In 1994, Psychiatrists met for the American Academy of Child and Adolescent Psychiatry annual conference. About 10 of these esteemed Psychiatrist met for a discussion on Bipolar Disorder and Children. At this time, only 2 of the psychiatrist had seen any children that might have had bipolar disorder (it was not believed that Bipolar Disorder occurred during childhood).
Fast forward three years later…same convention, same conference. The only difference? Instead of a mere 10 psychiatrist discussing Bipolar Disorder in Children, the room was packed with hundreds of Psychiatrists discussing a “new” diagnosis: Bipolar Disorder in Children.
What happened in just 3 years? And why are 60-90% of these children also diagnosed with AD/HD? Dr Stuart Kaplan, a noted psychiatrist practicing for almost 50 years questions this in an incredible article in Newsweek Magazine Online . This article was taken from his book, Your Child Does Not Have Bipolar Disorder.
According to Kaplan, in 1995 there were 20,000 outpatient visits for Bipolar Disorder in Children. By 2003 that number had gone to 800,000! Now, 1/3 of adolescents released from psychiatric institutions have received the diagnosis.
When I read about Kaplans book on Amazon, there were very few reviews (well 4 to be exact – 2 thinking he was brilliant, and 2 wanting to hang him from the nearest tree). What I wondered is if, perhaps, the parents had some how become attached to the diagnosis. FINALLY something fit their children that were out of control. I understand how that must be incredibly comforting to know “what is wrong.” I hear that a lot from Adults with a chronic illness that goes undiagnosed for years. By the time they get a diagnosis, they are one step away from feeling that it is all in their head. Finally they have a name. A disease. They read everything they can, join support groups, and push for more research dollars for a cure. PLEASE do not think that I am slamming these people. I reacted the same way when I found out I had Lupus.
But, what was MORE important to me than a label, is a CORRECT label. Don’t tell me I have Lupus and flush me full of drugs only to find out years later that I actually have MS and have been on all the wrong drugs, in all the wrong support groups, and have to deal with all of the emotional issues all over again (denial, anger, depression, bargaining, acceptance), and start googling for a new disease that was really the RIGHT disease all along.
I’ve seen these parents in my office when I worked with AD/HD kids. They were exhausted, upset, frustrated, and even in one case that I may not ever forget, terrified of their deepest, honest feelings, “I just don’t think I like my child. Am I horrid?”
No, they weren’t horrid – they were over the edge and needed to know who needed help- their child or them.
We see “labels du jour ” all the time. In the 90’s everyone’s child was AD/HD. But do pre-school children really have bipolar disorder? The problem is so many symptoms of Bipolar overlap with other childhood disorders, including AD/HD ,Oppositional Defiant Disorder, Symptoms of abuse, depression, conduct disorders, and others. So why is this happening and what do you do?
Now in my humble, and often wrong opinion, I believe that Big Pharma and those cute, perky young drug reps have a lot to do with what diagnosis is trending (remember my blog that mentioned the movie Love and Other Drugs). A drug comes out, promises to fix EVERYTHING wrong with your child (or you) and they run advertisements on TV, and every magazine,so patients come in BEGGING for XYZ drug by name.
So the bottom line is this. When your child is acting different and you go to a therapist, don’t rush to get a label. Bring a list of behaviors to the appointment. DON’T try to make them fit a diagnosis that you have read about. I know that is hard, because many people are afraid their therapist will miss something vital. If this therapist immediately believes your child needs to be filled to the brim with a lot of mood stabilizing drugs I would get a second (or third) opinion.
Make sure you are going to CHILD PSYCHOLOGISTS, not therapists that work predominately with adults, but see Children. After all, no matter what is going on, therapy should be part of the treatment. And even if all of the therapists come up with the exact same diagnosis after interviewing your child several times, find someone whom your child clicks with. And child therapy means entering their world through play, so find a therapist that works with toys, sand tray work, or art therapy.
So, are children really bipolar? Maybe some… What do you think?