In the late 1990s and continuing on into the past decade, bipolar disorder started being diagnosed more and more in children. This became a problem only because the criteria for bipolar disorder in children have never been firmly established. Researchers developed their own set of criteria which contradicted the official diagnostic criteria for the disorder. The research criteria basically did away with the need for a manic or hypomanic episode, and instead replaced it with irritability and anger.
Coincidentally, a few pharmaceutical companies also released a set of medications — called atypical antipsychotics — which can be used to treat certain symptoms of bipolar disorder.
Doctors started diagnosing bipolar disorder in children with a looser set of criteria, and felt more at ease prescribing a treatment for it because these new medications had become available.
This set of circumstances led to a reported 40-fold increase in the past decade of bipolar disorder diagnoses in children. This suggests a pretty obvious problem in the diagnostic criteria, since nothing has changed so much in the past decade to offer a reasonable explanation for this sort of increase.
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Yay, can finally comment on this post. I just wanted to say coming up with quaint names for life issues is just wrong. If I am the only one who has the fortitude to say it, the APA is a lost cause. As I have debated with another colleague at a different post, trying to label typical psychological behaviors/experiences as illness is only about medicating them.
Oh, and by the way, I hear from a colleague that there are studies trying to validate the use of opiates to treat depression. What?!
Hi Joel:
I agree. This is absolutely ridiculous! When I first read about the acceptance of the DSM-5 and its release date of May 2013, I realized we are not progressing, we are digressing. The field is becoming an embarrassment to many of us rather than something honorable.
Pathologizing “normal” behavior will do nothing but distract mental health professionals from the more severe illnesses that require our attention. Children will be labeled with “mental problems” based on a poorly defined and under-researched criteria in the DSM-5. The DSM-IV was already a “creation” that resulted in controversial diagnosing, now we have DSM-5. Where is the progress?
This new edition will require clinical insight, discernment, and intuition to properly diagnose and identify illness. The hard part of this, however, is that the DSM is often used to bill for services, so many people will be labeled inappropriately (for minor issues) just for billing!
This is outrageous. You have forgotten what it is to be human, to be normal. These hyper regulators want to define what you are supposed to be like as a child. Instead of leaving children and their parents the room to learn to be human, the hyper regulators are there to interject their supposed expertise. Can’t we find a pill to give the psychiatric union to regulate them instead? Hyper Regulation Control Disorder.
Perhaps those of you who think this is a frivolous diagnosis and this is simply “what it is to be human”, have never experienced a child in the throes of being completely out-of-control. We have been working with professionals since our son was 3 1/2 years old. He is now nine and has started some meds for ADHD which has helped at school. Not so at home. Last night he decided he didn’t want to do something and got upset over a not-so-important matter. He threw pillows -and punches- at his father, said the usual how much he hated us, we’re not his parents (he’s adopted), and pretty much wrecked the living room and hallway. He was screaming loud enough for him to be heard up the street and the doors and windows were closed. Once I was able to calm down, he kept saying ,”I’m so bad, I’m so bad. I can’t control it.”
I don’t care if it has one name or another, it’s still semantics. But please don’t say it’s normal childhood behavior. We are living in hell while we try to help our son.
Let me share some of my own experiences. I too have a son who has the same behavior issues as your son. At first it appeared to others (relatives, neighbors, etc.) as just bad behavior. As my son got older, it got worse with anger episodes. And contrary to what the others that have left comments above believe, there very well may be an issue here. After several months/years searching for an answer, a competent medical professional and hours of research, we came closer to an answer. Once early in our journey, my son was put on the psych drug (Risperdal) at a large hospital’s children’s Psych Unit which resulted with an angry doped up child who woke up every morning screaming in anger. After numerous therapists, psychologists, social workers and psychiatrists our journey continued. At some point our son was diagnosed with Asperger’s which sort of made sense. My son did not figure out how to make friends until he got into the 7th grade. But determination and the belief that he was not bipolar and did not need to be on Risperdal led to a Psychiatrist who was open to thinking and made the decision to treat my son for OCD. Needless to say after some increases in medication, he went from having a meltdown on a daily basis to once a week to once every few months. In a couple of months his behavior improved 200%. Now in the 10th grade my one concern is his ability to control his anger and keep his friends.
In summary, after a few years, the main thing I did learn is that most professionals in this field are mediocre diagnosticians, at best, and if it weren’t for a new diagnosis they would not know what to do.
I would like to offer some suggestions but this is no way stating you should not be under the care of a professional or that your son has the same condition my son has. I would be glad to contact you and share some of my own ideas. I am trying to encourage my wife, a writer, to write a book on the whole experience and maybe someday it may be used to enlighten and/or supplement the psychiatry population during the early years of their education.
Nick,
your comments ring true for me. My grandson has many of the behavioral characteristics that you have described in your son. He has been subjected to countless diagnosis and medications. His current medications have mitigated some of his anger but he cannot remain on them long-term due to the side effects. What has been most amazing to my daughter and me is that the “professionals” often rely on us to suggest medications and then simply write prescriptions. Apparently that is what psychiatrists do these days. I am amazed at the mediocre quality of people in this field!
I have been following the recent research on Ketamine for Bipolar or similar disorders. NIMH is currently recruiting children (ages 6 – 12)for a study and I have found some very knowledgeable professionals associated with this program. Unfortunately, the cohort they are recruiting is in the Northeast and we are on the West Coast. When I discussed my discovery of this program with “professionals” here they professed no knowledge of the work that has been done to date and seemed really quite uninterested. Never-the-less, they were ready to provide another diagnosis if that would help my grandson enter the program.
I agree with Smitty.I’m living a hell with my teenage son.he bullies me, calls me names, punches walls in and is always irritable. Its another job for me to deal with him as a single Mom. I’m happy to see some progress made in new diagnoses as psychiatrist do not like to make bipolar diagnoses before a child turns 18yrs old. This is frustrating because I don’t have a definitive diagnoses other than ADHD and conduct disorder. I am happy to say that he is now taking taking Adderal and I have seen some change so far and I hope it gets much better. Any med takes a good month to show its real effect on a person. I pray you find answers Smitty.
I used to teach dancing and had a few students who had mood disorders, mainly from crack addicted Moms.
Hard to work with but really nice kids.