According to a new study there has been a dramatic rise in the number of young Americans diagnosed with bipolar disorder in recent years.
Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in a person's mood, energy and ability to function which are not the same as the normal ups and downs that everyone experiences.
The symptoms of bipolar disorder are severe and can result in damaged relationships, poor job or school performance, and even suicide; it distorts moods and thoughts with often dreadful consequences.
The periods of highs and lows are called episodes of mania and depression.
Bipolar disorder affects as many as 5.7 million American adults or about 2.6 percent of the population age 18 and older.
The disorder usually develops in late adolescence or early adulthood but some people experience their first symptoms during childhood, and some develop them late in life.
Many people suffer for years from the disorder before it is properly diagnosed and treated; it is a long-term illness that must be carefully managed throughout a person's life.
The study by researchers from Columbia University, and New York State Psychiatric Institute examined the rates of diagnoses of bipolar disorder between 1994-1995 and 2002-2003 from data on doctor visits.
The study looked at visits by individuals aged 19 and younger compared to adults aged 30 and older.
The research team found that a diagnosis of bipolar disorder in the younger age group increased approximately 40-fold, from 25 per 100,000 in 1994-1995 to 1,003 per 100,000 population in 2002-2003.
In comparison during the same time, the diagnosis of bipolar disorder in adults increased almost 2-fold, from 905 to 1,679 per 100,000.
The researchers, led by Dr. Mark Olfson, from Columbia University say the dramatic increase highlights the need for "reliability studies" to determine the accuracy of diagnoses of child and adolescent bipolar disorder.
The authors suggest two possible explanations for the significant increase in cases of bipolar disorder in young people; it has either been previously under diagnosed in children and adolescents and the problem has now been rectified or else bipolar disorder is currently being over diagnosed in this age group.
The researchers say unless independent systematic diagnostic assessments are conducted they cannot confidently select between the two competing hypotheses.
Possibly of more concern was that Dr. Olfson's team also found that the vast majority of youth and adults were prescribed a psychotropic drug at the time of diagnosis of bipolar disorder.
These included mood stabilizers, antipsychotics and antidepressants and the researchers warn there is an urgent need to evaluate the effectiveness and safety of such drugs in young people diagnosed with bipolar disorder.
The study is published in the Archives of General Psychiatry.