The age of onset is important with Bipolar 2. Your teen is struggling with depressive symptoms. Your family doctor has suggested that your child may need expert help from mental health specialists.



The age of onset for Bipolar 2 is 15-20 years old which is a particular window of high school to college age. To me, this means young adults will be looking to and dependent upon support from their parents.

This is a big ask. The typical parent has no need to know about mood disorders. It is likely that their child will present as depressed. I think it is the inclination of most parents is to take a wait and see attitude as these years can be fraught with all sorts of challenges, emotions and transitions.

If the issues persist, or reoccur, a visit to the family doctor is a likely next step. This visit is great for ruling out physical causes and issues. However many family doctors will prescribe an antidepressant first. If the patient has a Bipolar 2 condition, the antidepressant may not help and could make things worse. The doctor may make a referral to a specialist, a psychiatrist.

It likely and hopefully will be recommended for the teen to have a psychiatric evaluation. If the parents have no reference point for mental health care, this may seem daunting and perhaps even overkill. Parents and the teen often reasonably have concerns and hesitations about a mental health diagnosis and possibly medication.

Diagnosis concerns with Bipolar 2

Psychiatrists have a challenging job with differential diagnosis when it comes to Bipolar 2. Bipolar 2 can share some symptoms with other disorders, like adhd and unipolar depression. A thorough evaluation is crucial.  This is a link to a previous post I wrote about bipolar that you may find helpful as you begin to learn more:

But here is an astonishing and heartbreaking statistic:

People with bipolar wait an average of 10 years to be correctly diagnosed with bipolar. They typically have visited 3 providers in that time seeking an accurate diagnosis and treatment.

If a parent has been diagnosed with bipolar, there is a 15-30 percent chance the adolescent will develop a mood disorder. In the general population, the risk is 1-3%. There is a strong genetic component.

It can take time to process and consider a Bipolar 2 diagnosis for both the adolescent and the parents, in part because the general impression they have from movies and media don’t match with their experience. Many people associate the word bipolar with manic states: grandiosity, impulsivity, spending sprees, days without sleep. How can my depressed kid have a bipolar diagnosis?

Resources and Education are Available

There is a learning curve. The teen and his parents have often entered into an unfamiliar world. Education and resources are essential. The Depression and Bipolar Support Alliance is a nationwide organization that provides information and support.I feel inspired and urgent about this. A young person properly diagnosed at onset has a better prognosis. The age of onset, 15-20 years old, means there is a window of opportunity to intervene early. They have a chance to have their mood stabilized with medications and therapy. If they are able to stay stable and learn how to manage their mood disorder past age 25, their likelihood of recurrences of episodes decreases. As the psychiatrist teaching the course suggests, they can “dodge a bullet.” A significant aspect of the treatment path is related to lifestyle and stress management.

The psychiatrist I refer to is Dr. Chris Aiken. HIs website is He has also written 2 books:
Bipolar, Not So Much, co-authored with James Phelps, M.D.
The Depression and Bipolar Workbook