Bipolar disorder is a mental illness characterized by extreme mood swings, from positive and active to depressed and lethargic. When bipolar disorder affects a teenage girl it can wreak some gender-specific problems. On the one end of the pendulum, a person with bipolar disorder can seem happy and highly energetic \u2013\u00a0this is the manic, or mania, phase. On the other end, the person can swing back to feelings of sadness, anger and negative self-perception \u2013\u00a0this is the depressive phase. The person may cycle through these phases every few days, weeks or months. Although the illness can occur in childhood, bipolar disorder usually becomes apparent during a person\u2019s late teens or young adulthood. Around 50 percent of cases start before a person celebrates their 25th birthday. When childhood bipolar occurs it\u2019s less frequently diagnosed in girls than in boys. By adolescence an equal number of boys and girls have bipolar disorder, but because boys tend to externalize symptoms and girls internalize them, it\u2019s often the case that girls don\u2019t get sent for treatment. Parents can usually tell something is wrong with their daughter because bipolar disorder often affects her menstrual cycle. If they miss periods or it lasts beyond the normal duration a gynecologist visit is in order. Disruptions in the menstrual cycle can hasten or delay full puberty and can also be linked to a heightened risk for diabetes. Just as it can be helpful to chart a teen\u2019s mood cycle, charting monthly periods and associated symptoms can also prove beneficial. Symptoms that parents should be on the lookout for prior to their daughter\u2019s monthly cycle include panic attacks, insomnia, depression, irritability, anxiety and inability to focus. Also, if the teen has a chronic illness such as migraine or epilepsy it\u2019s quite possible that symptoms may worsen during the days prior to menstruation. Teen girls with bipolar face not only physiological challenges but social challenges as well. During stable periods or manic episodes the young lady may be able to form friendships, but relationships can get derailed when her depressive episode takes hold. Anger, lack of motivation and intense acting out can make it hard for others to remain committed to an ongoing relationship. This can deepen her negative emotions and even lead to thoughts of suicide. Common symptoms of mania include: \tIncreased energy \tHyperactivity \tRapid or over talk \tProblems sleeping \tIncreased irritability, disproportionate anger and aggression \tInflated self-image and self-importance \tInability to focus \tRisk taking and impulsive behavior. Girls in the manic phase can demonstrate risk-taking and impulsivity in many ways. Some will drive recklessly, others will shop and spend beyond what they know their parents can afford. Hypersexuality occurs in 43 percent of young girls with bipolar disorder. This means that girls may dress provocatively or even engage in dangerous behaviors like sexting. In some cases, young girls have become victims of rape and forced prostitution due to their overtly sexual behavior during mania. Young girls with bipolar are seven times more likely to become addicted to substances like drugs or alcohol than girls without the illness. By comparison, boys with bipolar disorder face a three times greater risk of addiction. Common symptoms of depression: \tFeelings of guilt \tFeeling worthless and hopeless \tPersistent sadness \tDisinterest in formerly enjoyed activities \tSleeping problems \tChronic fatigue, low motivation \tSignificant drop in grades and\/or behavior at school \tAnger \tIncreased physical ailments like headache or stomachache \tMay become suicidal in the days leading up to her menstrual cycle. Depressed girls may act out in self-destructive ways such as cutting. Girls who cut are not necessarily trying to commit suicide, but they do need help. Bipolar disorder is a lifelong condition that requires careful attention and symptom management.\u00a0 The challenges of the illness are not minimal and particularly tricky for teenage girls. Parents need to be ready with positive interventions \u2013\u00a0a combination of medication, good sleep hygiene and therapy can be highly effective.