August 31st, 2010
01:08 PM ET

Bipolar disorder: Your thoughts

When it comes to bipolar disorder in children, controversy abounds.

Who is really "bipolar," and who is reacting directly to circumstances in the family? Who should take medication, and who should try other interventions? Should we have different diagnoses for children who have extreme tantrums, or would new disorders simply lead to more kids on psychiatric medications?

These are all open questions, and there are no easy answers. Mental health professionals have their own general opinions on these issues, but must approach each patient as an individual, since there is a wide range of behaviors and responses to treatment that any one child can exhibit.

CNN.com readers gave about 1,000 responses to my recent article on bipolar disorder in children. A lot of people were passionate about whether parenting plays a role in mental disorders. Reader 400thecat writes:

My 14-year-old son has Type 1 Diabetes. When you mention insulin to anyone, medicine is part of great science.

My 19-year-old son is autistic. When you mention Risperdal or Prozac to anyone, suddenly we are being duped.

Every organ in the body can have a problem and it is acceptable, but when the brain is not normal it is always viewed as a parenting issue.

The point here is that mental disorders such as autism and bipolar disorder are physiological problems just like diabetes, and require constant monitoring and treatment just as diabetes does. Studies have shown genetic components to mental disorders, meaning some kids will inherit a predisposition to develop bipolar disorder regardless of "bad parenting." But there is a lot more stigma around mental illnesses, and the mechanisms behind them are not as well understood.

Having said that, as Dr. Charles Raison points out in the article, there can be situations that cause children to behave badly, and it is very important to identify any non-biological reasons for bipolar-like symptoms. Medications should not be the first line of defense, says Dr. Rakesh Jain, a psychiatrist in Lake Jackson, Texas.

Bipolar disorder in children is much more complex than the adult version, leaving much room for misdiagnosis and confusion, notes Garry Earles, a clinical social worker in Turners Falls, Massachusetts. The mental health community is divided on whether adult criteria for bipolar disorder should be applied to kids, or whether more "mixed" symptoms - persistent irritability, rapid cycling between moods - are the signatures of a bipolar child. That's why some are pushing for a new diagnosis: Temper Dysregulation Disorder with Dysphoria. But this, too, is mired in controversy - a New England Journal of Medicine commentary in May cautioned that it could be "applied trivially to any kind of temper tantrum."

Got more to say? Share your thoughts below.

soundoff (228 Responses)
  1. The Third Sunrise

    I was diagnosed with Bipolar Disorder at the age of 12. Later in life, when i was 20 years old, I became a drug addict because I could not deal with the diagnosis. I am stable and sober now. You can recover from this illness. Please read the articles I have written on the subject and contact me if you like.




    July 6, 2011 at 11:48 | Report abuse | Reply
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  4. Mitch Dyche

    Bipolar disorder (also known as bipolar affective disorder, manic-depressive disorder, or manic depression) is a psychiatric diagnosis for a mood disorder. Individuals with bipolar disorder experience episodes of a frenzied state known as mania, typically alternating with episodes of depression...*;`

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  6. Jane

    I wasn't diagnosed with Bi Polar Disored until I was in my 30's. It took 2 attempts at suicide and severe depression before they diagnosed it correctly. The Drs. told my mother when I was a child that I was just spunky and spoiled. Since I have been put on 1.25 mg of Lamotrigine my Bi Polar has been under control for a long time. I was on Lithium for yrs but it stopped working after 14 yrs. I am now 53 and doing great.

    June 9, 2013 at 11:45 | Report abuse | Reply
  7. tony

    i was sexually molested at around age 5 during time i was also being abused but my uncles girlfriend,she would beat me with sticks and belts,throw me in the bathtub with water so hot it felt like my skin was gonna peel off,lock me in the basement with no light,in my teen years i was afraid to have girlfriends,i was picked on by some of my friends because of this,i did lots of hard drugs my whole life,i have been in lots of fights in my aldult years,i have confronted peope with bats,crowbars,screwrivers,knives and i once stuck a gun in someones face and was arrested because of this,i have been sent to the nutward at the hospital 3 times last year and never mentioned what happened to me as a kid or the violent things i have done in the past,each time i got sent there i was hi on meth so they would just shot me full of adavan and release me hours later,then there was a forth time that landed me in the alberta hospital for over a month,during this time i still refused to talk about my past,i was married for 14 years and lost my wife in 2007 to diabeties,after i lost my wife is when i really started to get violent,my wife was really bad at taking care of her diabeties and i have saved her countless times from having insulent reactions,she died from a insulent reaction and i blame myself for her death cause of drugs,my wife always new i had issues but i never told her about my childhood,ive been hooked on morphine after her death and ended up going into a methadone program for a year,the 3th month into the program i started useing meth and after a year i got off methadone but coninued useing meth until 4 months ago,i am going to be seeing a shrink sometime soon and 2 weeks ago i was in the office buildng of the shrink i will be seeing and i gave them the information they needed,i told them everything,for the first time in my life i talked about my childhood,i hear birds cherping and cats and low buzzing noises in my head all the time,im on small doses of seraquil and clamasapan right now but i abuse them so they dont last me the whole month their spose to but they do get rid of the noises in my head,i dont know how much longer before i get to talk to the shrink i will be seeng,please email me back and tell me what you think,i think about doing meth everyday and its been a rough 4 months with a couple morphine relaspes,sorry for any bad spelling,i only have a grade 9 edacation.

    June 9, 2013 at 12:44 | Report abuse | Reply
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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.