The Bipolar vs ADHD Diagnosis

It wasn't until recent years that professionals were even asking themselves the bipolar vs ADHD question. If you took you child to a psychiatrist with complaints about behavior (fair number of them from the school probably) you were likely to walk out with an ADHD diagnosis and a prescription for stimulant medication.

In fact, I still often see student after student at my school whose well meaning parents must sit back and trust the "professionals" because that is what we are taught to do; only to have the psychiatrist run through all the different ADHD medications at all the different doses, and to no avail.

Why? Because ADHD medication as the primary source of treatment for a misdiagnosed child will not work!

The bipolar vs ADHD question is an easy diagnosis to miss. Especially if you visit a psychiatrist or doctor who is not up to date or simply a non-believer that mood disorders exist in children. And yes, those are out there. On the surface, the symptomatic behaviors can look very similar.

  • restless
  • fidgety
  • impulsive
  • moody
  • distracted
  • aggressive
  • difficulty getting along with peers
  • difficulty with transitions

A leader in the researching of bipolar vs ADHD disorder in children and adolescents, Dr. Charles Popper believes that an ADHD diagnosis should be given only after an underlying mood disorder has been ruled out.

To help explain his position, he wrote a great article outlining the differences in the two disorders. It discusses the differences in

  • origins of aggressive behavior
  • the duration and intensity of outbursts and tantrums
  • the triggers of these tantrums
  • the different faces of the moodiness associated with both disorders
  • sleep habits
  • learning problems and giftedness
  • and the origins of general misbehavior

Click here to read the entire article.

So why, you might wonder, is answering the bipolar vs ADHD question so important? Because according to the Papolos' as many as 65% of children mistakenly diagnosed with ADHD can have serious adverse reactions when placed on stimulant medication. Sometimes being thrown into a manic state or becoming so severely psychotic that hospitalization is needed.

So what is a parent or guardian to do? Ask yourself these questions...

  • Is there a strong history of bipolar or mood disorder in the family?
  • Do you witness long temper tantrums, mood swings, or oppositional and defiant behavior?
  • Is your child explosive and aggressive to family?
  • Have you tried stimulant medication with negative results?

I cannot stress this enough - If there is any family history, pay attention to it! AND, if there is no diagnosed family history, ask yourself this. Have any first line relatives (parents, siblings, grandparents) struggled with the law, drugs, alcohol, had school and discipline issues throughout their life?

Here is a scenario I see often - Overwhelmed grandparent raising difficult child because parent is on drugs or incarcerated because of drugs or law breaking while on drugs. And often these parents will never have been formally diagnosed with anything. But if I ask the grandparent to think back, they will likely say the parent probably could have been diagnosed in their childhood or adolescence.

And here's a big one - the parent's drug problems are in actuality self medication. Over and over again I hear parents say they do not want to put their child on medication because they worry about drug addiction. The research overwhelmingly supports that proper medication does not cause drug addiction and in fact, drug addiction occurs in response to untreated mental health issues. Crystal Meth is a stimulant, cocaine is a stimulant, alcohol is a depressant, marijuana is a depressant. They treat, very poorly, what a person isn't letting a doctor treat.

The lesson? Even if you don't think there is a history, re-evaluate the possibility by considering behaviors and life productivity, not just doctor diagnoses.

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