Childhood Bipolar Disorder, Deconstructed

Eric Maisel, PhD
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All psychiatric diagnoses are suspect, insofar as they are descriptive and not explanatory. To say that an adult is having a “manic episode” is simply to provide a name for certain observable behaviors: for instance, that she is running naked down the corridors of her apartment building or staying up all night, night after night, to paint and repaint the walls of her bedroom.

That this particular naming makes sense is even less true for the “mania” that is supposedly a part of juvenile or pediatric “bipolar disorder.” There, all we might be seeing in the above behavior is an ordinary two-year-old rushing from activity to activity—practically a defining feature of being two years old. To call that behavior a “symptom of the mental disorder of juvenile bipolar disorder” is neither logical nor legitimate.

Have you ever been around a two-year-old? Don’t they sometimes melt down and have ferocious tantrums? Don’t they sometimes “suffer from excesses of energy”? Can’t they sometimes become inconsolably sad? Aren’t they sometimes willful and defiant? Yet all of these states and behaviors, as completely normal and ordinary as they are, are now deemed “symptoms of the mental disorder of juvenile bipolar disorder.” Does this make sense?

As Stuart Kaplan, author of Your Child Does Not Have Bipolar Disorder, explained in an essay in Newsweek:

“I have been a child psychiatrist for nearly five decades and have seen diagnostic fads come and go. But I have never witnessed anything like the tidal wave of unwarranted enthusiasm for the diagnosis of bipolar disorder in children that now engulfs the public and the profession. Before 1995, bipolar disorder, once known as manic-depressive illness, was rarely diagnosed in children. Today, nearly one-third of all children and adolescents discharged from child psychiatric hospitals are diagnosed with the disorder and medicated accordingly. The rise of outpatient office visits for children and adolescents with bipolar disorder increased 40-fold from 20,000 in 1994–95 to 800,000 in 2002–03. A Harvard child-psychiatry group led by Dr. Joseph Biederman, a prominent supporter of the diagnosis, recently insisted, ‘Juvenile bipolar disorder is a serious illness that is estimated to affect approximately 1 percent to 4 percent of children.’

“I believe, to the contrary, that there is no scientific evidence to support the belief that bipolar disorder surfaces in childhood. In fact, the opposite seems to be the case: the evidence against the existence of pediatric bipolar disorder is so strong that it’s difficult to imagine how it has gained the endorsement of anyone in the scientific community. And the effect of this trendy thinking can have devastating consequences. Such children are regularly prescribed medications that are not effective in kids and have unwelcome side effects.”

“Mania” in Perspective

As a therapist and creativity coach with artists for more than thirty years, I’ve frequently observed that people who are creative and who think a lot are more prone to so-called “mania” than people who do not think a lot and who aren’t creative. This fact, which is backed up by research, should alert us to the possibility that mania is not some pseudo-medical condition or brain abnormality but rather a function of the mental pressures placed on individuals who use and rely on their brains.

There is plenty of evidence to support the idea that intelligent, creative, and thoughtful people are disproportionately affected by the thing called mania. Research shows, for example, a clear linkage between “bipolar disorder” diagnoses and achieving top grades, scoring high on tests, and other, similar measures of mental accomplishment.

One study involving 700,000 adults and reported in the British Journal of Psychiatry indicated that former straight-A students were four times more likely to be “bipolar” (or “manic-depressive”) than those who had achieved lower grades.

Are these folks “more ill” than their C-average counterparts? Or are they putting their brains under relatively more pressure, thereby causing dangerous speeding accidents? Which seems more likely?

In another study, individuals who scored the highest on tests for mathematical reasoning were at 12 times greater risk for “contracting bipolar disorder.” Similar research underlines the linkage between creativity and mania, and we have thousands of years of anecdotal evidence to support the contention that smart and creative people often get manic (just think of novelist Virginia Woolf).

All this evidence suggests that enlisting your brain—say, to write a novel or to solve a riddle in theoretical physics—is a rather dangerous act, since it increases the stress on a brain already pressured by dealing with everyday matters such as financial difficulties, psychological threats, or just finding the car keys.

The current naming system used to describe “mental disorders” leads to many wrong-headed hypotheses—for example, that “because you are bipolar you are creative” or that “perhaps mania accounts for the higher test scores.” What is more likely is that the greater a person’s brain capacity and the greater their reliance on thinking long and hard, the more susceptible their revved-up brain is to racing.

All of the characteristic “symptoms of mania” that we see in adults, including high spirits, high arousal levels, high energy levels, heightened sexual appetite, sweating, pacing, and sleeplessness—and, at their severest, hallucinations, delusions of grandeur, suspiciousness, aggression and wild, self-defeating plans and schemes—make perfect sense when viewed from the perspective that a powerful pressure, likely from the existential task of making meaning in life, has supercharged a brain already feverishly racing along.

Challenging an “Epidemic”

As to what is going on in children labeled “bipolar,” we know even less. What we do know is that children already have racing brains, a feverish fantasy life, imaginary playmates, wild schemes, and all too often trauma-induced mental pressures. Doesn’t it make sense, then, to conceptualize “mania” in children (when it is something different from normal childhood curiosity and distractibility) as related to the way the mind can be pressured to race too wildly? If it is ever fair to call a child “manic,” isn’t the child’s environment the direction in which we should look?

Diagnosing children with juvenile or pediatric bipolar disorder is largely an American phenomenon. Do we actually have more “bipolar” children in the United States—or are we simply labeling more of them as such?

Peter Parry, Stephen Allison, and Tarun Bastiampillai addressed this issue in an article published in The Lancet:

“So why did the pediatric bipolar disorder diagnostic epidemic occur and remain mostly confined to the USA? Among more than a thousand, mostly American, articles about pediatric bipolar disorder, a few US psychiatrists and pediatricians have been vocal critics. They noted that diagnostic criteria for pediatric bipolar disorder deviate from strict DSM criteria, symptom-checklist approaches to diagnosis did not account for developmental and contextual factors, trauma and detachment disruption were overlooked, the pharmaceutical industry collaborated with key opinion leaders and researchers of pediatric bipolar disorder, and that the US health system often mandates more serious diagnoses in order to provide reimbursement …

“A systematic literature review of articles about pediatric bipolar disorder published from 1995 to 2010 noted almost no mention of the terms ‘attachment,’ ‘neglect,’ or ‘maltreatment,’ and very few mentions of the terms ‘trauma,’ ‘PTSD,’ ‘physical abuse,’ or ‘sexual abuse,’ and few mentions of the terms ‘verbal abuse’ or ‘emotional abuse’ in pediatric bipolar disorder research cohorts. In an era of dominant pharmaceutical industry funding and marketing, the presumption of biomedical causes for DSM disorders filled the etiological space.”

In other words, American psychiatrists seemingly intentionally overlook any explanations for troubled children’s behavior that don’t align with the assumption that the youth have a biologically based “mental illness.”

What About “Depression”?

If the “mania” part of “juvenile bipolar” is a problematic construct, so is the “depression” part. Might not any of the following cause the thing commonly called “depression”?

  • A child gets a string of bad grades and begins to feel hopeless about his chances at school.
  • A child is being bullied by a sibling, learns over time that she can’t come to her parents with her complaints or her pain, and feels helpless in her own home.
  • A child grows up scrutinized at every turn by a stay-at-home parent who expects nothing less than perfection.
  • A child is forced to live in a chaotic environment filled with marital discord, broken promises, and a lack of privacy.
  • A child begins to see life as unfair and a cheat and sours on life itself.
  • A child receives no permission to do any of the things that he actually enjoys doing and lives a life of rules and chores.
  • A child has her efforts criticized and ridiculed in cruel and shaming ways.
  • And so on…

It is dishonest to use “depression” as a pseudo-medical term under which to collect all sorts of negative states and behaviors including boredom, recklessness, irritability, anger, and so on. To say that a child is “depressed” when he is actually and obviously irritable and angry is to make a linguistic leap that is as illegitimate as an adult saying that she is “depressed” when she is irritable and angry.

Nor should the word be used as a twisted repetition of a self-reported mood or situation. But what too often happens is that a child says, “I’m depressed,” meaning something along the lines of “I’m being bullied” or “I hate life,” and his psychiatrist repeats, “You’re depressed,” but with a completely different, pseudo-medical meaning. What just happened is that the psychiatrist turned the child’s sadness, his everyday usage of the word “depressed,” into the “mental disorder of depression.”

For all these reasons and more, the construct of juvenile bipolar disorder is extremely shaky and suspicious. With some children exhibiting “manic” and “depressive” behaviors, nothing but childhood is going on. With others, something is indeed going on, but to presume that that something is medical in nature is not supported by the evidence. Pediatric bipolar disorder and other constructs of psychiatry—ADHD, ODD, and so on—are not rooted in medical science. They are labels affixed to a troublesome child or a child in trouble. The trouble may be real and genuine: but what is going on is nothing like a broken arm in need of casting.

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26 COMMENTS

  1. Joseph Biederman the corrupt creator of child bipolar was the recipient of the 1998 NAMI Exemplary Psychiatrist award.
    “Risperidone for Adolescent Aggression”
    Medical Focus, Winter 1996 http://web.archive.org/web/19961221104126/http://www.nami.org/

    It was NAMI and this guy Biderman using lots of drug company money that invented child bipolar to make billions drugging kids.

    This is the very best report I know about. https://highline.huffingtonpost.com/miracleindustry/americas-most-admired-lawbreaker/

  2. Some bipolar meds made me forget my childhood, others definitely confused entire years of my adult life. You could easily chemically remove the experience of childhood entirely with these drugs. I’m never getting clear memories back of my time in and out of hospitals. Nor do I particularly want them. But imagine not being able to remember the important things about yourself growing up…. Basically what makes you…you. Like I hate sugar because I barfed a cake up once. You could very well be taking away their capability of developing an identity. I lost mine while medicated as an adult. But at least I had one to go back to and build on. Why have kids or care for them if you don’t want cool idividuals to develop? This is TERRIBLE. My fiance suggested writing well thought out articles to major publications might help, but that could take years and I know what 1 day can feel like while subject to this inhumane treatment. It’s not remotely fair.

  3. I would imagine that some of the bipolar disorder, so-called, in adults is not exactly the frenzied activity of exceptional brains. When recreational drug use disturbs normal cycles of activity, of sleep and wakefulness, when people use uppers and downers regularly, it’s bound to have a major effect on all aspects of their life. Celebrities, occasional prone to receive a diagnosis of “bipolar disorder”, are also known to use recreational drugs liberally wherever such resources are flowing freely. Self-medication aside, if anti-depressants aren’t very effective at containing depression, I would doubt that a combination of uppers and downers are going to do the trick any better. Mess yourself up on drugs, uh, I mean develop “bipolar disorder”, and, wouldn’t you know it? Doctors think they have a drug for that.

    • Yeah, the whole fiction of latent bipolar is what really gets my goat. First drug someone, note the negative reaction, call it underlying disease without ever trying to see if the negative reaction goes away when you remove the offending drug. What a crock of utter horseshit. It would be like if someone had a psychotic reaction to one of the flouroquinalones and instead of changing the drug type, the doctors simply labeled it an underlying psychotic disorder and doubled down on the drug instead. Psychiatry logic is utterly bizarre and defies common sense at every possible turn, to the detriment of the patients so labeled and “treated”.

      • I agree “latent bipolar,” or what our “mental health professionals” were not long ago gleefully proclaiming to be “unmasking bipolar,” is bogus, kindredspirit. But just taking the person off the offending antidepressant won’t work either. Because the doctors think the common symptoms of antidepressant discontinuation syndrome are “bipolar” also. Despite their DSM-IV-TR clearly stating:

        “Note: Manic-like episodes that are clearly caused by somatic antidepressant treatment (e.g., medication, electroconvulsive therapy, light therapy) should not count toward a diagnosis of Bipolar I Disorder.”

        Apparently, we have an American only, completely iatrogenic, “childhood bipolar epidemic”, in part because America is the only country that has “mental health professionals” that are not intelligent enough to even read, and abide by, their DSM “bible.” Although, I do agree, Biederman is second only to satan, albeit he has delusions that satan is God.

        And I would like to point out that the psychiatric drugs don’t actually know how old the person taking the drugs is. Thus the ADHD drugs and antidepressants do also create the bipolar symptoms in adults, as well as children.

        And if these “bipolar” children are put on the antipsychotics/neuroleptics. It’s likely that they’ll develop what appears to the doctors to be the “schizophrenia” symptoms. Since the neuroleptics create the negative symptoms of “schizophrenia” via neuroleptic induced deficit syndrome. And the antipsychotics create the positive symptoms of “schizophrenia” via antipsychotic and/or antidepressant induced anticholinergic toxidrome.

        https://en.wikipedia.org/wiki/Neuroleptic-induced_deficit_syndrome
        https://en.wikipedia.org/wiki/Toxidrome

        But since these medically known psychiatric drug induced syndrome, that mimic the symptoms of the DSM disorders, aren’t billable DSM disorders. They’ll always be misdiagnosed as one of the billable disorders.

        “As a therapist and creativity coach with artists for more than thirty years, I’ve frequently observed that people who are creative and who think a lot are more prone to so-called ‘mania’ than people who do not think a lot and who aren’t creative.” Today’s psychologists believe thinking is “psychosis,” according to my medical records. They also believe dreaming and having gut instincts are “psychosis.” Which means they believe all people are “psychotic,” since we all dream.

        And now that the psychologists are starting to realize that medically unnecessarily drugging up lots of the artists results in a society with lots of “insightful” artwork, which points out the crimes of the “mental health professionals.” So the psychologists are now getting nervous, and trying to “take control” of the artists’ work, via legalese based thievery.

        Any, and everything, to try to maintain America “dirty little secret of the two original educated professions,” multibillion dollar, primarily child abuse covering up, scientific fraud based, iatrogenic illness creating, “mental health system.” It’s sick to turn children into “bipolar”/”schizophrenics” with the psychiatric drugs. This needs to stop.

        “There is plenty of evidence to support the idea that intelligent, creative, and thoughtful people are disproportionately affected by the thing called mania. Research shows, for example, a clear linkage between “bipolar disorder” diagnoses and achieving top grades, scoring high on tests, and other, similar measures of mental accomplishment.”

        I pointed out to my former psychiatrist that “bipolar” stigmatizations were inappropriately being given to those with high IQs about ten years ago. But I will ask, is it actually wise to defame, tranquilize, torture, and attempt to murder the best and brightest creators in one’s society? Or is that a recipe for how to destroy a nation? Which, of course, would make our “mental health” stigmatizers, traitors to our nation.

        • I will add in a manner identical to how the Nazi and Bolshevik led Russian psychiatrists functioned, a mass murdering manner, within their societies.

          I’d say Western civilization is dealing with a repeat of the worst of history, by today’s scientific fraud based psychiatrists. Likely since the psychiatric criminals have still never been held personally responsible for the massive in scope crimes they committed against humanity, in other countries.

          Western civilization needs to hold the mass murdering psychiatrists accountable for their historic, and continuing, crimes against humanity. And not continue to utilize the psychiatrists and their “mental health minion” to maintain, and empower, the satanic globalist world order. As wished for by the fiscally irresponsible, bailout needing, war mongering and profiteering, globalist banksters.

    • When I was in school they were calling “manic depressive psychosis” a rare genetic based “disorder”, but since the view that some children thought to suffer from “ADHD” actually had “bipolar disorder”, the population of people labeled “bipolar” has surpassed that of the population labeled “schizophrenic”, and, in fact, is now more than double the “schizophrenia” rate. How did this happen? I don’t know, but any day now now, researchers inform us, they are going to have identified the mutant gene behind it all.

  4. At the risk of being criticized for bringing up Lyme repeatedly, one of the reasons it’s so often mistaken for bipolar disorder is because of its relapsing remitting nature. A primary feature of late (untreated) Lyme disease is neuropsychiatric symptoms. When the spirochete is actively reproducing, the patient will have a flare up of whatever symptoms they experience (out of a dizzying array of possible symptoms), many of which will look strikingly like the cycling nature of so-called bipolar illness. In other words, deep depressions during flares, and a frenzy of “catch up” activity during times of no or few symptoms. Spirochetes have the ability to become dormant for periods of time (up to nine months), during which a patient will have no or few physical and mental symptoms. Then they begin to reproduce again and you’re hit like a ton of bricks. Or in psychiatric parlance, you crash or decomp. Stress, poor diet, and other lifestyle issues strongly effect the behavior of the bacteria. As the immune response wanes during periods of stress, the bacteria take advantage and multiply, producing symptoms that look like a decomp in response to environmental factors that is actually the bodies response to the Lyme reproductive cycle.

    Children are especially effected by Lyme disease because of their likelihood to be playing outdoors and in places where they will encounter ticks. When it isn’t caught and treated early and advances to late stage illness (which is common at all ages), you can develop what looks for all the world like a cycling bipolar illness.

    In general, medical professionals presented with psychiatric illness should (and sometimes do) first on the lookout for underlying physical illness, but they need to be aware of the massive and increasing presence of Lyme and of how to properly test for it.

    I think there’s more to the story than just bad families, bad kids, drug company profits, and changing societal norms involved in the explosion of children diagnosed with bipolar. Unfortunately, the rapid increase in systemic parasitic infections (LAD) has occurred over almost exactly the same time period as the increase in childhood bipolar diagnoses. I hope that the psychiatric research community is paying attention. Children suffering from a physical illness will not be helped by psych drugs and therapy.

    • Contracting Lyme is becoming more common. I am so sorry yours was not caught sooner. I hope the antibiotics you started recently can have some positive effects. Doctors need to be more aware and always have it on their radar as even Avril Lavigne was told she was “crazy” for while before she was finally diagnosed with Lyme.

      • Thank you, Rosalee.

        There is progress being made, partly due to the sheer number of people being diagnosed (and the estimates of how many are actually infected.)

        I just read new numbers were released for last year and the CDC surveillance was at 59,000 new cases. And if you extrapolate from that their own estimate that the true number is ten times that many, that’s over half a million new cases last year.

        Lyme research currently receives about 1% of the funding that HIV receives but effects around six times as many people as HIV. Because this is an emerging pandemic that Congress is taking seriously (even as the CDC sits on its laurels) I have hope that a cure will come eventually. And I believe that a great many people will find real relief from their Lyme (and coinfection related) neuropsychiatric symptoms when that cure eventually comes.

        Kris kristofferson, Avril Levine, Shania Twain, those are just the effected celebrities I know of immediately.

        They managed to make a vaccine for Ebola in less than a year; I know with enough funding, there will be a cure for Lyme.

  5. Before these absurd and damaging labels became the norm it was considered “the terrible twos” or a childhood “phase” that some kids go through and they usually outgrew it with time.
    Thanks for another great article and getting this vital information out there.

  6. The penultimate sentence resonated for me in an otherwise excellent blog: “They are labels affixed to a troublesome child or a child in trouble”. I can’t help but wonder if the latter is the more common problem: a child in one dreadful situation or another from which the situation is treated through the child (as pediatric psychiatric medicalization statistics bear out in foster care/homes, for instance).

    Two years ago my new neighbor informed me that the 12 year old boy I’d come to know (her nephew) was bipolar and had aspergers (of one kind or another?). Funny thing was, I found the kid to be highly attentive, curious and smart, and emotionally resonate, and stable as a rock-upon reflection. My neighbor then informed me that her mother had taken custody of this boy and his sister due to some “pretty bad stuff”, later confirmed as sickening abuse and trauma from my prying. Turns out the shrink had him on lithium. When I told the aunt of the long-term issues with the kidneys,’ etc., she told me the shrink was going to switch him to something new when he turned 18 (his future already settled here, apparently.) I tried to get her to see that whatever might be going on with him wasn’t (at least automatically) biological, and likely due to the glaring prolonged trauma several years earlier. She would have none of it. Though she agreed he was usually a great, easy going kid, etc., he had (occasional) tantrums that were very disruptive. My only thought here was…I wonder what unconscious trigger was going on from that earlier, traumatized, miscarried developmental stage? The kid haunts me: and so, too, the thought of all the kids in these situations.

  7. Thanks for this. It still doesn’t make sense. In 1984 at Smith College Summer CEU they had Rubin Blank a developer of Ego Psychology with his wife Gertrude talk about his own toddlerhood in which he was so troublesome his family would refer to him as Rubin the Terrible. He did it with love and humor and explanation of children needing to explore and deal with theirbgrowing sense of all the boundaries imposed by them in the world. At times, no is actually a good thing to know how to say. He also made a point that the families were are born into are our families. It is our life’s work to learn to cope with them. No matter how we wish they would not be our families it is part and parcel of us. Bad or good or indifferent.
    Selma Fraigberg’s The Magic Years goes into this thinking.
    Trauma was known to some professionals , I guess not enough to stop the tide. Still how did this happen?
    And yes the other causes beside and or including trauma. Noise pollution, air pollution, chemical exposures. Rachel Carson found multiple examples thought the earth’s environs and did not have any background in psychological anything- if we had a modern day Rachel Carson looking into the equivalent of chemical toxins and yes visual artists are exposed all the time- look at possibly Van Gogh? Abd prescription drugs what would she find? And would she be allowed to go forth?
    Serpico? And have there been others who were stopped by the vargities of life and our world as we know it?
    C Henry Kempe a WWII refugee from Germany exposed child abuse. It helps to have a survivor’s experience to think out of the box. And Salk whatever concerns some have with vaccines – do you know he received no profit from his patent PER HIS REQUEST. A true caring person. Some professionals are not worthy to clean his shoes- truly.

  8. As a therapist and creativity coach with artists for more than thirty years, I’ve frequently observed that people who are creative and who think a lot are more prone to so-called “mania” than people who do not think a lot and who aren’t creative.

    Therefore we should figure out what factors lead to this lack of thought and creativity and, to be consistent, explore what biochemical processes might need to be jump-started to free these people from their rigid ways of living, even if they object due to anosognosia. 🙂

    • The cure is obvious. Make everybody stupid and boring.

      Ah! The bliss of a certifiably “sane” and normal world of conformists.

      Ever read “Harrison Bergeron” by Kurt Vonnegut? A Dystopia where the authorities put “handicaps” on those deemed too smart so they can’t think as clearly. Just like shrinks “help” folks by dumbing down, numbing, and keeping them in a low grade depression.

      (A psych worker told me they actually aim for low grade depression since happiness often leads to mania.)

  9. This article mentioned “lack of privacy”. So, I want to provide you with examples of parents who (sometimes together with teachers) intentionally try to deprive their kids of virtually any privacy whatsoever:

    https://qz.com/1482833/parents-are-putting-gps-ankle-monitors-on-their-teenage-kids/

    https://qz.com/1318758/schools-are-using-ai-to-track-what-students-write-on-their-computers/

    I hope people here do not approve such… eh… “parenting methods”. Don’t you?