Paediatric Manic Depression
In children, manic depression is rarely diagnosed in the United Kingdom.
In children manic depression is rarely diagnosed in the United Kingdom; in the United States it is diagnosed quite frequently. Cardinal symptoms used to support a diagnosis of manic depression are insomnia and grandiosity (where the child has a persisting and genuine belief in his own self-importance – as opposed to temporary play acting which is of course normal). There is often co-morbid drug use which can obfuscate the picture. The area is of major importance as parents may wonder if their adolescent mischief-maker is ‘organically’ sick or just going through the growing pains of youth in a disorderly manner. There is value in early diagnosis of manic depression, though it is often only made retrospectively, and early management is important. In reality, the older the youth is the more likely manic depression is to be correct diagnosis. There is an increasing incidence into the early twenties (being the maximum age of onset).
The adolescent should have a careful evaluation by an experienced psychiatrist. Differentiation from ADHD (Attention Deficit Hyperactivity Disorder), ‘personality disorder’, drug use and behavioural disorders in a healthy child brought up in a dysfunctional manner are key. An accurate and careful diagnosis is important. Clear diagnosis may not be possible where there is a combination of these elements initially.
The danger of over-diagnosing as a society is that everyone ends up being ’sick’ with something that needs ‘treating’ with medication. That doesn’t mean manic depression does not exist; it just means we have to be on the look out for over-diagnosis.
There are studies suggesting that children/adolescents going on to have manic depressive illness have a higher IQ than the average but if this is true it may be only a small difference. Highlighting the potential of manic depressive sufferers can have a backlash in the frustration of those unable to focus their energy and intelligence into a successful outcome.
