Tuesday, September 6, 2011

In the News: Puberty is Good Threshold for Bipolar Diagnosis

The above clip is Dr. David Cohen at a press briefing at the annual congress of the European College of Neuropsychopharmacology. During this interview, Dr. Cohen shares his view that puberty is a good threshold for bipolar diagnosis.
“Puberty is a good threshold for talking about bipolar disorder. TDDD is a better diagnosis for pre-pubertal children” because at that stage of life the manic symptoms of bipolar disease, such as irritability, mood change, hyperactivity, and sleep disturbance, can serve as risk markers for the eventual development of bipolar disease, but not at high rates. “Only once a child is at least 11 or 12 years old can you see these symptoms and be confident that it is likely bipolar disease of adolescence or beyond.” Adolescence is when the diagnosis of bipolar disease can truly start. A reliable diagnosis of bipolar disorder in a younger child is really exceptional.” (Zoler, Family Practice News, 9/4/11)

It is interesting to read about the views of the psychiatric field with regards to bipolar disorder. It was only in 1957 when bipolar disorder was officially classified as a diagnosis for adults. Is there any wonder that 54 years later we’re still trying to figure this out? Early onset bipolar disorder has only been acknowledged by some of the psychiatric community for only a handful of years and to this day, remains a divisive topic among psychiatrists. Some doctors think that it doesn’t exist at all in children, Dr. Cohen is an example of one who believes it exists after a certain age, where Dr. Demitri Papolos and Janice Papolos wrote the “The Bipolar Child”, the bible of early onset bipolar disorder.

So what are we suppose to think of all this? Well at times I find it very frustrating, other times I shrug my shoulders and think... call it what you want, my child has a mental illness and he needs treatment. Other times, I have to remind myself that we have to be patient. Just because the psychiatric field doesn’t know how to diagnosis it in children, doesn’t mean that it doesn’t exist in childhood. I’m sure that diabetes existed long before they knew what it was and all the forms it presented itself in. The way I see it, they still have to understand this illness in its early form. It’s like an easter egg hunt, I know the egg is there and all these doctors are searching for it, someday they’ll figure it out and realize that the answer was right in front of them. Hopefully this will happen during our lifetime.

* * *

Read more about this with additional info at:
New DSM-5 Category May Curb Youth Bipolar Overdiagnosis

References:Family Practice News, 
Mitchel L. Zoler 
Published: 9/4/11
Consulted: 9/6/11

Video Clip Provided by:
Uploaded by  on Sep 4, 2011



  1. I'm with you Mama Bear, mixed feelings. The brain undergoes massive change in adolescence and I can see where that would bring about changes in mental state.
    But it also seems that bipolar disorder doesn't just come "out of nowhere" and if doctors could get a better handle on what these brains looked like as children--might there be hope of directing a positive change through adolescence rather than a wait and see where the chips fall approach?
    My husband and I were talking about my son the other day and how he was a "difficult" child from the beginning--even when I was pregnant with him. If we touched him through my stomach--he would push back so hard sometimes I thought he was trying to break outta there!

  2. Heather- I like your perspective of directing a positive change in adolescence rather than waiting to see.