World of Psychology

Is Early-Onset Bipolar Disorder Simply Normal Childhood?

By John M Grohol PsyD
December 12, 2007

When researchers start referring to their own work in the field as a “bible” when it comes to the topic of their research, it makes you wonder if they’re perhaps drinking too much of their Kool-Aid. After all, researchers are supposed to be objective scientists, not simply advocates for their own beliefs and personalities as “leaders” in a field.

So it was refreshing to see psychologist John Rosemond call out Dr. Demetri Papolos and his wife Janice for becoming the leaders of their own little belief system where children who exhibit everyday, normal childhood behaviors should be labeled as “early onset bipolar disorder,” a non-existent diagnosis that the Papoloses are trying to push as a legitimate concern.

Rosemond hits a homerun with this simple observation:

Especially intriguing is the Papolos’ proposed list of “very common” symptoms for EODB including separation anxiety, tantrums (especially in response to the word “no”), defiance, hyperactivity, inattentiveness, unpredictable mood swings, and distractibility. Those “symptoms” will be familiar to anyone who has lived with a toddler.

If we start medicalizing and demonizing normal behavior, then we might as call it a day and label everyone with something. Children responding poorly to being told “No” as a toddler? That’s normal and can be diagnostic of absolutely nothing.

Should most toddlers be on drugs? I have to admit to having no small amount of difficulty with the reasoning involved here. One thing is certain: The Papoloses are a boon to both the mental health and pharmaceutical industries. I’m not so certain they are a boon to children.

In their book and in the May 2007 issue of their newsletter, available through their website, the Papoloses recommend against using the word “no” with a bipolar child “because it will trigger a meltdown.” When they were toddlers, my children often suffered wild seizures at the sound of “no.”

Interestingly, however, these seizures were eventually cured with regular doses of that very word in combination with consequences the Papoloses would probably consider draconian.

It’s amazing what people can find if they believe it hard and long enough.

It’s also refreshing to read experienced psychologists such as Rosemond calling the Papoloses out for the absurdity of some of what they are proposing. While indeed there may be such a thing as “early onset bipolar disorder,” the Papoloses aren’t helping forward their cause any by pushing it in their own self-acclaimed “bible.”

Read the aritcle: Is Early-Onset Bipolar Disorder Also Known As ‘The Terrible 2s’?


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16 Comments to
“Is Early-Onset Bipolar Disorder Simply Normal Childhood?”

Rosemond is not a doctor! On his website, it says that he has an MS…he has no Ph.D., and he has no MD. He is a Mr., not a Dr.

Also, he spelled the name wrong…it is not “Dimitri,” it is Demetri.” He appears to have not read the Papolose’ book, as they explain how they got there. Rosemond uses sounds bites.

His colleague, Dr. David B. Stein (http://www.drdavestein.com) also does not agree with the diagnoses of bipolar.

Thanks for the clarification, we updated the entry to correct these errors.

It is truly amazing at how true this article is. The part where is states that people will learn to belief something after awhile if they tell themselves thats what is true. The sad part to this is that to many parents are becoming busy and forgetting that kids are going to be kids and today’s world is very different from the older generations so it is no wonder that maybe the terrible two’s turn out to be the terrible three’s and four’s as well but that is no reason to slap a label on a kid and turn to medications to fix the problem.
I suffer from manic depression and for along time I was part of the yo yo approach to what I had. Test after test and medication after medication and I slowly starting believing that I was going crazy and almost lost sight of what I was and what my real problems were. Thankfully I had some close friends that were watching and pulled me aside and reminded me of what I was.
I do believe I have depression but its not as bad as the doctors wanted me to believe and I don’t have to be a zombie to live life.

Rosemond fails to state that the commonly associated behaviours are NOT diagnostic criteria. They are just common - just like in children with autism. If I had depression, hallucinations, mixed states, insomnia, etc… I think that I also would be having a “meltdown”!

He might be interested in this article: Some Temper Tantrums Can Be Red Flags: Study: Kids’ Violent Temper Tantrums May Indicate Depression (ABC News)– http://www.abcnews.go.com/Health/Depression/wireStory?id=4035143

A child diagnosed with bipolar just based on normal behaviour is actually being misdiagnosed. That is sad, and I hope that John Rosemond’s article prevents some misdiagnoses.

Children I know diagnosed with bipolar, had those diagnoses based on the diagnostic criteria of depression, hypomania/mania, mixed states, and hallucinations — not based on any associated behaviours.

Of course, in the end, at least in my own child’s case, the doctors did not know she had multiple medical issues going on, and the medications given for other MISdiagnoses probably contributed to those diagnostic symptoms, but that is another whole topic.

i sure do think that rosemond missed the mark. the behavior of my children are not reprentative of normal behaviors and were they not on medication for pediatric bipolar then they would be worse. i cannot agree and we went through all sorts of the forms of hades to get treatment for them. at this point they are fairly stabilized and recieving treatment both in therapy and with medication.

Sure would like to see what Rosemond would say or comment to the Time May 26 2008 page 33 article of Welcome to Max’s World. I have two similar children.

The Papolos’ list of “very common” symptoms perhaps may be seen in any toddler - but the emphasis on these symptoms and their extend is qualified later in their book. Tantrums last for hours and include knives, defiance would be biting and hitting your parents when just asking a child to take a bath - we are talking EXTREME symptoms that last beyond toddler age and certainly deserve further analysis. Not all children have early on-set bipolar BUT the ones that do are grateful that the Papolos have done their research and published (and communicate) a book addressing these rare but horrible disorder. Shame on anyone that prevents children from getting the help that they need and continues the stigma of mental health when the struggles are hard enough and life threatening for all involved. There are other symptoms involved in a diagnosis such as night terrors etal that are also considered in a complete and thorough analysis—and those begin at the age of 2! Everyone should support any research and publications that dive into the mysterious world of mental health. Its not an exact science but certainly a living hell.

Especially intriguing is the Papolos’ proposed list of “very common” symptoms for EODB including separation anxiety, tantrums (especially in response to the word “no”), defiance, hyperactivity, inattentiveness, unpredictable mood swings, and distractibility. Those “symptoms” will be familiar to anyone who has lived with a toddler.

Anyone who has a child with Early Onset Bipolar can tell you that the toddler behaviors Rosemond mentions, are seen in BP kids far beyond the toddler years. Furthermore, everything with BP is extreme. Toddlers having a tantrum do not frighten me. They are annoying, but not truly scary like a bipolar meltdown. I have two children, one who is not bipolar, but who went through typical toddler behaviors at the appropriate age. My other child who has bp is a completely different story. I would also like to mention that our family is loaded with this disorder and other mental illness. It is not that far fetched to say my child has early onset bipolar. Walk a mile in my shoes, Mr. Rosemond. I am thankful to have a reference source I can refer to from the Demitri book. Their book isn’t a bible, it is a reference book. It has helped me cope.

This is the most ignorant article I have ever read. This man obviously doesn’t have a bipolar child. Come see mine any time!!!

This article is great! All of you who commented have children who misbehave, not children who are bipolar. Try taking a parenting class!

Early onset is NOT a parenting problem! I have 4 children, all whom are adopted from infancy and all who have been raised the same. I have lots of exp with raising children and with children in general. I have been a teacher for preschool and have babysat children since I was 10. In order to adopt, my abilities to parent were reviewed with a fine toothed comb. I KNOW how to parent but yet my 5 year old son has displayed most of the traits that the Demitris refer to in their book. My 2 oldest children are successful and in college. My youngest doesn’t display any of these extreme traits either. Only my 5 year old. And it is no coincidence that his birth parent had BP. His behaviors are far away from typical (and I know typical from all of the toddlers that I have been around)
I knew without a doubt that something was different about him from the time he was around 2 months old! I didn’t know it was bipolar but it was evident that he was not like other infants his age. Unless you have lived with a child like this then you have no idea the intensity involved. It upsets me that others are trying to lessen the validity of the Demitris work since I believe it will help many parents learn how to help their children.

i disagree with Rosemond. I took my son to see Dr. Papolos and he was assume. He provided alot of answers and insight into what my son deals with. Many child psychiatrist do not know how to deal with the condition. Since seeing Dr. Papolos and following his recommedations, my son has improved. Alot of doctors are not aware of this disorder nor do they care. They automatically say ADHD which it is not.

My daughter has this terrible mental illness and has absolutely nothing to do with my parenting. My 4 year old daughter displays all of the symptoms of EOBD and it took 6 months to get a diagnosis. Last week she detailed a plan for suicide and told me that she will die when her brain tells her it’s time to die. She has horrific and bloody nightmares. Meltdowns that last hours. Hypersexual behavior. Extreme seperation anxiety and mania. I have another child (step)who will be 5 soon and while he is hyper and challenging at times he is NOTHING like his sister. There is a STRONG history of mental illness and suicide on both sides of my daughter’s family. And we do not allow either of our children any exposure to any graphic materials.
Now I’m sure that the next post will attack me as a parent, and I expect that. If you don’t have a mentally ill child then you would think we are crazy parents who need to get control of our children because all you have to compare is your own experience with your difficult child. Let me assure you, unless you have a bipolar child, you CANNOT understand or even fathom the heartbreak and literal hour to hour struggle to raise a child with this illness.
I have an education and background in a field that promotes and enforces parenting skills. I have taken parenting classes and sought counseling myself as I have spent her lifetime blaming myself for her behavior problems. I have finally began to see that my daughter’s problems are not because of me or something that I did wrong as a parent. Nothing I can do would make my daughter hallucinate that bugs are crawling all over her or that there are bats flying all over her room.
I tried EVERYTHING to avoid medicating her until last week when she was almost admitted to a psych hospital due to a calm statement that she was going to invite people over to our house to say goodbye before she waits in the street for a car to run over her.
I’m sure the next poster will find something wrong that I’m doing as a parent but unless you’ve walked in my shoes, your solution won’t mean anything. Believe me I’ve already tried what you have to say.

Well I don’t know anything about the poster above me, she may be a great parent or a horrible one. I do know my personal experience. My mother was highly abusive and put me on medication late in elementary school. Now our family to my knowledge did not have any history of mental illness. I would act up in school, and my parents were somewhat violent, hiding bruises. In fact I owned many turtle necks, blush make up was used to hide it. She was a former social worker, so she knew how others would spot things, thus she could hide them. The drugs made things like standing still impossible, and some would cause frighting halluciantions. It was a living hell, and now I have been off them for four years and still face chronic pain, muscle twitches, light headed moments. She constantly told me how worthless, how I was lucky she did not kill me.

She drilled into me, that if they knew about what she did, they would put me a foster care, that no one would love me because I was a “mutant”, that I would be locked in a basement and fed government cheese. She used the “disease” as an explanation for my acting up in school. Not because I was demoralized, punched in the gut by my step father, and smacked in the face, or had my hair pulled by my mother. Now am I getting my life back in order. I don’t what a normal childhood was. Maybe most diagnoses are accurate. All I can say, is that it is a shame if you ask me. Those pills took allot of things from me, I was a bit of a prodigy, scored several years above my grade level, when I started taking the pills it made thinking like walking while glued to the ground. They made me gain weight. Before I was thin and athletic. I can only imagine what those years could have been, and where I could have been now.

I understand how what I have said might seem hard to believe. Every word it truth whether you choose to believe it or not. I hope my personal story may help someone by reading it.

Joey that’s terrible that your mother did those things to you and it’s wonderful that you have grown into someone capable of taking charge of their life. I did not have a childhood like that and cannot concieve of a life like what you have described.

While my little girl has had quite the opposite childhood than you, I do hope that as she grows she will be able to do what you have done and learn about herself enough that she can live without medication.

Thanks for sharing your experience on this matter.

I love how others can think they know how to parent every child in this world! We have been through hell trying to get a DX on my daughter since the age of 5. ADHD, anxiety….and finally we’ve received a dx of EOBPD. We have a family history of BP and if you look back to her infancy, she had almost every issue that the Papolos’ list in their book.

Even now that she is correctly medicated, we have issues every single day. This is not a child who needs stricter parents, this is a child who needs meds and behavioral therapy to deal the blows that life has dealt her. I am really glad for her sake that God chose to send her to us than to some of the other’s posting on this site.

I take my role in her upbringing seriously and I love her in spite of her MEDICAL issues. I am so glad these wonderful people started questioning the behaviors they saw and brought attention to EOBPD.

And when we get equal treatment for Mental MEDICAL conditions in this country it will be a fine day, too. But that’s another story. Thank goodness that Mental Health Parity passed!

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    Last reviewed: By John M. Grohol, Psy.D. on 15 Dec 2007

 


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