Bipolar disorder is a mental condition not often diagnosed before adulthood. Many who are diagnosed do not exhibit definitive criteria until they are in their twenties or thirties, but may show some symptoms earlier in life. In addition, those who specialize in bipolar disorder are reluctant to issue a diagnosis until they have a complete picture of a person's physical and mental symptoms. As with any mental disorder that requires medication, specialists are cautious when diagnosing and treating serious symptoms. A recent study, however, provides evidence that some symptoms of bipolar disorder may be evident much earlier than previously thought. Conducted by researchers at the National Institute of Mental Health, the study shows that for many, the experience of one major symptom of bipolar disorder can begin during the teen years. The symptom is called mania, and it is recognized by the presence of excessive energy, impulsive risky behaviors and a lack of sleep. The study finds that nearly as many teens as adults report having mania, suggesting that the disorder often begins during the adolescent years. Lead author of the study, Kathleen Ries Merikangas, Ph.D., chief of the genetic epidemiology branch, explains that mania has generally been believed to begin during a patient's twenties and thirties. The study provides important information showing that mania can begin earlier, during adolescence. Bipolar disorder is often recognized by its cycles of alternating rounds of depression and mania. One type of diagnosis, however, is absent of the depression cycles and is only manifested in mania. Dr. Merikangas explains that there has been previous research conducted that shows mania present in children, but this study is focused on providing specific numbers of bipolar disorder occurring among youth. To evaluate bipolar disorder among youth, the research team surveyed more than 10,000 teenagers and asked questions about mood and behavior. The results of the interviews showed that 2.5 percent of participants met criteria for mania and depression and 2.2 percent of teenagers reported experiencing the symptoms within the past 12 months. In addition, the researchers found that in the 12 months preceding the survey, 1.3 percent of the teens had experienced mania and 5.7 percent reported depression. Dr. Merikangas says that the results indicate that bipolar disorder is much more common in teenagers than previously thought. While the study's findings may be based on a relatively broad survey of mental symptoms, the researchers say that the teens identified as having a mood disorder qualified for diagnosis according to the DSM-IV. Approximately 20 percent of those who were identified as having mania or depression had attempted suicide, and about half of those also reported having anxiety or a behavior disorder. The information gained in this study provides new insight into the needs for screening and identifying bipolar disorder symptoms before adulthood. The study's findings are published in a recent issue of the Archives of General Psychiatry.