Your Child is Not Bipolar

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Bipolar disorder in children was nearly unheard of two decades ago, but recently it has spread like wildfire in the U.S.

Treating moody, distracted or hyperactive children as if they were manic adults: good for drug companies, not so good for everyone else.

Our guest, Stuart Kaplan, MD, argues that this rise in so-called “pediatric bipolar disorder” (PBD) is a dangerous fad. The book The Bipolar Child, published in the year 2000, was a leader in an outburst of popular and clinical interest in PBD. Whereas, before 1995, bipolar disorder was very rarely diagnosed in children and adolescents, today nearly a third of all children and adolescents discharged from child psychiatric hospitals are diagnosed bipolar and treated accordingly. Between 1995 and 2003, There was a 40-fold, or 4000%, increase in outpatient office visits for pediatric bipolar disorder. Such a dramatic shift in so short a time makes it hard to argue that many more children today are bipolar or that more many bipolar children are now being discovered. Moreover, children diagnosed bipolar do not meet the official criteria in the DSM; whereas a manic episode must last at least a week and is distinct from normal behavior, “bipolar” children are generally irritable and have short-lived tantrums.

Dr. Kaplan says the growing misdiagnosis of PBD has burdened children with a serious, lifelong medical label and has led them to take inappropriate, sometimes harmful medications. He argues that the right diagnosis for these children is Attention Deficit / Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD), or maybe the newly created Disruptive Mood Dysregulation Disorder. The rise of “bipolar” children, he argues, is not based on any factual scientific discovery, but on a media-like event that grabbed hold of psychiatrists’ perceptions. Join us as we scrutinize this trend and offer advice for parents and psychiatrists alike. Download the podcast here.

For more background, see Dr. Kaplan’s Newsweek article, NPR’s feature story on switching bipolar children to a new diagnosis, Neuroskeptic’s reliably insightful commentary on PBD, and Dr. Allen Frances’ prominent op-eds in HuffPo and NY Times. Dr. Kaplan was also interviewed on Shrink Rap Radio, and his book is Your Child Does Not Have Bipolar Disorder: How Bad Science and Good Public Relations Created the Diagnosis.