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The Bipolar Child, Part 2

by Daniel on June 18th, 2012

Misdiagnosis then leads to incorrect, even harmful treatment. The crux of the problem, she said, “is that the drugs given for children with ADHD or depression exacerbate and make a bipolar child’s condition much worse.”

As part of their studies, the Papolos’ worked with about 400 families, hearing on a daily basis the kinds of problems families endure, both in dealing with symptoms at home and in getting a diagnosis in a doctor’s office.

“It was not unusual to see children who have early onset bipolar disorder having four or five different diagnoses,” said Demitri Papolos, “but never the right one. And they would usually have to go through trials of antidepressants and stimulants that would ultimately make the child worse.”

About six or seven years ago, antidepressants started to be increasingly prescribed to children. “That number has increased logarithmically over the last 3 years or so,” he said.

While antidepressants are appropriate in many cases for unipolar depression, they can have a very different, and negative, impact on those with a bipolar disorder. Demitri Papolos said incorrect medication can induce manic episodes, severe aggression, frequent cycling between highs and lows, and hallucinations, among other responses. Ultimately, it may result in hospitalization.

“Mania can be life-threatening,” said Waltz. “It’s like being in a car that’s out of control. You’ve got no brakes.” Her own daughter, she said, was prescribed some medications whose effects were “horrible.”

Janice Papolos said she learned of cases where bipolar children on antidepressants “get thrown into a mixed state. They have all the morbid dark thoughts of depression with the intense energy of a high.”

In adults, bipolar disorder manifests itself as highs or lows that last for a week or more at a time. In children, however, the highs and lows can last for minutes and a child can cycle back and forth between the two within a day, even within an hour.

“The condition looks very different in childhood,” said Demitri Papolos, who noted that its manifestations can start as young as 18 months old.

As many as 90 percent of the children who have bipolar disorder also have the symptoms of ADHD, like distractibility, hyperactivity, over-talkativeness, fidgetiness and restlessness, he said. Other symptoms in the bipolar child often include rages, tantrums and separation anxiety.

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