APA Proposes Alternative to Juvenile Bipolar


In response to pressure over the 40-fold increase of bipolar diagnoses in children, many of which are being reviewed and dropped in retrospect, the APA has proposed a new, potentially more transient “disruptive mood dysregulation disorder” that would apply to children with chronic irritability and recurrent temper outbursts, and would ostensibly be treated with antidepressants instead of antipsychotics. The proposal, according to the Boston Globe, has brought new scrutiny to Joseph Biederman, who argued that chronic irritability can be interpreted as juvenile mania.

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Related Items:
Experts unconvinced by changes to psychiatric guide (Reuters)
Newsflash from APA Meeting: DSM-5 Has Flunked Its Reliability Tests (Huffington Post)
Updates to Psychiatric Guide Spur Controversy (Washington Post)
First DSM-5 Field Trials Generate Mixed Results (Medscape Today)
Psychiatry Manual Drafters Back Down on Diagnoses (New York Times)

Related “In the News” Items:
Call For DSM-5 Reform Continues
Incoming APA President Emphasizes “Positive Psychiatry”
Weak Field Trials Scuttle DSM-5 Diagnoses
DSM-5 Retreats from Some Controversial Diagnoses
Ethics Complaints Over DSM Filed With the APA


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Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected].


  1. when a child is chronically irritable and disruptive, he/she needs attention, love and hugs not antidepressants and even less antipsychotics. These psychiatrists are often parents themselves, for crying out loud! I just don’t understand how their mind works-

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  2. This is a backwards attempt to cover up for the APA’s earlier foolishness in traveling down this pathway. Rather than admit that irritability is a normal developmental event for many children which they eventually mature out of, we now have to reinterpret this as a new “disorder” so that the APA doesn’t have to eat crow. Naturally, this new “disorder” is to be treated with the exact same drugs as the old one – old wine in new bottles.

    This is a classic example of Alice Miller’s observation that the powerful adults always have to protect their “rightness” at the expense of the children, who then grow to inflict similar damage to the next generation.

    This is one of the most egregious misrepresentations in a book full of misrepresentations. It should not be allowed.

    —- Steve

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