Tuesday, December 4, 2012

A Valid Argument for Adolescent Bipolar Disorder Being a Real Diagnosis

There’s a lot of buzz about the new disorder DMDD (Disruptive Mood Dysregulation Disorder) being added to the DMS guide next year with hopes of reducing the number of children misdiagnosed with bipolar disorder. In some cases, such as Dr. Kaplan, he’s “Driving a Stake in The Heart of The Beast of The Misdiagnosis of Pediatric Bipolar Disorder” holding strong to his belief that bipolar disorder doesn’t even occur in children. Though there are many parents that would argue against this. What I came across today is an article by Dr. Nassir Ghaemi published in Psychology Today arguing against these “bipolar skeptics”, claiming that bipolar disorder can begin in childhood. I found his argument to be pretty compelling.

He asked the question “Does depression occurs in children” and if so, points out that depression often precedes manic or hypomanic episodes, and since 25-50% of children who have depression in childhood grow up to have full blown manic or hypomanic episodes, isn’t it then reasonable to believe that they had bipolar disorder all along?

He states:
Does it mean that they have “major depressive disorder” until age 20, at which point their disease magically changes to something completely different: bipolar disorder? Or is it rather the case that they have bipolar disorder from the very start, with the first episodes of their mood illness being depressive episodes, and manic episodes beginning later? This is a course of bipolar illness, depression preceding mania, that has been described for over a century. (Dr. Nassir Ghaemi Psychology Today)

You should read his entire article, it’s not that long, but very interesting.

Check it out:
Depression in Children: Proof of Bipolar Disorder

Dr. Ghaemi’s First Article in a Series:
Childhood Bipolar Disorder: Erasing Myths


  1. Thanks for posting those interesting article. I have a question though. Do you and your husband attend any support groups and if so do you find them helpful. I am having trouble finding any in Brisbane Australia, but I wonder whether this is just a natural progress for parents of mental ill children. For us to just be so desperate for help that just does not even exist. We are not looking for anything for our 7 year old daughter as she is full with Psychiatrist and OCD clinic as well as behavioural management and life as it is.
    What do you do?

    1. Great question Donna! Currently I am not in a support group, but may be some day. Right now I use this blog to connect with other parents just like me. I also have a best friend who I met because our kids both have bipolar disorder, so we have become a support system to each other. I have also met with a woman in my church for support who has a college age daughter with Bipolar disorder. Once a year I attend a conference in Stanford for families to learn about bipolar disorder, there I have also met some amazing mothers who I still stay in contact with–they still reach out and give me support.

      So though I don't met with a group face to face, I have created support through many avenues in my life with people who have direct experience with this. If I didn't have these avenues, I would seek out a group or start one. I know it can be hard to find, my first attempts came up empty in my local area, I would have to drive a little farther out to get into a group. Check with your doctor for a support group or through NAMI, they can connect you with groups that meet.

      Here is a list of other places to look:
      Mental health specialists, such as psychiatrists, psychologists, social workers, or mental health counselors
      Health maintenance organizations
      Community mental health centers
      Hospital psychiatry departments and outpatient clinics
      Mental health programs at universities or medical schools
      State hospital outpatient clinics
      Family services, social agencies, or clergy
      Peer support groups
      Private clinics and facilities
      Employee assistance programs
      Local medical and/or psychiatric societies.
      You can also check the phone book under "mental health," "health," "social services," "hotlines," or "physicians" for phone numbers and addresses. An emergency room doctor can also provide temporary help and can tell you where and how to get further help.

  2. Donna, I think we've all been through those feelings of being isolated, overwhelmed and in need of support from other parents dealing with similar issues. So sorry you're going through it! All of Mama Bear's suggestions are great, and I would add one more possibility--your school or school district (if you have such a thing in Australia). In my community, a group of parents in our district formed a "Special Education" support group for parents. It's affiliated with the PTA (Parent Teachers Association). Our members have kids with a broad range of mental and physical disabilities-mood disorders, Autism, ADHD, Dyslexia, Muscular Dystrophy. But it is amazing how many similarities our kids--and we--share. Good luck!

  3. Donna,
    I have something to say about support groups. My husband and I sought one out through NAMI (National Alliance on Mental Illness here in the US) and went for a while, but we both found it to be more upsetting than supportive. In our case, most of the parents had older kids who were having a lot more difficulty and it looked like we were just staring an even worse future in the face that way. (on the other hand since we haven't been in a while, we are thinking the dynamics of the group may have changed some and it might be worth trying again.)

    I think that support is ESSENTIAL, but you have to make sure that it is the right kind. I've gotten a lot of support just from reading Mama Bear's blog and some other blogs, and emailing people. I have a friend who has a son with some similar behavior issues and we know we can discuss these things with each other and not be judged. It takes time to build up support, and risk is involved in disclosing things to people. I have had things fall apart because people who thought they could be understanding and supportive just couldn't do it when the chips were down. But I've also found support in people I've reached out to who really did understand. These people are a subset of another group I belong to (a homeschooling support group for a specific type of student.)

    So if one group or person doesn't seem to fit, find other ways to get support. Just keep trying. Dealing with this can be so isolating, and our kids really need us to be strong.

    1. Great points Heather, you also make a really good point that in order to get support, you need to take a risk in disclosing to others your situation. At first this was very scary, but was well worth it because through it I found great connections!

  4. Thanks for all the great feed back. We went to a group some time back and it was really a 'my child is worse than your's' sort of thing which was not what we are looking for and why I wouldn't put my daughter into one. i have started my own blog on the subject but our little person has just been so unwell i haven't had time to write. I will look into the organisations listed above and see what I can find. This is our second child with these conditions and are so pleased that our oldest daughter is happily married to a man she has known since preschool and after several rounds of IVF they are expecting twins. She gives up both hope and insight into what our little one might be feeling. That is so valuable to us. Our baby's condition is far worse than my oldest daughter. i never thought that could be possible but unfortunately it is. Our 7 year old has fantastic support from school. they go above and beyond the call of duty to take care of her. (we homeschooled until this year)
    Thanks again mums for your great ideas.