Diagnosing Bipolar Disorder in Children and Teens (NPR's "Talk of the Nation", 9/4/07)

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Link to the webpage and podcast here.

The number of children and teens being treated for bipolar disorder has dramatically increased in the last decade. Was the disorder under-diagnosed in the past and is it over-diagnosed today? Dr. Mark Olfson, a professor of clinical psychiatry at Columbia University, discusses what's behind the jump in bipolar diagnoses.

Mark Olfson, MD, professor of clinical psychiatry at Columbia University; senior author of recent study about treatment and diagnosis of bipolar disorder in youth

I only wish they would've diagnosed bipolar disorder in teens when I was a kid.

I remember having weird episodes as a kid: obsessing over a hobby at the expense of everything else (including school and family), days in a row when I couldn't get out of bed, being overly sensitive to an offhand comment or remark, spending all my allowance on things I didn't need or even want, etc.

My first "big" episode happened when I was sixteen. It cost me most of my friends at the time, and led me to spend most of my junior and senior years of high school in my bedroom.

Yes, some doctors are quick to slap a diagnosis on anybody, but I really wish they would have diagnosed me properly when I was a teenager, 20+ years ago. I'm sure there's a lot of others who feel the same way.

[Larissa238]

1. I was "diagnosed" as a child...

My bipolar has been way more depression than mania, but I still had signs. My family knew when I was a teenager, if I stayed up too "late" (past 10) I would be a terror the next day. I would get bad mood swings, be randomly angry (or royally pissed) and be depressed afterwards. I learned very early on that the less sleep I got, the more moody I could get. I would also get these grand periods where I felt like I could do anything, but they were short lived. It was mostly depression that was so bad I would go to sleep thinking I wouldn't wake up the next morning because the depression would kill me. I wrote more than one goodbye note because I thought I was really going to die in my sleep - it wasn't natural to feel so down breathing was hard.

I was "diagnosed" with bipolar as a child (maybe around 10 years old) but that term meant nothing to me. I checked webmd.com one day at work when I was about 19, and realized that I was in the middle of a hypomanic episode. Getting by with less than 6 hours sleep? Yup. I'm normally dead when I have 10 hours of sleep. Having too much energy? Yup. Grandiose thoughts? Yup. (I had this delusion that would come and go that I was going to be the next Virgin Mary and give birth to the next Jesus). I didn't have my first full blown mania till my 20's, but that unstable pattern in my childhood should have been a giveaway that I needed help.

I looked back on my symptoms on webmd.com and thought "Well, that doctor all those years ago was right about this. Then I thought maybe it was psychosomatic, and then realized how could I manifest symptoms of a disease when I didn't know what the symptoms were? After I realized what I had, it still took me a while to get help. I had some very supportive roommates (and some non-supportive ones, but that's another story) who helped get me into the therapy and the meds I needed.

[mopinko]

2. not sure how long ago it changed

but you didn't used to be allowed to give a dx of bipolar until someone was an adult. also, the symptoms can be very different in kids. it think a lot of the things that my daughter did as a little kid were related to her bp. but 20 years ago, i don't think anyone really had a good grip on the natural history of this disease, and how it impacts kids development. it is undoubtedly a good thing to be intervening at the earliest possible stage.
not sure "they" know what to do exactly when they do intervene. but it is a start.

[GreenPartyVoter]

3. Underdiagnosed in my case. Took til I was 35 to be told I was BPII

[fed-up]

4. I'm reading "Acquainted with the Night" Paul Raeburn 2004-A Parent's Quest to Understand Depression

and Bipolar Disorder in His Children. It is an interesting read and he talks a lot about the lack of adequate medical help and awareness of the issue of BP in children. And also the lack of meds for kids.

I am newly diagnosed BP at the age of 49....(due to adverse reaction to Remeron a few weeks ago)

I am "obsessively" trying to learn all I can.

My sis believes that all six of us siblings are probably BP with individual variations of course. My dad and probably mom were BP, along with many great aunts and uncles...

I am now very concerned my son inherited the genes also as I learn about criteria for diagnosis. Both me and his late father are BP. His dad committed suicide about 5 years ago, so this is not an issue to take lightly...