The sections that that describe the differences between adult bipolar disorder and early-onset bipolar disorder are particularly impressive. The sections on other diagnostic categories (such as ADHD which is frequently a "misdiagnosis" with tragic results) are equally impressive.

In short, this book ought to be "required" reading for everyone involved in the life of a bipolar child, including parents, relatives, teachers, therapists, and doctors. As the parent of a child diagnosed ten years ago at age five with bipolar disorder, I can say with confidence that this book more than lives up to its subtitle, "The Definitive and Reassuring Guide to Childhood's Most Misunderstood Disorder." It is a medical reference book, parent handbook, educational planning book, treatment roadmap, and book of hope--all rolled into one!

124 of 128 found the following review helpful:


Footsoldiers In The Battle To Comfort Children  Jan 29, 2004 By Thomas J. Burns
One might argue that the authors attempted to squeeze too much information between one set of covers. It does seem that there are actually two books here: one, a medical analysis of the etiology of Bipolar Disorder, particularly early onset in very young children; and another book guiding parents in recognizing the symptoms and navigating the medical, insurance, and governmental mazes to obtain treatment for their children. Be that as it may, the authors have written a very provocative treatment of Bipolar Disorder that brings into print what psychiatrists, mental health professionals, and many parents have been concerned about for some time. For the past decade or so, there has been growing concern about the precision of children's diagnoses vis-à-vis Attention Deficit Hyperactivity Disorder. While many parents and school officials wonder if the ADHD diagnosis is rendered too often, there is another school of thought emerging that as many as a third of ADHD diagnoses are in reality cases of early onset Bipolar Disorder.

The authors are not alarmists; their stance, research, and professional networking is mainstream. But this work is alarming. It argues from the testimony of hundreds of parents connected to the authors from around the country by the Internet, that their children were much more violently ill than DSM-IV criteria for ADHD would admit, and that traditional ADHD treatments were not working, in fact making the situations worse. Admitting that the ADHD/bipolar differential is tricky for the diagnostician, the authors have arrived at useful clinical clues. For example, when a hyperactive child breaks something, more often than not he is angry with himself for his clumsiness. The bipolar child, on the other hand, often demonstrates an outward rage or anger with his destructive actions directed at family and peers. The Papoloses note also that bipolar children are more inclined to night terrors and violent imagination in story telling and art work.

The authors point out that pediatric pharmacology in the treatment of early-onset Bipolar Disorder is extremely critical and presents a wide array of problems. As noted above, Bipolar Disorder can be mistaken for ADHD. The standard medication for the latter has been stimulants, which unfortunately will severely aggravate the manic tendencies of the bipolar client. Other clients may present as depressed, and even though the FDA has severely cautioned against the use of SSRI's with depressed children, it has not forbidden their use outright. In children and adults, SSRI's have been found to trigger manic episodes where the depressed mood was a feature of misdiagnosed Bipolar Disorder.

Even when the diagnosis of Bipolar Disorder is correctly made, the medication problems for children are significant. Over the years the common practice has been the use of such mood stabilizers as Lithium and Depakote. These medications have required regular blood work, which has made compliance an issue with children who naturally despise needles. More recently, anticonvulsant and atypical psychotic medications have proven useful in severe cases. However, these medications involve significant side effects ranging from aggravated weight gain and acne to such extremes as facial distortions and the other trademark symptoms of psychotic medications. The Papoloses examine each medication, pro and con, to assist parents and practitioners in treating and educating their clients.

Parents are reminded that dating back to 1973 federal law has mandated the educational opportunities of children with mental disorders. In a similar vein, children's rights to medical treatment, including institutionalization for weeks or months, are also reviewed under the provisions of Medicare and Medicaid, among other plans. The authors are thorough in spelling out the rights and the best procedures to follow in dealing with the bureaucracies of government, schools, and insurance companies. A number of useful organizations, with phone numbers and web sites, are provided. However, in the two states whose budgets I monitor, New York and Florida, Medicaid funding for children has been significantly reduced due to strapped state budgets. At this writing, California is considering wholesale reduction of service as well. Consequently, even those parents who are faithful to the advice rendered by the Papoloses may have difficulty in accessing service. The authors' advice here, while correct may be a bit too rosy in the present health care environment. In addition, I attempted to use several of the web sites, and some of them have been disbanded.

But in the final analysis, this work fulfills what I think were the intentions of the authors. First, it provides assurances to parents that the bizarre and deeply troubling behavior of their children may have organic causes for which they are not responsible. Caregivers are reminded that they are not alone, that they have rights, and most importantly, that there are support groups and practitioners who are beginning to understand the scope of their problems. Second, this work is successful in encouraging practitioners to think more expansively about the pervasiveness of early-onset Bipolar Disorder. Until fairly recently popular wisdom had that Bipolar Disorder was "a grownup's disorder." Today any practitioner will tell you that in the absence of significant personal and family history, the establishment of a bipolar diagnosis is extremely difficult. So much the more for children, particularly when we are not conditioned to routinely look for manic depressive features.

The Papoloses also discuss the troubling prospect that disorders of mood are gradually increasing in scope and intensity in America and appearing at earlier ages than ever before. I do not expect that this contention will go unchallenged. But if the authors are anywhere near correct in this contention, our research into the causes and treatment of many children's mental disorders, which now appear inherited and to emanate from the frontal regions of the brain, must accelerate not only for the safety of our children and families, but as a humane gesture to their suffering.

75 of 78 found the following review helpful:


Good timing for this book  Feb 09, 2000 By mom of bipolar son
I am so glad that his book became available when it did -- my 13 year old son was just diagnosed with bipolar disorder in November, 1999 after a two week stay in the hospital for mania. Just a year before, he was hospitalized with ADHD and depression for a week. He was diagnosed ADHD at the age of 6. Over the years, he was very moody and had many up and down periods. The stimulants and antidepressants actually made the disorder worse. I tried to find information regarding children with bipolar in November, but could find very little. Then I found out about this book. I was very excited. This book is great! It provided very accurate information that described my son and let me know he wasn't the only one who had this. I also found the information regarding how to find a good doctor very helpful also. I feel based on that info. we have found a great doctor (after going through four). I know a couple of the reviews were negative; and I don't know if your child suffers from this disorder, but you really don't know what's it's like until you live with it. Thanks for reading.

59 of 61 found the following review helpful:


INVALUABLE tool for raising an explosive child  Aug 21, 2000
This book is a MUST for ANYONE raising a child who is explosive, inflexible, easily frustrated and difficult. Demitri and Janice Papolos have offered help and hope for any parent seeking answers to raising a child such as this.

From the day I read this book, I began to understand what was going on with my son and my journey began. Suddenly, the pieces to the puzzle fit and I had the road map I so desperately needed. Without sounding dramatic, but being completely honest, I COULD NOT have gone in the right direction medically without having the knowledge I received from this book. I know carry it with me when traveling with my children and use it as a guide when needed.

"The Bipolar Child" offers a symptoms checklist, medication information, school information, physiological info on this disorder, and more. I would highly recommend it to any parent, educator, or health care professional. Dr. Papolos treads and researches where many doctors avoid to go. Because of him and his wife, many will receive direction to get the help they so desperately need. My son is now stable and happy. Thank you to the Papoloses!

57 of 59 found the following review helpful:


Essential for any Parent  Jan 06, 2000 By Krista Long
Dr. Demitri Papolos and Janice Papolos (authors of Overcoming Depression) have given the equivalent of What to Expect When You Are Expecting for parents of children with a mood disorder. Written in language a frantically searching parent can understand, this concise and comprehensive guide captures both the emotional and clinical facets of this disorder. The organization of the work makes it well suited to thumb through and find information pertinent to a current situation. Divided into three distinct parts, it is a vital addition to a caregiver or professional's library. I will be keeping it as a reference, although it was also fairly easy to read cover to cover.

Beginning with stories of parents from the trenches, which give a perspective on the disorder, the first focus is on diagnosis and treatment. Following the stories are detailed descriptions of possible symptoms of Early Onset Bipolar Disorder. Wide arrays of treatments are also covered, including alternative therapies and possible benefits and drawbacks of treatment courses. In addition to an excerpt from Dr. Charles Poppers ADHD Vs Bipolar paper, I found one of the most useful references to be the comprehensive medication section. This section describes all medications that may be used to treat and the possible side effects, as well as a chart on drug interactions.

The second section focuses on the medical aspects of Bipolar. It explores different theories of the causes of the disorder and the genetics of it. This was actually the hardest section to read. It was quite technical, but well worth the time I put into it.

The third section is one of the best. It is about day to day life and coping. It has a model IEP. It talks about school, hospitalization, and the social aspects of Bipolar Disorder. I cried while reading the first chapter, "The Impact on the Family." I was moved by the similarity to my own life, and it explored areas I prefer to forget normally. It has an excellent chapter on adolescence, hospitalization and insurance as well.

This well-written book truly delivers on the subtitle: The Definitive and Reassuring Guide to Childhood's Most Misunderstood Disorder. I felt like my life was bared on those pages, for the world to see, understand, and eventually accept. I give it 5 stars and will be buying copies for anyone that works closely with my child.

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