View Full Version : Most Children with Rapidly Fluctuating Moods Do Not HAve Bipolar Disorder

Kunga Dorji
12-31-10, 07:06 PM
It is nice to see that "the Science" is finally catching up with what should be blatantly obvious.
Note especially the comment that ADHD was the most common underlying diagnosis.


Relatively few children with rapidly shifting moods and high energy have bipolar disorder (, though such symptoms are commonly associated with the disorder. Instead, most of these children have other types of mental disorders, according to an NIMH-funded study published online ahead of print in the Journal of Clinical Psychiatry on October 5, 2010.

Some parents who take their child to a mental health clinic for assessment report that the child has rapid swings between emotions (usually anger, elation, and sadness) coupled with extremely high energy levels. Some researchers suggest that this is how mania—an important component of bipolar disorder—appears in children. How mania and bipolar disorder are defined in children is important because rapid mood swings and high energy are common among youth.
Furthermore, many experts believe that overdiagnosis and misdiagnosis of bipolar disorder in youth may play a role in the increasing numbers of children being diagnosed with and treated for bipolar disorder ( In choosing proper treatment, it is important to know whether children with rapid mood swings and high energy have an early or mild form of bipolar disorder, or instead have a different mental disorder.
In the Longitudinal Assessment of Manic Symptoms (LAMS) study, Robert Findling, M.D., of Case Western Reserve University, and colleagues assessed 707 children, ages 6-12, who were referred for mental health treatment. Of the participants, 621 were rated as having rapid swings between emotions and high energy levels, described as "elevated symptoms of mania" (ESM-positive). Parents of the other 86 children did not report rapid mood swings. These participants were deemed ESM-negative.
Results of the Study

At baseline, all but 14 participants had at least one mental disorder, and many had two or more. Attention deficit hyperactivity disorder ( (ADHD) was the most frequent diagnosis, affecting roughly 76 percent in both the ESM-positive and ESM-negative groups. However, only 39 percent were receiving treatment with a stimulant, the most common medication treatment for ADHD, at the start of the study.
Only 11 percent of those with rapid mood swings and high energy (69 out of 621) and 6 percent of those without these symptoms (5 out of 86) had bipolar disorder, meaning that only this small percentage had ever experienced a manic episode, as defined by the current diagnostic system. Of the children with rapid mood swings and high energy, another 12 percent (75 children) had a form of bipolar disorder that includes much shorter manic episodes.
Compared to children without rapid mood swings and high energy, those with these symptoms:

Reported more symptoms of depression, anxiety, manic symptoms, and symptoms of ADHD
Had lower functioning at home, school, or with peers
Were more likely to have a disruptive behavior disorder (oppositional defiant disorder and/or conduct disorder).

12-31-10, 10:31 PM
I wouldn't expect them to.

Happy New Year



12-31-10, 10:39 PM
For once I agree.

BP is way ovediagnosed and ADHD way underdiagnosed IMO

01-01-11, 07:52 AM
Bipolar is such a controversial childhood dx, it needs a lot more research.

Earlier this year I had my 6 y/o assessed for bipolar before putting her on stims for ADHD. I did this because her Dad is bipolar and they are very similar characters. I purely wanted an expert opinion before starting medication for ADHD due to family history (Stims induced mania in her Dad).
Sadly, the dr who did her assessment told me that bipolar 'doesnt occur in children'.

I don't believe my child is bipolar, or that bipolar is common in childhood, and I'm happy to report that my daughter has responded well to stimulants. But I also don't think it 'can't' happen because of age, however unlikely bipolar may be in kids.

In our modern, hectic, anxious, stressful society, I think it's only a matter of time until bipolar becomes a more common dx.

We may have eradicated prior diseases, but realistically we only replaced them with stress-induced, modern-day versions. If we keep living this pace - they will start to onset earlier.

01-01-11, 07:07 PM
That's a relief to hear. Of course, now the question is what do they have and what can we do to make it better?

12-13-11, 04:55 AM
Such a good tutorial the best around