The Therapist in Me

I feel like I need to mention this, just because I've seen it so often in my practice. Bipolar disorder with childhood onset is a bit of a hot topic now, and is therefore getting more publicity. It's a fairly new idea that a child can have bipolar disorder, and this leads to a boom of diagnosis, hopefully mostly accurate, but because of the newness and lack of familiarity, some may not be accurate as well. Just because your child is acting out, even in the same ways you see listed in books you're reading, does NOT necessarily mean that he/she is bipolar, or has any mental health condition for that matter. Before Pajama Monster was diagnosed, the psychologist did extensive looking at my husband and my own parenting skills, our home environment, the possibility of abuse from home or another source, medical problems, family history of mental health problems and medical issues, major transitions or changes, and longevity of the problem, to name just a few. He did this because it is very often one or more of these factors. A child can appear to be bipolar as a result of poor parenting skills, or medical problems, sexual abuse inside or outside the home, trauma, etc. There are also many overlapping symptoms between bipolar, depression, anxiety, sensory processing disorder, OCD, ADHD, and ODD.
I'm writing this blog to talk about how I'm coping with life with a bipolar preschooler, and all the heartaches and joys and setbacks, but please, please, PLEASE, never diagnose your child yourself! I'm a therapist. I'm qualified to diagnose bipolar in a child, and still I would never have considered making the final diagnosis myself. I'm just too close to the situation. There's too great a risk that I'll see what I want to see and not see what I don't want to see. Beyond that, for the nonprofessional, reading a list of symptoms just isn't enough to make a diagnosis. That's why no therapist will diagnose until he/she has seen the child. It's how all the pieces fit together that informs diagnosis, not just a list of check boxes. We see supervisors and learn over time what the diagnosis really looks and feels like before we diagnose it in others.
I just want to make sure I don't give the impression, by jumping in with where we are today, that we skimmed over all the other steps of diagnosis. They are incredibly important, and unfortunately very time consuming. Be honest with your child's therapist. It's the only way to get an accurate diagnosis, and be willing to wait while all the information is being gathered. It may be the diagnosis you suspect, but then again it might not. I once met a little girl diagnosed with autism because of headbanging, screaming, failure to develop language, flailing motions, no interactive response to other's attempts to speak to her, etc. Autism? Everyone thought so, that is until someone took a look in her ears and discovered the horrendous ear infections she had behind both eardrums. She couldn't learn language or engage in attempts at speaking because she couldn't hear, and the rest of the symptoms were her frantic attempts to deal with the pain in her head and to express her needs without words. The diagnosis isn't always what it first looks like. Take your time and never be afraid to question.