Child's Behavior: BP Disorder or Learned Behavior?
[Home] [Bipolar News] [Bipolar Disorder] [Medications] [Treatments] [Bipolar Disorder/Job/School] [Disabilities] [Ask the Doctor] [Ask David] [Self-Injury] [Personal Stories] [Graham's Column] [Steven's Column] [Storm's Column] [Columnist Archives] [Suicide] [Community Support] [Family Members] [Expressions] [Greeting Cards] [Books] [Awards] [Links & Rings] [About Us] [Contact Us]


Q:  Child's Behavior:  BP Disorder or Learned Behavior?

Is it likely that a child growing up with a diagnosed yet unmedicated Bi-polar parent that was abusive will show signs of BPD but not truly have the disorder themselves? If a child is surrounded by the behavior for 15 years can it be a learned behavior that they are acting out rather than truly carrying the disorder themselves? Can a counselor that does not specialize in BPD evaluate accurately if this is the case. Can the behavior be seperated from the true disorder?


Dear R' --
Mmm, tricky, this one. For starters, we could say, as you are suggesting, that the child's behavior could be:

a) bipolar disorder;
b) learned;
c) (I would add) a reaction to the environment that isn't "bipolar" but isn't "learned" as such either.

The latter possibility might fall under the diagnostic label of "post-traumatic stress disorder" (PTSD) and the symptoms there would include hyperreactions to minor events; insomnia; unexplained agitation; avoidance of situations and stimuli that might somehow suggest aspects of the original trauma -- and this one can be a huge "umbrella" if the term avoidance includes acting out behaviors such as crying, anger, creating a disturbance, etc., in other words nearly everything one might expect from a troubled child bipolar or otherwise. In this model the "trauma" can range from simply having one's own emotional needs utterly unrecognized and met; to getting hit; to getting sexually abused -- roughly speaking.

Worse yet, PTSD is very difficult sometimes to separate out from complex bipolar disorder. So, can a counselor evaluate this distinction? I'd suggest that even a specialist might find teasing out these possibilities very difficult. Sometimes it's so difficult we have to just proceed to treat the symptoms, without being certain about the "diagnosis". It's a little easier to proceed in this fashion than you might think, because the medications we use to treat bipolar disorder can help even when the diagnosis is incorrect: for example, if a better overall explanation is PTSD, or explosive anger problems, and there's no good response to non-medication approaches which might generally be tried first especially if the child is still less than 18 or so, a medication like Depakote can still help (even though, granted, it has it's risks too).

So, I would hope that anyone attempting to arrive at a "diagnosis" in a situation like this would strive to keep their mind open to all possible diagnostic interpretations, as you go along; and that at each step, the risks and benefits of different treatment options, including therapy versus medications, would be re-examined. Good luck with that.

Dr. Phelps

Published December, 2003


Bipolar World   1998, 1999, 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014
Allie Bloom, David Schafer, M.Ed. (Blackdog)
Partners:  John Haeckel, Judith (Duff) 
Founder:  Colleen Sullivan

Email Us at Bipolar World


About Us  Add a Link  Advance Directives  Alternative Treatments  Ask the Doctor   Ask Dr. Plyler about Bipolar Disorder   Ask The Doctor/ Topic Archives  Awards  Benny the Bipolar Puppy  Bipolar Chat  Bipolar Children  Bipolar Disorder News  Bipolar Help Contract  Bipolar World Forums  Book Reviews  Bookstore  BP & Other mental Illness   Clinical Research Trials & FDA Drug Approval   Community Support   Contact Us  The Continuum of Mania and Depression   Coping   Criteria    Criteria and Diagnosis  Criteria-World Health Disabilities,  DSMV-IV   Dual Diagnosis  eGroups  Expressions (Poetry, Inspiration, Humor, Art Gallery, Memorials  Family Members   Getting Help for a Loved One who Refuses Treatment  Greeting Cards  History of Mental Illness  Indigo  Job and School  Links  Manage Your Medications  Medications   Medication and Weight Gain    News of the Day  Parent Chat  Pay for Meds  Personal Stories  Self Help  Self Injury  Significant Others  Stigma and Mental Health Law  Storm's Column  Suicide!!!  The Suicide Wall  Table of Contents   Treatments  Treatment Compliance  US Disability  Veteran's Chat  What's New?