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Bipolar is characterized by inappropriate levels of response to stimuli, internal and external. Accelerated thought, sensory integration issues and anxiety are huge issues.
The disorder is a 'spectrum disorder' meaning that the presence of distress significant enough to impair normal function is present in predictable groups of symptoms. Bipolar always includes depressive disorder. It can also include mania, but not everyone will swing to that far end of the spectrum. Common comorbids are; delusions, ADD/ADHD, ODD, OCD, PTSD, insomnia, generalized anxiety, antisocial personality disorder, learning difficulties, psychotic behaviors, perceptual issues (self/others/paranoia). Teenagers will often see a complete reversal in their circadian rhythm patterns (which upsets all the other emotional levels).
Treatment is generally a mixed blend of CBT and pharmacological support 'by symptom'. So, you would treat anxiety with benzodiazapines, delusions with antipsychotics (typical and atypical), insomnia with a barbituate or suitable alternative. Most bipolar patients will require a cocktail of meds. Some stimulant based meds are okay (ritalin based meds) but others cause extreme suicidal ideation and mania (Seroquel has been shown to elevate the risk over 100% when prescribed to this group).
So, there is no one answer to your question...it's all about restoring balance. One final note, the protocols require doctors to prescribe the minimum level of effect dose, so they will often front-load heavy and taper off once a patient is stabilized. When there is an obvious break in the therapeutic threshold level they re-elevate the meds back to an effective dose. Treatment takes time and personal commitment. Being an adolescent is going to compound the issues.
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