Much has been written about bipolar disorder in children and ado­les­cents and perhaps the biggest controversy in our field relates to it. My opinion, like that of many other psychiatrists, is that it is being over diagnosed. Too many children and adolescents who have tantrums and meltdowns are being diagnosed as bipolar without clear evidence that they have symptoms of mania. Tantrums and meltdowns are associated with many disorders.

It is more accurate to ascribe these behaviors to bipolar disorder if they exist in association with several more typical symptoms of mania such as extreme energy level, rapid speech, reckless behavior, rapid and disorganized thought processes and grandiosity. Cyclical periods of different mood states, with shifts from manic like behavior to calm or depressed states, is also suggestive of bipolar disorder. Bipolar disorder is more likely to occur if there is a family history of it.