Sunday, February 21, 2010

You say temper, I say rage.

Take the opportunity to have some input into the New DSM-5 development:

Here is my letter:

To whom it concerns,

My sincere hope is that this label does not preclude a separate entry for Childhood Onset Bipolar Disorder, if that child also experiences cycles of mania and depression that presents with suicidal ideation, and cycles from one extreme mood to another, much like an adult. My second hope is that if this label is indeed adopted in lieu of Bipolar Disorder, the description, Temper Dysregulation Disorder with Dysphoria, will be changed to something that reflects an actual mental health disorder akin to bipolar disorder - such as Mood Dysregulation Disorder with Dysphoria, rather than labeled as something that confers a parenting issue/behavioral problem. Terming the intense, often psychotic rage that a child displays in an almost seizure-like manner, a "temper", invalidates any real mental health disorder, and instead confers a discipline problem, or parenting issue, which is clearly not the case. For far too long, society has turned a disapproving eye toward the parents of those unfortunate children who have uncontrollable mood disorders, and put the onus on the parents as somehow responsible for the child's condition, rather than understanding the child suffers from a debilitating brain disorder, not unlike adults with bipolar disorder.

Please consider a more appropriate name for what we now unofficially call "childhood bipolar disorder" if DSM -5 is not planning to recognize it as an actual disorder similar or equal to adult bipolar disorder. If adult medication, prescribed off label, improves the symptoms for children as it does for adults and creates stability of mood, one could reasonably assume the child has bipolar, or some juvenile form of the same. Unless DSM is planning to rename adult bipolar disorder also as Temper Dysregulation Disorder with Dysphoria, it is inappropriate to make a distinction between a brain disorder that children and adults both suffer, but only one group can claim as a "real" chemical imbalance in the brain, and the other rely on adjustments to parenting techniques. There are instances of young children -- as young as 8 years old - un-medicated, or mis-medicated - committing acts of suicide. That is clearly not temper-driven behavior.

With all due respect to the professionals involved in revising the manual, please understand, especially from a parent as well as a teacher's perspective, the use of the word "temper" downplays the serious affect of this childhood disorder we can only now label a mood disorder, or cautiously, childhood bipolar disorder.


Dawn Scott
Mother to a 7 year old child dx as Bipolar I, and now stable on adult bipolar medication.

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