Bipolar Label Soars Among Kids

Peter J. Dorsen, M.D., LADC

Frankly, I am glad that author Jeremy Olson of the Minneapolis Star Tribune in his recent “exclusive,” reports that the upcoming Diagnostic and Statistical Manual (DSM V) due out this summer will categorize a new disorder replacing bipolar disorder in children. It will be called Disruptive Mood Dysregulation Disorder(grade school children with outbursts in more than one location and irritability between outbursts). You may recall, I discussed my own belief of a separation in fact between BD and explosive anger in my last posting.

I have long struggled how people label outbursts or inappropriate behavior simplistically and even inaccurately with the label a “bipolar moment.” The author of this excellent and well- documented article, alludes to the marked concern many parents have with psychiatrists labeling their children with BD and the likelihood of carrying this stigma indefinitely.

Olson offers statistics and interviews how potentially dangerous antidepressant use leveled off since 2004 with the concern about child suicide. Antidepressants leveled off but atypical antipsychotics like Seroquel and Risperdal “surged.” Spending for antiseizure medications like Depakote or Gabapentin increased “sevenfold.” Meanwhile he, explains, how there is a tail wagging the dog process how psychiatrists must label children with BD. Children “ can’t gain insurance coverage for even short stay unless a patient has a major diagnosis.”

The reporter alludes to some worrisome allegations circulating within the academic community particularly Dr Joseph Biederman of Harvard who albeit the “father of the childhood bipolar movement,” has allegedly been part of what many like John Whitaker in Mad in America (Perseus, 2002) allege experts do is travel and speak about off-label prescribing, distort research for the pharmaceutical companies and make handsome sometimes unreported fees.

This article is a wonderful overview of what is perhaps terrifying about what appears to have become a tendency to overcall BD in children. As I mentioned in an earlier posting, what about achieving a level playing field especially with adequate and appropriate medication. How we as clinicians define that ball park may depend on how our friends, loved ones, ourselves or our patients continue to remain compliant to treatment. Certainly Kay Redfield Jamison (An Unquiet Mind, Free Press) is living proof that a return from the ashes is possible. In an upcoming posting, I plan to review Maria Angell’s article “Why is there an epidemic of mental illness,” in The New York Review of Books (June 23, 2011. Vol LVIII.

Like the protagonist, Ms Beckman, of Olson’s solid recent montage, whose defiance for a bipolar diagnosis weakens as the intensity of her daughter’s tantrums and outbursts worsens, living with BD day-to-day means constant reevaluation of our belief system toward this protean illness.