Either eating excessively or having little interest in food.

Family History

• Genetic predisposition: A family history of bipolar disorder or other mood disorders increases risk.

When to Seek Help

If an adolescent shows persistent, severe, or escalating symptoms in more than one area, especially with impaired functioning, consider consulting a mental health professional—preferably one experienced in pediatric or adolescent mood disorders.

Would you like a printable checklist or tracker to help with monitoring?