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by Rosalie Greenberg
Da Capo, 2007
Review by Stephanie Moulton Sarkis, PhD, NCC, LMHC on Apr 8th 2008

Bipolar Kids

Dr. Rosalie Greenberg is a board certified child and adolescent psychiatrist and an assistant professor at Columbia University.  Her book, Bipolar kids: Helping your child find calm in the mood storm (2007), provides a wealth of information that is applicable to both parents of bipolar children and clinicians. 

The book consists of eleven chapters.  The chapters include information on the symptoms and etiology of bipolar disorder, descriptions of the mood states, less commonly known symptoms of bipolar disorder, positive characteristics of children with bipolar disorder, the process of a psychiatric evaluation, comorbid disorders, medication, psychotherapy, inpatient hospitalization, schooling issues, and issues of parenting and daily living. 

The author strikes a balance between a scholarly yet colloquial style and is accessible to anyone who has parented a child with bipolar disorder, whether it be for years or just a few months.  The vignettes provided throughout the book provide helpful examples to parents and clinicians alike.  Many of the vignettes give both the child's story and the parent's story.

In chapter 2, "Depression and Mania: Riding the Mood Pendulum", the author effectively describes the difference between irritable depression and irritable mania in children, with vignettes providing further detail.  The author writes that in irritable depression, the "child feels as if she is a powerless victim and the world is against her" (p. 30).  In irritable mania, "a youngster's anger is directed at the outside world" (p.30).  The author also writes that cyclothymic symptoms "don't cause major problems in functioning, nor do they create severe difficulties in several areas of a person's life" (p. 35).  One might argue that while persons with bipolar disorder do have more severe difficulties than those with cyclothymic disorder, cyclothymic disorder can cause major problems in functioning. 

In chapter 3, "The Hidden Aspects of Bipolar Disorder", the author addresses both behavioral and physical symptoms, such as an aversion to surprises and clowns, difficulty waking up in the morning, separation anxiety, difficulty with transitions, reddened ears, and frequent sinus infections.

Chapter 4, "How Bipolar Kids Shine", gives the positive characteristics of children with bipolar disorder.  Children with bipolar disorder have a tendency towards excelling in creative arts, although, as the author states, the longer the child suffers impaired functioning, the creative ability lowers.  The author also writes that children with bipolar disorder tend to persevere when faced with physical illness.  It would be interesting to address, in a future edition of the book, whether a child with bipolar disorder may have a higher threshold for pain. 

In Chapter 5, "The Psychiatric Evaluation: Finding a Doctor and Examining Your Child's Symptoms", the author gives a total of 27 questions that an evaluator may ask parents.  This is a valuable resource, as parents can copy these questions and write out answers prior to their initial appointment.  Chapter 6, "Comorbidity: Is This Bipolar Disorder or Something Else?" provides individual charts of the behavioral differences between bipolar disorder and ADHD, separation anxiety disorder, obsessive-compulsive disorder, and autistic spectrum disorders.  The charts are well-organized, detailed, and easily understood.

Chapter 7, "Medication: The Art and Science of Treatment", not only discusses the types of medication for bipolar disorder, but also addresses alternative therapies.  The author does an excellent job of addressing parents' concerns regarding side effects from psychotropic medication.  By detailing the side effects of the commonly prescribed antibiotic amoxicillin, the author provides a gentle reminder that there are benefits and side effects to any medication, even antibiotics commonly prescribed to children. 

In chapter 8, "Why Therapy Matters", the author realistically points out that psychotherapy is a "long-term investment".  In chapter 9, "Hospitalization: When Therapy and Medication Aren't Enough", the author gives helpful information regarding the dance between hospitalization and health insurance.  The author also provides six pages of very pertinent questions and answers for parents who are considering inpatient hospitalization for their bipolar child. 

Chapter 10, "Going to School: Easier Said Than Done", details school situations that may arise, and provides information on how to reduce the frustration of both the child and the parents.  The author also discusses the very important topic of a child's educational rights.  Chapter 11, "Real Life, Real Answers", gives solutions to scenarios that parents of bipolar children experience, such as difficulties in taking their child to the store or a restaurant.  The author emphasizes that parents can and should trust their intuition about their child. 

Many parents ask if their child's behavior is a direct result of the disorder, or if it is willful disobedience.  The author eloquently and realistically gives her point of view regarding the differences between biology and learned behaviors.  She writes, "the illness is neither the fault of the parent or child; further, how the youngster deals with his actions and behavior is his responsibility" (p. 47; italics author's own).  

While this book was first published in 2007, many of the references are from the 1990s.  In fact, all of the references in the chapter on comorbid disorder are from 1995 and 1996.  For example, the author cites a 1996 study on rate of comorbid bipolar disorder and ADHD.  There have been several recent studies conducted on the comorbidity rate of the two disorders, including Biederman et al. (2005). 

In future editions, it is recommended that the author address the concept of "kindling", as it is possible that parents will be cognizant of this term.  Other than an omitted parenthesis in a chart on page 121, the book appears to be free of typographical errors.  This book is highly recommended to both clinicians and parents of children with bipolar disorder.  The author provides a friendly yet factual guide to the maze of bipolar disorder.  This reviewer has already recommended the book to parents. 

Biederman, J., Faraone, S.V., Wozniak, J., Mick, E., Kwon,A. (2005) Clinical correlates of bipolar disorder in a large, referred sample of children and adolescents.  Journal of Psychiatric Research, 39(6), 611-622.

© 2008 Stephanie Moulton Sarkis

Stephanie Moulton Sarkis PhD NCC LMHC is the author of 10 Simple Solutions to Adult ADD: How to Overcome Chronic Distraction and Accomplish Your Goals and Making the Grade with ADD:  A Guide to Succeeding in College with Attention Deficit Disorder.  She is a national certified counselor and licensed mental health counselor in private practice in Gainesville, Florida.  She is an adjunct assistant professor at the University of Florida and is the Director of Evaluations at Sarkis Family Psychiatry and Sarkis Clinical Trials in Gainesville, Florida.  She can be reached at www.stephaniesarkis.com or Stephanie@stephaniesarkis.com

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