The Recent Controversy over Children and Bipolar Disorder
by G.J. Gregory
Thursday, February 22nd, 2007

The New York Times ran an article the other day, Debate Over Children and Psychiatric Drugs. In the article they describe a 4 year old girl who died from an overdose of psych medications. She had been prescribed Seroquel, Depakote, and Clonidine since her diagnosis of bipolar disorder two years earlier.

You read that correctly, she was diagnosed with bipolar disorder at age two.

I can?t help but think the prescribing psychiatrist should be held accountable. The parents deserve the benefit of the doubt and our sympathy, as they were likely following the advice of the child?s medical professional. But how do you diagnose a mood disorder in a child who can barely walk and talk?

I?m opening myself up to the wrath of parents who have children sufferering from bipolar disorder, but I?m often skeptical about diagnosis in a pre-teen child. How can you reliably diagnose a child whose hormones and normal emotions are all over the board?

I?ll be the first to acknowledge that early diagnosis of bipolar disorder can be lifesaving. Teenage self-harm is a very real danger, and early diagnosis can lower that risk. It can also be invaluable in helping them succeed in school and in life. My son?s earlier diagnosis and treament would have made his school career so much easier, might have prevented legal problems, and could possibly have kept him from experiencing several medical emergencies.

As with any diagnosis of bipolar disorder, the diagnosis depends on identifying manic and depressive states. Per the National Institute of Mental Health Web site:

"Symptoms of mania and depression in children and adolescents may manifest themselves through a variety of different behaviors. When manic, children and adolescents, in contrast to adults, are more likely to be irritable and prone to destructive outbursts than to be elated or euphoric. When depressed, there may be many physical complaints such as headaches, muscle aches, stomachaches or tiredness, frequent absences from school or poor performance in school, talk of or efforts to run away from home, irritability, complaining, unexplained crying, social isolation, poor communication, and extreme sensitivity to rejection or failure. Other manifestations of manic and depressive states may include alcohol or substance abuse and difficulty with relationships."
I don?t know about all kids, but I have 5 children, and I can say with certainty that they all, at times, have met almost every criteria shown above.

I am truly heartbroken about this child and her family. This being said, I don?t want this post to be misinterpreted. My point is that where diagnosis of bipolar disorder in our children is made, take extra care to ensure a correct diagnosis, and watch them like a hawk.