Here is one such article, Maybe child isn't bipolar, just bratty as normal, in which he lists behaviors commonly associated with bipolar in children (the same, by the way, that are commonly associated with autism) as if they were the diagnostic criteria.
John Rosemond blasts the book, “The Bipolar Child” by Papolos and Papolos. He does not state the diagnostic criteria for bipolar, such as severe depression, mixed states, suicidality, and mania or hypomania, along with greatly disturbed sleep and commonly accompanied by hallucinations, and even, in these children, temperature dysregulation (indicative of a hypothalamic dysfunction). Instead, John Rosemond brings up, out of context, commonly associated behaviors of these children, such as having severe tantrums, being oppositional, distractible, and having separation anxiety.
Those are not the diagnostic criteria for childhood-onset bipolar disorder, just the commonly associated behaviors.
If I had horrific nightmares that would not stop, severe depression, mixed states and hallucinations, I might also have the behaviors commonly associated with these bipolar children, too.
Dr. Papolos did not enter this field from a psychology point of view. Rather, he was studying genetic problems with early symptoms, called Velo-Cardio Facial Syndrome (VCFS). This genetic problem is also highly associated with “schizophrenia”, and has even been called one of the leading causes of it.
It is possible that some children with behavioral problems due to poor parenting, or a mismatch in parenting styles, are getting MIS-diagnosed with bipolar disorder. The fact that the DSM-IV includes purely “behavioral disorders” of children which can be corrected by changing parenting tactics, complicates public understanding when other problems of a completely different etiology, yet with some behavioral repercussions, are listed in the same volume.
I appreciate John Rosemond advocating that parents not abdicate their parental responsibility to teach appropriate behavior. But I wish John Rosemond was not trying to throw the baby out with the bath water.
When my little girl was diagnosed with bipolar disorder (however briefly), it was not based on any behavioral issues. In fact, she was extremely well-behaved, and of all the adjectives ever used to describe her, “bratty” had never been one of them. The diagnosis was based on severe depression cycling with periods of hypomania and very little sleep, mixed states and hallucinations. She also had other common symptoms described in the book by Papolos and Papolos, such as nightmares that would not stop, and temperature dysregulation.
Did she have “meltdowns” and anxiety? You bet! The worse her depression and horrific hallucinations were, the worse her anxiety and tolerance for frustration got (note – it was internal frustration, NOT due to what anybody else said or didn’t say or what she could or could not have).
The diagnosis is supposed to be based on “diagnostic criteria”, not on associated behaviors which may or may not be present.
John Rosemond describes those behaviors commonly associated with bipolar disorder in children as those seen during the "terrible-twos". He has a point. But he stopped in the analysis too soon. These same commonly associated behaviors are seen when an autistic child cannot cope and has a "fit".
In fact, we saw the same regression in our own child when overwhelmed by psychosis, nightmares and resulting terror.
The research showing that kids who have severe tantrums--ones that go beyond the range of "normal" as evidenced by their intensity, chronicity, and not being able to be soothed in a timely manner, can indicate that the child actually suffers from yet another symptom--depression. And DEPRESSION is a symptom that something may be BIOLOGICALLY - MEDICALLY - going awry.
Some Temper Tantrums Can Be Red Flags: Study: Kids' Violent Temper Tantrums May Indicate Depression (ABC News) says that healthy children tend to have less aggressive tantrums and their tantrums are generally shorter. They warn that parents of children who hurt themselves or others or children that cannot calm themselves without help, should seek medical help.
Just as people would not ridicule an autistic child acting younger, he thought it was appropriate to ridicule a bipolar child doing the same thing. There is something going terribly wrong neurobiologically when a normal articulate bright child keeps having episodes during which ... yes... he/she acts very much like an autistic one in regards to not being able to cope and having hypersensitivity to inputs and internal feelings.
In any case, my daughter’s “bipolar” was as "neurodevelopmental" or "biological" as we now know autism to be.
She was a mature, well-behaved, kind, sweet, loving little girl with no psychological or "behavioral" problems. But she understands how easily another child without her compulsivity to NOT be "bad" might easily have been labeled as such. And, maybe because she compulsively controlled herself to NOT have "bratty-looking" tantrums, perhaps she caused herself more stress, distress, and more "meltdowns" in the long-run!
Unless others really know the details--all the details-- of what lies behind a diagnosis... others have no right to judge.... in my opinion.
From my experience with my child and others diagnosed with bipolar based on actual diagnostic criteria—the actual diagnostic criteria are severe and those children diagnosed using them are severely suffering. And their families are suffering along with them.
I’ll be posting later about research showing some biological overlaps between autism, bipolar disorder and schizophrenia (see some links below under "Additional Reading").
The parents of children with autism, fought long and hard for that diagnosis to be brought out of the dark ages, and removed from the bucket of “mental” illnesses. The same needs to be done for our children with these other neurobiological disorders.
- Genetic Links to “Developmental”, “Mental”, “Auto-Immune” and other Medical Disorders
- Is Schizophrenia a “Psychotic Disorder”?
- Autism Is Not a “Mental Illness”
- Childhood-Onset Schizophrenia Has High Rates of Comorbid Diagnoses Including Autism and ADHD
- The Stress Connection: Meeting Hormonal, Nutritional, and Metabolic Needs
- Inflammation of Body and Brain
- Important Links to Help Our Children
 Genetics of Childhood Disorders: XXV Velocardiofacial Syndrome. Doron Gothelf, M.D., and Paul J. Lombroso, M.D. J Am Acad Child Adolesc Psychiatry,40:4,489-491 April 2001 (http://www.med.yale.edu/chldstdy/plomdevelop/genetics/01aprgen.htm )
See also: "Brain Scans May Predict Mental Illness in Children with VCFS"
Updated: 23 Jan 2013