Q:  Paranoia in Bipolar Disorder?  Symptoms of BP at Age 4?

I am a 23 year old female, and was diagnosed as Bipolar when I was around 11.... Through out these many years, I have not found that much information on this topic.  I currently take 1750 mg of Depakote daily... For the most part the manic episodes have been under control, however several years ago I started to develope Paranoia.  I fear people are always talking about me,  trying to get me fired from work... etc....Since I work very closely (professionaly) with my Physician, I fear telling him of my Paranoia.  Does Paranoia occur in people with Bipolar or is it unrealted to it altogether.  I have heard it can be caused from over medicating...but my monthly Depakote levels are usually within a theraputic range, and if not it is adjusted accordingly...my liver function tests are also fine...The Paranoia is begining to disrupt my life, and that of my families...I also have a 4 year old son that is showing signs of having "a very bad temper" as his Daycare has been reporting...Is he too young to have symptoms of Bipolar?  Thank you for your time!

Dear Jamie -- 
As I wrote to someone else this month, sure enough paranoia is indeed a symptom of bipolar disorder; so you should tell your doc', because she/he would want to know of any symptom that's not fully controlled.  

Is 4 too young?  Hard call.  Pretty complicated.  A child psychiatrist who knows a lot about bipolar disorder would be good to ask, as a "consultation" even at this age -- but if she/he didn't start treatment, that would be fine: it's really young to consider starting medications.  

Dr. Phelps

Published July, 2001