Bipolar disorder in kids often confused with ADHD

Bipolar disorder is often hard to diagnose in children, and parents should be careful to not mistake its manic phase for attention deficit hyperactivity disorder, warns Joan Luby, a child psychologist at the School of Medicine and St. Louis Children’s Hospital. Learn more in the following St. Louis Post-Dispatch article.

Don’t confuse manic depression with ADHD

(Republished with permission from the St. Louis Post-Dispatch. This article originally ran in the Health & Fitness section on Monday, March 21, 2005)

Contrary to common belief, recent findings show that bipolar disorder, also known as manic depressive illness, occurs in children as young as 6.

In adults, bipolar disorder is a brain disorder that causes unusual shifts in a person’s mood, energy and ability to function. Most adults with this disorder have recurrent episodes of elevated mood that interfere with their daily functioning. However, some have rapid mood cycles, shifting from euphoria to depression. Rapid cycling appears to be the most common manifestation in children.

Diagnosis in children is difficult, because the manic phase can be confused with the more common attention deficit hyperactivity disorder. The confusion arises because mania and ADHD both involve hyperactivity, irritability and distractibility. However, researchers have developed a diagnostic interview that differentiates bipolar disorder from ADHD and other psychiatric illnesses.

To investigate the effectiveness of medications for childhood bipolar disorder, the National Institute of Mental Health recently funded a nationwide study called TEAM (Treatment of Early Age Mania).

The national study – the first and largest federally funded study of its kind – is under way at five sites across the country, including St. Louis Children’s Hospital. Dr. Barbara Geller, professor of psychiatry at Washington University School of Medicine and a pioneer in the recognition of bipolar disorder in children, leads the national study.

Qualified participants will receive lithium, valproate or risperidone, which are all medications used in adults with bipolar disorder. The drug an individual child receives is determined randomly, like the flip of a coin.

This study is unique because no inactive placebos are given; all children receive active medication. Children who qualify receive free comprehensive diagnostic evaluations, study medications and laboratory tests. For more information about participating, please call the study coordinator, Samantha Blankenship, at 314-286-2783.

Dr. Joan Luby is a Washington University child psychiatrist at St. Louis Children’s Hospital.

Key manic or depressive symptoms:

  • Being too happy or too silly or giddy.
  • Acting more irritable than other kids.
  • Feeling smarter than grown-ups.
  • Believing they are the boss at home or school.
  • Believing they can do things better than anyone else.
  • Feelings of power, greatness or importance.
  • Talking nonstop or needing very little sleep.
  • Becoming sad for no reason.
  • Not wanting to play.
  • Complaining of boredom.

Copyright 2005 St. Louis Post-Dispatch, Inc.