A dubious diagnosis
Beware the doctor who diagnoses your five year old with bipolar. Although increasing numbers of children, particularly in the US, are being medicated for the condition – one characterised by severe mood swings – many say there isn’t any hard evidence for the epidemic in infants. It’s further argued that bipolar, also known as manic depression, affects only older teenagers and adults.
So what accounts for the misdiagnosis of bipolar disorder in kids on such a grand scale?
Those working in the mental health field are familiar with the DSM – the Diagnostic and Statistical Manual of Mental Disorders. This essentially lists all the officially recognised mental illnesses and their symptoms. Back in the 1960s, the DSM had 134 pages and in terms of content, reflected the Freudian views prevalent at the time.
Then a psychiatrist by the name of Robert Spitzer came along and decreed the DSM would be about checklists instead. The idea was a psychiatrist could pick up the manual and having matched the patient’s symptoms with those described for a particular disorder, make a diagnosis.
Today’s DSM is a whopping tome and defines every mental disorder psychiatrists have so far been able to come up with. Psychiatrists love it because it makes their job easier. Patients love it because it’s a relief to label their suffering.
But there are problems. According to Spitzer who now bemoans the manual’s biblical status, the nature of DSM means “psychiatric diagnoses are getting closer and closer to the boundary of normal”. In other words, there are some conditions listed in the DSM that simply shouldn’t be there, including childhood bipolar disorder.
Sptizer’s main concern is that kids who are simply tricky to handle or overactive, are being diagnosed with bipolar and prescribed antipsychotic drugs that cause serious side effects including weight gain, tics, irritability and sedation.
But dropping childhood bipolar disorder as a diagnosis won’t be easy. For one thing, it benefits drug companies for parents to believe their kids have a mental illness and need to be medicated. Plus some parents find it much easier to blame their child’s problem behaviour on a chemical imbalance than on more difficult to solve externals such as domestic disharmony or school yard bullying.