Dissociative Disorder is Often Diagnosed as Bipolar Disorder

The number of children diagnosed with bipolar disorderInc. center carried a past diagnosis of bipolar disorder.
has risen dramatically. A study of mentally ill children inThe differentiation between the two diagnoses when
community hospitals, published recently in the Archivesrapid mood swings are present is sometimes difficult
of General Psychiatry, found the proportion of childrenand sometimes both disorders are present. A major
diagnosed as bipolar shot up from less than 3 percentresearcher in the field of dissociative disorders, Dr. Paul
in 1990 to 15 percent in 2000 and this rate is stillDell, has developed reliable evaluation instruments that
climbing.these specialty clinics use to make this differentiation
Before 1995 we believed that bipolar disorder waswith confidence. Adults, adolescents, and children with
exceedingly rare in children. Then psychiatrists at thedissociative disorder often report that:o They have an
Massachusetts General Hospital published researchemotion (e.g., fear, sadness, anger, happiness) that
that showed 16 percent of the children referred to theirfeels like it is not their own.o They hear the voice of a
psychopharmacology clinic fit the diagnosis. Thatchild in their head.o They have another personality that
observation suggested that perhaps 1 percent of allsometimes takes over.o They experience blank spells
children might be affected. Recent studies document aor blackouts in their memory.o They feel like they are
steep increase in prescriptions of antipsychotic drugsonly partially 'there' (or not really 'there' at all).o They
to children of all ages and this is probably due to thefeel strong impulses to do something - but the impulses
increasing diagnosis of bipolar disorder. Manydon't feel like they belong to them.o They feel like they
psychiatrists question whether the disorder reallyare often different from themselves.o They feel that
affects so many children and whether the benefits ofpieces from their past are missing.o They feel like
the diagnosis outweigh the risks of the drugs in manysome of their behavior isn't really theirs.o They feel
cases.distant and removed from their thoughts and actions.o
One factor in the increased use of the diagnosis is theThey feel that they have multiple personalities.o They
availability of new, potentially effective drugs,feel that they have another part inside that has
particularly antipsychotic and mood stabilizers. As thedifferent memories, behaviors, and feelings
bipolar diagnosis gained popularity in recent years, soSometimes people with bipolar disorder experience
did prescriptions for powerful antipsychotic drugs suchsome of these symptoms but at a much lower
as Risperdal and Zyprexa, which have been approveddegree than those with dissociative disorder. I
for use in adults, but are also prescribed for children. Arecommend that parents of children who demonstrate
concern is that if you have kids on these medicationsany dissociative symptoms find a psychiatrist or
for long periods of time they may develop majortherapist who will at least consider childhood trauma
medical problems as adults.and therapy for it as a possibility. If the diagnosis of
Unfortunately the bipolar diagnosis is being applied tochildhood bipolar disorder is made I recommend
children and adults whose condition arises from seriousseeking another opinion before agreeing to medication
childhood trauma that results in symptoms very similaras treatment.
to the depression and mood swings of bipolar disorder.Children and adults with dissociative disorder can
Therapists estimate that about one-third of dissociativerespond rapidly to psychotherapy alone, particularly the
patients referred to the specialty clinics of the Traumaso-called exposure therapies that focus on childhood
Recovery Institute and the Intensive Trauma Therapytraumas.