As a mainstream concept, the diagnosis had arrived.I have been a child psychiatrist for nearly five decades and have seen diagnostic fads come and go.(The psychiatrist concluded that Rebecca’s two siblings were bipolar as well.) In addition to diverting the psychiatrist from the very real problem in Rebecca’s family—a well-chronicled history of child abuse—the diagnosis led to the prescription of a common cocktail of medications.
In the autumn of 1994, a novel idea was afoot in my profession.
At the annual conference of the American Academy of Child and Adolescent Psychiatry, I attended a workshop on bipolar disorder in children.
About 10 of us attended the meeting, held in a small, poorly lit room.
Only one or two doctors reported having actually seen a child with bipolar disorder, but we all agreed to keep our eyes open for other sightings.
My view is that a diagnosis of bipolar disorder in a child is almost always a case of severe ADHD combined with severe ODD, both fairly common in elementary-school children.