Bipolar disorder or ADHD?

Bipolar disorder and attention-deficit/hyperactivity disorder (ADHD) are two diseases that are being diagnosed increasingly more often in children and teenagers. 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? And 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 hard to diagnose. That's especially true for teenagers for whom irritability and moodiness are two traits that 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 can have actual bipolar disorder with mood swings going from depression to mania.

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 behaviour. Children or teens with bipolar disorder often have similar behaviours.

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. However there are those who say it can be a result of a lack of parenting that leads to protesting behaviour being tagged as a disease. Some studies have shown that youth 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 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 performances
• distressed relationships
• increased rates of substance abuse
• multiple hospitalisations

In adults bipolar disorder is marked by mood swings that go from depression to mania. Adult mania is characterised by 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 can 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.

However what is clear is that bipolar disorder is an increasingly common diagnosis in children - including children of infant school age.

What are the warning signs of bipolar disorder in children and teens?

With bipolar disorder there are both manic symptoms and depressive symptoms. If your child or teenager has five or more symptoms that persist for at least a week, it is important to seek professional help. With medication and/or psychotherapy, doctors can help stabilise your child's moods. Treatment can also stop the depressed or manic thoughts and behaviours.