2024 August InMaricopa Magazine

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No, your child probably doesn’t have bipolar disorder BY RAMIZ AUDI, MD

Maricopa Foot & Ankle welcomes newest physician D R. JORDAN RICHARDSON RECEIVED HIS BACHELOR’S DEGREE FROM ARIZONA STATE University and his doctorate from the Western University of Health Sciences College of Podiatric Medicine in Pomona, Calif. Dr. Richardson was born and raised in Arizona and loves the desert. He completed a three-year podiatric and surgical residency with reconstructive rearfoot and ankle certification at Intermountain Medical Center in Murray, Utah. During residency training, he spent time training with top-tier surgeons and physicians. He trained in all aspects of podiatric medicine and surgery including reconstructive diabetic limb salvage, foot and ankle trauma and sports medicine. He is well trained in both conservative and surgical approaches to podiatric care, and he believes in putting his patient’s needs first. Prior to a career in medicine, Dr. Richardson acquired many skills from careers as a veterinary technician, police aide and home automation. However, he found his passion in podiatry and caring for patients. Outside of work, he can be found spending time with his wife and five children. He also enjoys working on cars, cooking, playing guitar and outdoor recreation.

T HIS ARTICLE FOCUSES ON THE distinction between bipolar and other mental health diagnoses. Here are some examples of the misconceptions that come with bipolar. If one is frequently irritable — a propensity to get angry — then one can be labeled bipolar. If one is very hyperactive, impulsive and talkative, then one can be labelled as bipolar. However, this is not likely to be the case. Bipolar has become part of our pop-culture vernacular, so it’s time to draw the line and educate the masses about the distinction between bipolar and more common diagnoses. A child’s behavior can fall under more common diagnoses like the following: ADHD, anxiety, behavioral problems and depression. ADHD is a neurodevelopmental disorder that effects about 9.8% of children in the U.S., followed by anxiety at 9.4%, behavioral problems at 8.9% and depression at 4.4%, according to the CDC. Bipolar is a mood disorder (cycling between mania/hypomania and/or depression) with a prevalence rate of under 3%. It is more likely that your child may have symptoms consistent with ADHD, anxiety or depression.

As for Bipolar, it is defined as episodes of mood swings between mania and depression. Mania/hypomania includes symptoms of hy- peractivity/impulsivity, distractibility/inatten- tiveness, decreased need for sleep, irritability or extreme happiness with the main features of inflated self-esteem or grandiosity, sexual or so- cial disinhibition, racing thoughts and desire to pursue more activities than they can accomplish. Hypomania can last at least 4 days and mania at least a week before transitioning to major depressive symptoms for two weeks or longer. Depressive symptoms will present with sadness or irritability, decreased energy, social withdrawal, loss of interest leading to decreased activity, poor sleep, distractibility/inattentiveness, feelings of worthlessness and recurrent suicidal thoughts. Moving forward you will see episodes of those symptoms mentioned above cycle between these two mood phases. Diagnosing bipolar in children younger than 11 should be done cautiously and possibly delayed due to their limited ability for self- reflection and limited use of language used to describe their thoughts and emotions. There are couple of points to remember when observing your child’s behavior:

First, symptoms of hyperactivity, distract- ibility, impulsivity, difficulty with sleep and irritability can be seen in ADHD, depression, and anxiety/PTSD with various levels of intensity. If all these symptoms are more pervasive and present daily — meaning the child is manifesting them in various settings like in a classroom, social interactions, afterschool sports/programs, home or job — then this can be problematic. The symptoms need to be explored by a mental health professional to differentiate between diagnoses. Secondly, irritability is a very common symptom that spans across many diagnoses. Children and adolescents can surely experience irritability and significant defiance with ADHD, anxiety (OCD, generalized anxiety and social anxiety) or depression, not just with bipolar. Irritability can be persistent, meaning you will see your child have a chronic pattern of low threshold to get irritable over many little things most of the day, nearly every day. It can also have mild or severe presentation to the point of physical or verbal aggression. Or, irritability can be episodic, meaning it can come and go depending on the mood phase as discussed above with bipolar. Children with chronic irritability are statistically likely to suffer from anxiety and depression as they get older, NOT bipolar disorder. All these disorders can significantly impair your child’s ability to function socially and academically, and your child may exhibit poor decision making, ultimately leading to poor self- esteem. Therefore, we recommend seeking help mental health professional because the sooner the child can be treated, the better the trajectory of their psychosocial and emotional growth and increased chances of successful academic, vocational and social functioning. Early intervention and treatment will help prevent adolescents from abusing illegal substances to self-medicate their moods and behavior, car accidents and unwanted pregnancies.

D r. Jordan Richardson

Maricopa Foot & Ankle Center

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