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Bipolar Disorder or ADHD

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Bipolar disorder and ADHD, or attention deficit hyperactivity disorder, are two conditions that are increasingly being diagnosed in American children and teens, often together. And interestingly, in children and teens, there are some similarities in the symptoms of the two conditions. But how can a doctor know for sure if the child has bipolar disorder or ADHD? Also, how does the treatment for these two conditions differ?

Medical science is learning more about bipolar disorder in children and teens. But the condition is still difficult to diagnose. That's especially true for teenagers in whom irritability and moodiness commonly co-exist as part of a normal adolescence. A preteen or teenager with mood swings may be going through a difficult but normal developmental stage. Or he or she may be suffering from bipolar disorder with periodic mood changes that shift from depression to mania.

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In addition, symptoms of ADHD often mimic symptoms of bipolar disorder. With ADHD, a child or teen may have rapid or impulsive speech, physical restlessness, trouble focusing, irritability, and, sometimes, defiant or oppositional behavior. Children or teens with bipolar disorder often have similar behaviors.

According to one study, today's children and teens are 40 times more likely to be diagnosed with bipolar disorder than they were 10 years ago. The reason isn't entirely clear. The higher rate of diagnosis could be the result of more awareness on the part of health professionals. There are those, though, who say it could be a result of a lack of parenting that leads to behaviors that are tagged as mental illness.

 Some studies have shown that children and teens diagnosed with bipolar disorder are more likely than adults to also be diagnosed with ADHD.

What is childhood bipolar disorder?

Bipolar disorder is a persistent and difficult mental illness. When it occurs in childhood or adolescence, it can completely disrupt the life of the family. Bipolar disorder that's undiagnosed, misdiagnosed, or poorly treated is associated with:

  • Increased rates of suicide attempts and completions
  • Poorer academic performance
  • Impaired relationships
  • Increased rates of substance abuse
  • Multiple hospitalizations

In adults, bipolar disorder is marked by mood changes that go from depression to mania. Adult mania is characterized by decreased need for sleep, rapid speech, euphoria, grandiosity, irritability, racing thoughts, and frenetic activity. The definition of mania is not so clear for bipolar disorder in childhood. Some experts say that being irritable, cranky, and negative may be the only signs of mania in children with bipolar disorder. And other experts argue that childhood bipolar disorder may not even be the same disease as adult bipolar disorder.

What is clear, though, is that bipolar disorder is an increasingly common diagnosis in children -- including children of preschool age.

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