Many experts agree that children with bipolar are at developmental risk when they don’t receive proper diagnosis and treatment. Here are some reasons for the trend in diagnostic challenges and the risks for not getting an accurate evaluation for your child:
#1 The great imitator
Bipolar in kids can mimic other conditions, such as anxiety disorders, attention deficit and hyperactivity disorder, oppositional defiant disorder and conduct disorder, to name a few. Many mental health professionals agree that the process of diagnosis is difficult given that the disorder is a spectrum of symptoms and severity. Given this, there must be appropriate time for the diagnosis process, and great expertise.
#2 Children vs adults
Bipolar disorder presents differently in adults than it does in children and older criteria for diagnosis are based on the severe adult forms of the disorder. Also, an accurate diagnosis cannot be done simply on the basis of “observable symptoms” as is usually the case when diagnosing adults. Current difficulties, developmental history from birth and an extensive family history are also needed to provide a precise conclusion.
#3 Importance of diagnosis
Bipolar expert and author Gregory T. Lombardo, MD, PhD., believes “substantial harm” can occur if the diagnosis of bipolar disorder is missed or avoided in a child. He says there is an average of ten years passing before the proper diagnosis and treatment begin and, in fact, more than half of adults with bipolar say their mood symptoms began before age 20. “For each year of illness, children with bipolar disorder have a 10 percent lower likelihood of recovery.”
#4 At risk of developmental problems
If left untreated, bipolar disorder in kids can profoundly affect their development—behaviorally, socially, and academically. Lombardo concludes that children will be at high risk for “recurrent depression, academic failure, substance abuse in adolescence and the development of a character disorder.” These resulting developmental problems, which are likely to occur in later years of the child’s life, will then be more difficult to treat than problems associated with mood.
#5 At risk of family discord
Without a diagnosis and treatment for a child, Lombardo argues there is a risk for a “lasting serious misunderstanding between the parents and the affected child. Parental discord, resentment among siblings, physical or sexual abuse within the family and divorce may be affiliated to not pursuing a diagnosis of bipolar disorder in a child.”
#6 Early diagnosis and treatment is key
While many mental health experts agree there is a risk of developmental harm if children with bipolar are not diagnosed and treated, there is a flip side: treatment of bipolar in children can result in “dramatic improvements” which are not commonly seen in the treatment of adults. This fact alone illustrates why diagnosis and treatment in kids is so crucial.
#7 Seeking an expert evaluation
Some argue that of the biggest challenges in the diagnosis of children with bipolar is the lack of child psychiatrists who can perform a comprehensive and adequate evaluation. It’s important for parents to search and seek out a credible expert. Lombardo reminds parents that any diagnosis of bipolar disorder in a child is “tentative and must be proved over time by the child’s developmental course and response to treatment.”
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