Question

My brother has just been diagnosed with 'bipolar'. Is it hereditary? Are there any tests I can have? I'm really worried about this as my son has attention-deficit/hyperactivity disorder.

Answer

It is very important for yourself and your son to receive answers to your three very pertinent questions and it is also really important that your son has been diagnosed correctly. Bi polar disorder is difficult to diagnose in children, and often a child diagnosed as ADHD can have bi polar disorder which is misdiagnosed. Because your brother has been diagnosed as having bi polar disorder it is particularly important to have the correct diagnosis for your sonNow we will answer your questions in the order asked.
 

1) Bipolar disorder has a genetic component. The National Institute of Mental Health says that more than two-thirds of people with bipolar disorder have at least one close relative with the illness or with clinical, or "unipolar," depression. However, having relatives with bi polar disorder does not necessarily mean that you will have it.
 

2) There is a Mood Disorder Questionnaire (MDQ), a tool designed to help you recognize the signs and symptoms of bipolar disorder, which can be taken, and results discussed with your doctor, if you have personal concerns. ( see link below) .
 

3) The Child & Adolescent Bipolar Foundation estimates that at least 750,000 American children and teens have bipolar disorder, but most are undiagnosed. Many times, children with bipolar disorder are given a misdiagnosis of attention-deficit/hyperactivity disorder (ADHD). There is a difficulty of diagnosing bipolar disorder in children. People with bipolar disorder often spend years suffering through their illness before they are properly diagnosed. You would therefore be advised to read the related links provided and then discuss your son's condition with his treating doctor. However, it is also your right to obtain a second opinion should you feel this is necessary for a sure diagnosis.
 

One of the biggest challenges has been to differentiate children with mania from those with attention deficit hyperactivity disorder. Both groups of children present with irritability, hyperactivity and distractibility. So these symptoms are not useful for the diagnosis of mania in bi polar disorder because they also occur in ADHD. But, elated mood, grandiose behaviors, flight of ideas, decreased need for sleep and hypersexuality occur primarily in mania and are uncommon in ADHD. Below is a brief description of how to recognize these mania-specific symptoms in children.
 

Elated children may laugh hysterically and act infectiously happy without any reason at home, school or in church. If someone who did not know them saw their behaviors, they would think the child was on his/her way to Disneyland. Parents and teachers often see this as "Jim Carey-like" behaviors.- Grandiose behaviors are when children act as if the rules do not pertain to them. For example, they believe they are so smart that they can tell the teacher what to teach, tell other students what to learn and call the school principal to complain about teachers they do not like. Some children are convinced that they can do superhuman deeds (e.g., that they are Superman) without getting seriously hurt, e.g. "flying" out of windows.- Flight of ideas is when children jump from topic to topic in rapid succession when they talk and not just when a special event has happened.- Decreased need for sleep is manifested by children who sleep only 4-6 hours and are not tired the next day. These children may stay up playing on the computer and ordering things or rearranging furniture.- Hypersexuality can occur in children with mania without any evidence of physical or sexual abuse. These children act flirtatiously beyond their years, may try to touch the private areas of adults (including teachers), and use explicit sexual language.-.In addition, it is most common for children with mania to have multiple cycles during the day from giddy, silly highs to morose, gloomy suicidal depressions. It is very important to recognize these depressed cycles because of the danger of suicide. Hopefully this information and the links below will be helpful to you in further consultations.
 

Related Links
Bipolar Disorder
Child and Adolescent Bipolar Disorder
Mood Disorder Questionnaire for Bipolar Disorder
ADHD