Diagnosing Bipolar Disorder in Adolescents
Before the 1990s, it was believed that children under the age of eighteen would have been rarely diagnoses with bipolar disorder. This all changed in the mid-1990s when there were 800,000 children labeled with bipolar disease and an astonishing number were under the age of five (Carmichael, 2008). The controversial findings have alerted psychiatrists and psychologists that the disease is much more common than originally thought (Carmichael, 2008). According to a recent article Children labeled bipolar, psychiatrists have been discontent with the number of children being labeled with bipolar disorder at alarming rates. Dr. Janet Woziak, an assistant professor at Harvard Medical School of psychiatry, was educated with the idea that a professional in the psychiatric field would only see one or two cases of a child with bipolar disorder in a lifetime because of the rarity. Woziak, along with the famous Harvard child psychiatrist Dr. Joseph Biederman, felt that there were a number of children whose attention deficit hyperactivity disorder (ADHD) problems seemed to stem beyond the normal anger characteristics of ADHD ("Children labeled ’bipolar’," 2010). Doctors Biederman and Woziak both professors and researchers at Harvard Medical School, published research in 1995 to reflect a much more violent attention deficit hyperactivity disorder with children showing signs of heightened uncontrollable temper tantrums, violent hitting, screaming and kicking beyond the normal irritability. These signs included children not being able to regulate impulses (Journal of the American Academy of Child & Adolescent Psychiatry, 1995). Wozniak and Biederman co–authored the research paper that explained the differences between attention deficit hyperactivity disorder, adolescent bipolar disorder, and temper dysregulation disorder; the paper won awards and later redefined the definition of adolescent bipolar disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) ("Children labeled ’bipolar’," 2010). The DSM-IV-TR is the official dictionary for diagnosing mental disorders that is acknowledged by American Psychiatric Association. The DSM –IV-TR assists health care providers with clients’ diagnoses and insurance companies with payment reimbursements ("Children labeled ’bipolar’," 2010). In February of 2010 Dr. David Shaffer explains in a article published by the National Public Radio how Woziak and Biedermans research changes the definition for adolescent bipolar disorder, “The defining feature of manic-depression was that it was episodic,” says Shaffer ("Children labeled ’bipolar’," 2010, p. 3) . “You had episodes of depression and episodes of mania and episodes of normal mood, and that was really, its defining characteristic.” ("Children Labeled ’Bipolar’“," 2010, p. 3) In laymen’s terms, the child no longer fits the discrete week-long or month-long cycles of depression or normal moods episodes that are seen in adults. The episodes are radically different. Children cycle from brief and very frequent mood episodes that include manic, depressions and back to normal two or three times a week. These include frequent tantrums, enormous temper elevations between stages of abnormal moods (Fritz, 2005). Child psychiatrist have previously used the DSM-IV-TR to help diagnose children that suffer from aggressive or depression (ADHD) but missed the manic part ("Children labeled ’bipolar’," 2010). Children that suffer from bipolar disorder will usually show signs of ADHD and will have been treated for that but not for the co-existing mania that is easily overlooked. (Carmichael, 2008) A child psychiatrist from Stony Brook University, Dr. Gabrielle Carlson, disagrees with the new bipolar label because with this diagnoses, children...
Please join StudyMode to read the full document