It is my observation that there is always a diagnosis de jour.  Eventually, it is used to such excess that it becomes meaningless and even neophyte mental health professionals shrug when they see it in a record or chart.

In my experience, “bipolar disorder” is a label attached to every difficult child, especially in the teenage years.  What was once dealt with using discipline and structure, is now medicalized.

I will also say that many teenagers go through a couple of nasty years starting in about 8 grade when they act outrageously (and culture affirms this).  The “disease”  subsides after a couple of years, especially if the circle of friends can be modulated, however the label lasts forever.

Several years ago, a teen-age girl was diagnosed as bi-polar. Unfortunately, for the staff psychiatrist and psychologist one of her parents has a doctorate in counseling psychology. The first question out of the parent’s mouth - what drugs are you prescribing? The second question: what symptoms are you basing this diagnosis on? After 20 minutes of the parent conference, it became clear that bi-polar was not only the diagnosis du jour but that the diagnosis provided cover for a much desired insurance payment. A generation ago, the eminent psychologist, Dr. Bill Cosby, had a wonderful comedy routine which described adolescence as a form of temporary psychosis. Some kids are deeply troubled and do have forms of psychosis, but I wonder how much of what we call “illness” today is nothing more than the normal human experience. Even for teens and pre-teens.

An interesting point, Dan Crawford (#3), about cover for the insurance payment.  I wonder how many of cases might fall under this category.  From my personal experience, I’m found that insurance companies aren’t all that eager to cover mental health.  (Granted, some of them aren’t eager to provide any type of coverage, but that’s another matter.)  Could there be instances where the teenager might be facing mood fluctuations that don’t quite fit into a strict bipolar diagnosis, but the insurance won’t cover treatment without a diagnosis of a “severe mental disorder”?

Kevin,
Yes, there are.

Although reasonably well behaved as a teenager, I experienced emotional ups and downs that have made the rest of life seem placid. Being a teenager is bipolar. Being a clinically bipolar teenager (as one of my close friends was) is far worse.

“Bipolar” carries (and was intended to carry) less of a stigma than “manic depressive.”

Any chance that adopting this kinder, gentler name helped facilitate classifying a larger number of patients in this category?

Has anybody ever heard of a bipolar Amish kid?  Just wondering.  I’m with you, Dan.  Bill Cosby got it right.

Insofar as teenage bipolar disorder has become the faddish diagnosis du jour, let’s call it the MEDICALIZATION OF ADOLESCENCE.