The above link is to an article I just read regarding the overdiagnosis of bipolar disorder in children. Written by a Dr. Kaplan (child psychiatrist), he notes that many children with ADHD or ODD have been diagnosed with bi-polar disorder due to temper tantrums, grandiosity, impulsivity, racing thoughts, elevated silliness, etc. These symptoms are really happening but Dr. Kaplan does not believe they are associated with bipolar disease (and thus not appropriate to be treated with medications like Lithium, Wellbutrin, or Depakote). Dr. Kaplan goes on to say that he thinks there isn’t any scientific evidence of bipolar beginning in childhood.
Not sure I would agree with him about this but I do agree that bipolar is an easy target when a child has frequent outbursts and is difficult to rein in. He and others are right to point out that irritability is not a good indicator of bipolar disease. Nor is emotional lability a good indicator. Many ADHD kids end up with a bipolar diagnosis when they should not have it.
What should the overdiagnosis tell us? It is not really about “big pharma” trying to drug our kids. It is not about psychiatrists just wanting to push pills. It is about overwhelmed parents and teachers who do not know what to do with the overwhelming emotional/behavioral rollercoaster some children exhibit. They (parents and kids) need help and our understanding of these issues (lability, irritability, grandiosity, tantrums, etc.) and how to best help these children are poor.
Rather than beat up on the system, let us figure out better methods to parent and counsel these types of children.