A reader asked:
Our 13-year old daughter has signs of a mood disorder -- persistent anger, oppositionality, impulse control -- along with NLD and executive functioning problems, but her therapist does not believe she is bipolar because she is not hypersexualized. When she was willing to take medication, Abilify seemed to help. Given that there seems to be no consensus about the parameters of adolescent bi-polar disorder, I'm concerned that the therapist is giving that diagnosis short shrift. Is she?
Her therapist is incorrect - hypersexuality is not a required symptom of mania- it is one of a group of symptoms that go into the diagnosis, which include elated mood, irritability, grandiose thinking, decreased need for sleep, distractibility, increased activity and energy, pressure of speech, flight of ideas, and impulsive behavior (hypersexuality is usually in the latter category). However, anger, oppositionality and impulse control problems are not by themselves enough to identify a child as bipolar - does she sleep less than a usual night and not feel tired the next day? Seem loaded with new ideas, wanting to do a lot of activities, lots of unrealistic plans? Any sign of depression, fatigue, loss of energy, withdrawal, suicidal thinking?
Any family history of bipolar?
If you live near LS you could call our clinic for a full evaluation: 310-825-2836.