A Burst in Diagnosis of Bipolar Disorder

Listen to this 'Talk of the Nationn' topic

This study on the growing diagnoses of bipolar disorder in kids was startling. Doctors treated 40 times as many children in 2003 as they did in 1994. And it wouldn't be outlandish to expect that number has grown even higher in the last several years. Which means bipolar disorder is now more commonly diagnosed in children than clinical depression. There is some debate over what the study means, some researchers argue that more diagnoses is just a result of greater awareness of the problem. But, others believe that bipolar disorder is being overdiagnosed. The truth may lie somewhere in the middle. Dr. John March gave an interview in the New York Times today.

"From a developmental point of view," Dr. March said, "we simply don't know how accurately we can diagnose bipolar disorder or whether those diagnosed at age 5 or 6 or 7 will grow up to be adults with the illness. The label may or may not reflect reality."

We'll talk with one of the doctors involved in the study on the show today. He'll take your questions about what it means. If you're a parent of a child diagnosed as bipolar, what are your thoughts?

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As a psychiatric nurse, I've noticed that there has been a tremendous increase in the numbers of people being diagnosed with bipolar disorder(I, II and bipolar 'spectrum'.) In some cases -- but not all -- it seems to be driven by pharmaceutical companies who want to sell the newer antipsychotics.

Sent by Joyce Pusel | 2:45 PM | 9-4-2007

Parents seem willing to diagnose there kids as bi[polar, but as a family physician working with adolescents in placements for 15 years. they seem unwilling to address the children's chemical use or oppositional behavior. Rather they keep looking for the next pill to try to deal with their "bipolar" problem

Sent by Terry Cahill | 2:48 PM | 9-4-2007

As a practicing mental health professional, I find clients who are now enter therapy with self diagnosed Bipolar d/o - this self labeling/diagnosis is often as a result of the Bipolar buzz that has overshadowed the work needed to get to diagnosis - it seems like the "prescription" is written before the workup to diagnose.

Sent by Mina Schoenheit | 2:53 PM | 9-4-2007

What is the rate of similar diagnosis in other countries? If this is a real and significant problem, won't it exist everywhere to the same degree?

Sent by Bill Kingston | 2:55 PM | 9-4-2007

i started therapy at 12 for depression, so I've been thought the therapy ringer. One doctor i went to diagnosed me as bi-polar after 15 minuets when i was 18. i walked out of her office. it was a devastating blow. after 4 years of therapy with a great therapist, i manage my depression without medication, I'm successful, and certainly NOT bi-polar. i cant imagine where i would be if i went down the path of the quick to judge doctor who diagnosed me.

Sent by Carli | 2:55 PM | 9-4-2007

I work in the field of healthy space consulting and have learned through studies in Northern Europe, especially the Scandinavian countries that the increase in ADD, ADHD, atutism and Bi-Polar disorder can be attributed in part to the exposure to environmental factors, especiallyl EMF's.

Sent by Tricia McKenzie | 2:56 PM | 9-4-2007

Why is medication the obvious choice for coping with these 'problems'? Also, how is it we know mental deviations from 'normal' are debilitating? We trust psychiatrists to help us, but medication is not ever completely harmless, and is this profession to quick to seek an instant 'cure' to an interpreted 'problem'. Especially for less extreme instances of mental health issues.

Sent by kurt | 2:57 PM | 9-4-2007

I'm curious about the strength of heredity in bipolar disorder. I am increasingly convinced my adult son may be bipolar. He has been treated for depression since returning from Iraq but I recently found out that his father was diagnosed as bipolar. He absolutely refuses to consider that he might suffer from this illness. I can think back over his childhood and see much of what has intensified in him as an adult.

Sent by Karen M. | 2:58 PM | 9-4-2007

I have read numerous links between ADHD and bipolar. Is there an accurate test that can definitely differentiate from the two? What if a child has severe ADHD, and then you add immune system difficulties that affect the brain-could this mimic bipolar? Is it true that in children you may not see the diagnostic criteria of the mania, and could only see irritability?
Thank-you,
Lisa Hughes RN, BSN

Sent by Lisa Hughes RN, BSN | 3:00 PM | 9-4-2007

I was been variously diagnosed with bipolar disorder, depression, ADHD. I have serious doubts about how psychologists diagnose mental illness. There is a large population of adult males, who are highly intelligent and socially mal-adapted. They are variously diagnosed as bi-polar, ADHD, Aspbergers, or a combination of all three. Really, though, these diagnoses are just a justification for what psychiatrist really do: perscribe pills. In real life, psychologists go from pill to pill, regardless of the diagnosis, until they find something that works. If the ritalin makes the child settle down and study more, the prescribe that, even if the underlying bipolar symptoms are not treated. Now as a young adult I see that the cocktail of pills I was taking really did more harm than good. Ultimately, we need to better under stand how are brain works, and come up with science-based diagnoses, so we do not prescribe young children the wrong pills, which give parents a false sense of security.

Sent by Steve Scott | 3:09 PM | 9-4-2007

Kurt, mental deviations from normal ARE debilitating. I would not be alive today (literally) without psychiatric medication. Medication is not an instant cure: it usually takes several weeks to see the full effect, and "tweaking" or finding combinations of medications that work can take time. Yes, these medications, like meds for any type of sickness, have side effects, but personally, I'd rather live with the side effects than live either dangerously manic or suicidal. Psychiatric medications don't necessarily solve all the facets of mental illness, but they enable the ill person to think normally enough to pursue therapy and a healthy life.

Sent by Anonymous | 3:31 PM | 9-4-2007

It is all too easy to be diagnosed with neurotic disorders these days.

In the last year I have been subjected to countless doctors, psychiatrists, psychologists, etc. that have diagnosed me with everything from ADHD, to BI-polar disorder to borderline personality disorders, etc. with in 15 minutes of meeting me. (Not to mention throwing all sorts of hard-core chemicals at me all at once.) Ya, thanks for the band-aid, but none of these labels were correct. The case was that I had an eating disorder and I was depressed because of that. Once I realized this, I was able to slowly recover.

It seems these doctors just pick a disorder out of a hat and hand it to you and that it that. Investing emotionally in you takes too much time and is far less lucrative.

Sent by Ashlie Atwood | 3:40 PM | 9-4-2007

There are inevitably those who might err in prescribing medication for bipolar disorder and other mental illnesses. But for every case of prescribing where not needed I believe there are many more who need help and are going untreated. As a parent of a child with bipolar disorder I can tell you that it exists, it is real and the right combination of therapy and medication can literally be a lifesaver. Some, (Scientologists for example)will always be against medication of any kind so I won't waste my time trying to convince those folks of anything. I'd rather offer hope and suggestions to parents whose lives are a living hell (mine was) and who haven't yet found the help they need. I have a few suggestions: A very good book on the subject is a must read -- The Bipolar Child by Dimitri Papolos. A great resource is the Children and Adolescent Bipolar Foundation (CABF) which can be found at bpkids.org. Seek professional help for yourself and your child. Follow your instincts. If you have a bad experience with a psychiatrist and it just doesn't feel right, don't give up. Find the right doctor. And finally, there is a program that helped both me and my daughter tremendously. I don't usually go for these kinds of things but this one sounded so good that I took a chance and I'm very glad I did. (I hope I don't sound like a salesperson. I promise I have no financial stake in this!!) Anyway, it's called
"Total Transformation" by James Lehman and you can check it out for yourself by googling it. It's a way to help you work with your child and yourself to undo some of the negative patterns that might be making things even worse. For me, learning how to talk to my daughter and how to handle seemingly impossible situations, combined with therapy and the right medications, has resulted in a nearly miraculous turn-around. Good luck to you all.

Sent by Karen Wildfoerster | 4:16 PM | 9-4-2007

I was treated for post-partum depression with SSRI's after the birth of my son; I consequently nursed him while I was taking Zoloft. Five years later I was diagnosed with ultra-rapid cycling Bipolar II,probably exaccerbated by my misdiagnosis and years of SSRI use.

Last year, at the age of 10, my son was diagnosed with bipolar. Is it possible that his exposure to SSRI's through breast milk in infancy caused the early onset of the disorder?

Sent by Misty | 4:55 PM | 9-4-2007

There's not a lot more I could add to what most of us are blogging. $$$ for the pharmaceutical companies, parents looking for a "quick fix", teenagers being teenagers.

After spending ten years in and out of psychotic depressions, I learned about life and its beauty seldom seen. I've been med-free for nearly 15 years, how? By following Natural laws that by not following lead me to the psych ward.

The lack of following Natural laws, such as proper sleep, whole foods, enriching conversations, love, diaphragmatic breathing, and much, much more are what people are really suffering from. It goes by several "diagnoses" but the marketing of legal drugs is a sad commentary of our times.

Sent by Mike Allen | 4:55 PM | 9-4-2007

It was mentioned on the show that there is a 4:1 ratio of boys to girls being affected by bipolar disorder. This is also true in autism. We know that mercury has a unique chemical relationship with testosterone. I am wondering if there may be something similar going on with bipolar disorder. Also, I would have liked to hear some discussion regarding Gardiner Harris' recent article in the Times titled "Psychiatrists, Children, and Drug Industry's Role".
http://tinyurl.com/35j3e2
It seems to me that as in autism, medications are often pushed by doctors who have conflicts of interest with the drug companies.

Sent by Christina Blakey | 5:00 PM | 9-4-2007

My sister is having terrible problems with her son. He is 17. He was treated for depression, and the medication helped. But not enough. His anger was less violent, but still there. He stopped taking the antidepressants. We don't know if he is bipolar, we have thought that it might be Oppositional Defiance Disorder, as his behavior fits that. but in his moments when we can talk to him he says that the symptoms fit his feelings. His rages are frightening, and his violent behavior has injured his sisters and his mom. The problem is we cannot get him to go to a doctor. He absolutely refuses. He's abusing drugs. His father doesn't really care. His mother cares, but she is 5'2" and the kid is over 6'. She cannot physically force him into the car and make him go. He is looking for a "magic pill" to make his problems all go away. His mom knows, and has told him, that if he is bipolar, he'll have to go to a doctor to get a diagnosis, and it would take many visits and a long time. He doesn't want to listen to this. What does the guest think of a case like this?

Sent by Nanny | 8:50 PM | 9-4-2007

Boy am I tired of hearing/reading people who think they know everything about mental illness. Nothing worse than telling a depressed person "Oh everyone feels bad sometimes, buck up" Or "Medication is uneccesary, everyone has problems!" It's so insensitive and frankly, its rather ignorant.

Sent by Terri | 8:57 PM | 9-4-2007

You MIGHT say it was better diagnostics -- 20 years ago, a distressingly large percentage of the therapeutic community would have told you the same presentation of symptoms was due to the psychogical trauma of satanic or other ritual sexual abuse.

However, I strongly suspect that the real reason for the staggering rise in diagnoses of bipolar disorder is more directly related to the availability, advertising, and other promotion of new drugs to treat the disease.

Sent by TK Major | 11:45 PM | 9-4-2007

Competent medical professionals do not diagnose Bi-polar lightly. For the parents, most likely with medical insurance that offers minimal mental health coverage and very low lifetime benefits, getting help for their child is very difficult. I consider myself lucky. I was first advised that my child's ADHD, diagnosed at 7, could in fact be a precursor of bipolar. Looking at genetic links(it was on both sides of the family), testing, teacher observation, psychiatrist observation, we finally ended up with that diagnosis 7 years later. My child finally feels in control of himself.

Sent by Cindy | 11:48 AM | 9-5-2007

I agree with what TK Major said (above) about advertisins and promotion of drugs having alot to do with the rise in awarenes/over diagnosing of mental illness.

I also strongly agree with what Karen Wildfoerster said (above) that the right combination of therapy and medication can literally be a lifesaver.

I have experienced both of these truths. It shows us that we have to be proactive in our own treatment- become informed- do research- get 2nd opinions- talk to someone with the disorder- because we are ultimatly blind consumers in this situation. Also, the emotional effects from the pain can be softened if we understand WHY and WHAT out illness is/stems from.

Sent by Ashlie Atwood | 11:48 AM | 9-5-2007

Pharma-driven diagnoses? Doubtful. Lithium, a naturally occurring element in the earth, is the most successful medication prescribed for the treatment of bipolar disorder. It is also "off patent" and not a moneymaker for the pharmaceutical industry.

Speaking as person with bipolar disorder (who spent nearly 20 years misdiagnosed with everything from clinical depression to OCD to "laziness"), I am greatful for the medications that do exist, and that allow me to lead a somewhat normal and productive life.

Serious mental illness is not something you "get over". It is a devastating, debilitating neuro-chemical imbalance that can be treated with medication and counseling.

We all have scars. Some of us just wear them on the inside.

Sent by Dan | 10:47 PM | 9-5-2007

How can anyone who has not directly experienced the effect of chilhood bipolar disorder make a judgement about use of meds? I already had 2 kids, a nursing degree and experience as a psych nurse when my third child started having symptoms of depression. He wanted to be killed, his thoughts were morbid and later he had extreme anger outbursts. This was different, not at all like other kids I knew. What mother would want to put a kid on meds if it weren't needed? I'm grateful for the diagnosis that allowed him to get on the right meds. He is now on a mood stabilizer and an antipsychotic. Ask HIM if he feels better! It has been a world of difference and I thank God that we could get him treated early, before more damage could be done.

Sent by anon | 12:32 PM | 9-6-2007

I listened with interest to the Ladie from Fair Oaks as I too have a child with bipolar disorder and have a very difficult time finding a program to help her with social intervention and behavior. I would like to get in touch with her and to hear more on your program that could give information about programs available in California for the adolescent population. If you have the ladies information please forward my e-mail address to her so we can be in contact and I can learn more about the Turning Point program she is using. Thank you

Sent by Julie Matthews | 1:51 PM | 9-6-2007

I am a child psychiatist who has not joined the semi-religeous bipolar cult. Like the hysterical conversions in the late 1800's, blaming mothers for all psychopathology in th 50's, the MPD/DID/recovered memories/satanic-cults-are-eating-babies-and-killing-elephants craze in the 80's, this most recent psychiatric fad too shall pass. The basic problem: lazy psychiatrists and mental health professionals. It is far easier, and pays better, to see someone for 30 minutes, diagnose bipolar disorder, and throw medicaiotns at an individual with problems. In fact, drug companies have paid well for psychiatry to have the "chemical imballance (biggest load of crap in medicine in my opinion) is the root of nearly all paychopathology paradigm. It is a shame really. Then again, who has the time with managed care limitations to work on other factors that can lead to mood lability and anger problems (molestation, deprived, neglected, picked on, relationship problems, drugs... It is a long list)? Besides, the medications used for bipolar diagnosis usually help with mood lability or anger issues no matter what the diagnosis, just as ritalin will help with focus and impulsivity evaen if one is not AHDH. It's so sad: many psychiatrists equate medication response to a diagnosis. It makes me ashamed to be a psychiatrist at times. But, not everone has bought into the bipolar hysteria. Not all psychiatrists are idiots. Many are. But not all.

Sent by James Freeman, MD | 5:40 PM | 9-6-2007

I think Bipolar disorder is either missdiagnosed, not diagnosed, or just completely ignored.

http://my-bipolar-blog.blogspot.com/

Sent by Dannielle | 12:52 AM | 9-7-2007

I was diagnosed with bipolar disorder two years ago after a debilatating bout of depression. For ten years I was on multiple depression medications and had seen numerous therapists but I saw no improvement and I got to the point where I could harldy function inschool, work, & social situations. After beginning treatment for bipolar disorder my life has changed. I take medication for bipolar as well as ADHD, which often accompanies it, as well as going to therapy. Now I went back to school, I have kept a job for several years and all my relationships have improved. The correct diagnosis can change one's life so I think it is the patients responsibilty to be aware of the differnces in disorders and to seek multiple opinions if you question the physician's diagnosis.

Sent by Anonymous | 3:43 AM | 9-7-2007

I am sorry I missed most of this program when it was aired. However, I did want to bring attention to a newly released book, Bipolar and Pregnant, by Kristin Finn. It in a terrific source for anyone who is bipolar and thinking of having children.

Sent by kgatch | 8:56 AM | 10-11-2007

I live in Tulsa Oklahoma and i was wondering if their is anyone where i live that can diagnose and treat the bipolar disorder.

Sent by Brad | 1:30 PM | 2-11-2008

I have four children. One, since birth, was clearly different. With all due respect to Dr. Freeman (above) my baby, and then toddler, and then child had not been molested, was not neglected, deprived, picked on, etc. It would've been far EASIER to work on those issues than it was simply to parent this child. His emotional response to the same environment as his siblings was clearly "off". Intense, scary, debilitating. I observed the behavior for years and purposefully avoided reading about psychiatric disorders in order to prevent myself from "pushing" him into a diagnosis. When I described his horrible symptoms to doctors I got no help. When, at the urging of a social worker, I took him to a reknown pschiatric ER I was given random parenting advice. The social worker informed me that there were medications but never pressed me on them. He knew that I was resistant to any kind of medication. Finally, when the symptoms were worse than any medication could be - meaning that he would be dead by suicide at 9 years old - I knew that I had to try something. And, yes, Dr. Freeman, these meds obviously work on the symptoms (mood liability, irritability, anger, etc.) no matter what the diagnosis. So what? It is the symptoms that are so disabling. I do not know if my son has bipolar disorder(although he is being treated for bipolar type behaviors) but I do know that the mood stabilizer he is taking has made it possible for him to live, and, get at least a little semblance of normality into his life. He is grateful for the help. What I see as the problem is that we do not know enough yet to really diagnose any kind of mental illness. We have a lot to learn. In the meantime categorizing clumps of symptoms is an attempt to understand and work with the obviously painful mental illnesses that we do know without a doubt exist. Even in children.

Sent by ANONYMOUS | 12:47 AM | 4-10-2008