Since the dawn of time, exasperated parents have wondered aloud if their kid was bipolar. Children, generally speaking, do not have as firm a grasp on their emotions as do their adult counterparts. In days gone by, they probably did't use the term "bipolar" to describe their kid's unpredictable mood swings. My guess is it went by many different names, one of them being "demonic possession." These days we are more enlightened.
In 2013, The American Psychiatric Association (APA) revised their mental health Bible and added several “new” disorders, many fraught with controversy. The Diagnostic and Statistical Manual (DSM 5) is what clinicians use to assess and diagnose clients with mental health and substance abuse disorders. Bipolar Disorder is in there, but the diagnosis is generally reserved for adult populations. Also known as manic-depressive disorder, it is tough to diagnose in children and adolescents, as many children present with symptoms in the normal course of development. Five year olds, for example, can be laughing and giggling one minute and throwing a tantrum the next. A diagnosis of bipolar this does not make. Some children, however, present with severe and recurring symptoms which impair their ability to function, which is a basic requirement of almost any disorder in the DSM 5. Many frustrated parents would disagree that bipolar is a term best left for adults and the new DSM 5 seems to address this with a brand new category:
If there is such a thing as a “hot” new diagnosis in mental health, it is Disruptive Mood Dysregulation Disorder (DMDD). While technically categorized as a “Depressive Disorder,” DMDD is basically bipolar for kids. While nobody likes to place labels on children, the emergence of DMDD as a recognized disorder allows clinicians to provide appropriate treatment for kids who have repeated tantrums, verbal and/or physical aggression, and a persistent angry or irritable mood. The criteria for DMDD is fairly complex and is only appropriate for children older than six but younger than 18. If a parent suspects that their child suffers from this affliction, they should enlist the services of a licensed clinician who specializes in children and adolescent psychotherapy. While specific criteria for any mental illness are readily available on the Internet, it takes a trained clinician to confirm the existence of an actual disorder.
Children are not adults. This is especially true when it comes to mental health diagnoses. Bipolar presents in adults differently than in children, mostly because children are still travelling through various developmental stages and learning how to regulate their moods and emotions in ways that are appropriate for their age. Tantrums in children are typical. In adults, they are cause for alarm. DMDD at least gives a name to a condition that many parents and clinicians already know exists and it provides a criterion-based framework for proper diagnosis and treatment.
Diagnosing children is almost always a controversial issue, but sometimes it is necessary so that the child can get proper treatment. Have you been diagnosed with bipolar or do you have a child who has been exhibiting this symptoms. Tell us about it in the comments section below. I value your feedback.
Child Mind Institute
DSM 5 Overview (.pdf)
American Academy of Child & Adolesent Psychiatry