Childhood bipolar disorderInterested in the truth about childhood bipolar disorder? Bipolar disorder is a complex and controversial condition. But bring up bipolar kids or even bipolar symptoms in children and the controversy goes through the roof! How did this become such a hot topic? Bipolar Kids According to Wikipedia
Should childhood bipolar disorder be diagnosed according to the same criteria as we use for adults (taken from the definitive professional psychiatric manual known as the DSM-IV)? Or does it take a special form unique to bipolar kids? After all, key symptoms of mania for adults may include things like hypersexuality, spending sprees, compulsive gambling, or reckless driving.
Bipolar kids and age of onset
Doctors Frederick Goodwin and Kay Jamison, in their authoritative text Manic-Depressive Illness: Bipolar Disorders and Recurrent Depression, combine a number of the most recent and reliable studies, revealing that the average age of onset is 22.2 years. However, given the usually lengthy gap between actual diagnosis and the first onset of symptoms, it seems that early symptoms such as unstable moods probably begin before age 20 for many if not most sufferers. What is clear - as long as the focus remains on clinical studies instead of anecdotes, pop culture fashion victims, and media hype - is that bipolar disorder in CHILDREN is RARE. There is a long way to go before we can arrive at reliable statistics. If we take as our starting point that bipolar disorder occurs in approximately 2% of the population (National Institute of Mental Health or NIMH), and that genuine cases of pediatric bipolar disorder are rare in comparison, then it can probably be safely stated that bipolar in kids younger than 14 will be less than 0.01% of the population (possibly much less) and that the frequency of occurrence decreases as age decreases. Bipolar children controversy
Many are skeptical about such an astronomical increase. Today in the US over a million children have been labelled as "bipolar". These huge increases have not been matched in other countries as the UK, Germany, Australia, or Japan. The "childhood bipolar epidemic" seems to be a uniquely American phenomenon.
One of the reasons this rash of diagnosis may appear unconvincing is that much of it is based on the work of Dr Joseph Biederman, now disgraced for failing to disclose the millions of dollars he was paid by the manufacturers of bipolar medications. Biederman provided the foundation for a phoney epidemic by broadening the diagnostic criteria for bipolar disorder in children. Specifically, he speculated that one of the defining characteristics of bipolar disorder - the episodic nature of the fits of mania and depression - took a different form in children. This enabled him to label any child who was aggressive, troubled, irritable, disruptive, uncooperative, or who for any reason would not or could do as he or she was told as "bipolar".
These medications have serious side effects, and may actually exacerbate some personality, psychological and psychiatric problems. All of this is not to say that there is NO childhood bipolar - just that it does seem clear that the 4000% rise in diagnosis is misleading and has resulted in harmful or inappropriate treatment, especially in children 4-14. On a more positive note, the heightened interest in children and bipolar has led to much innovative and quality research which, in time, should help fill in the gaps on our very incomplete understanding. This will be especially helpful in clarifying the overlap and distinctions between bipolar disorder and ADHD and/or severe emotional or behavioral dysregulation. We are also getting better at tailoring treatments for high risk kids such as the children of parents with bipolar disorder.
Bipolar Symptoms in Kids - What Child Psychiatrists Say
Click to move from Childhood Bipolar Disorder to the Bipolar Family
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