Dr. Hal Pickett on Ken Barlow and Bipolar Affective Disorder

I have always been a Ken Barlow fan and, after reading the Sunday, January 20th Star Tribune, I am even a bigger fan.  I do not know Ken personally but have always liked his presence and friendly style when doing the weather and his easy banter when he was a guest on KDWB.  This past Sunday, he was brave enough to reveal himself as suffering from Bipolar Affective Disorder.  Thank you Ken, for giving a real face to an often confusing disorder.

Bipolar Affective Disorder has historically been called Manic-Depressive Disorder and has been strongly linked to genetic predisposition. It has proven to be one of the more successfully managed mental health disorders with appropriate and well-managed medication.  In the article in the Star Tribune, Ken also alluded to the fact that he has been taking medications to successfully manage the disease.

Maybe a decade ago, the professional community muddied the waters when research literature began to emerge about “early onset bipolar disorder” that could be theoretically identified in children as young as three.  This literature pointed at studies of young children with significant mood dysregulation, many times being incapable of soothing and long uninterrupted bouts of tantrums. As a result, many doctors and parents started to wonder whether every child demonstrating severe behavioral problems had a bipolar disorder, skipping the previously strong genetic pattern traced in many families.  Over the decade, treating these children with the same medications used for treating bipolar disorder had mixed results.  Following these children over time did not always unearth the typical pattern seen in Bipolar Affective Disorder.  Many of the children continued to have significant mood dysregulation but did not develop a pattern of manic and depressive cycling. 

Today, many families come into my office questioning whether their “acting out” adolescent has a bipolar disorder.  My answer to that is that I do not know until I have completed a thorough assessment. This must include an accurate picture of the long-term clinical history of the mood problems, a psychological assessment to rule out other disorders, and referrals to a psychiatrist and/or neurologist.  And even after that, the picture may not be clear.  Bipolar Affective Disorder is a problem that is best diagnosed over time with evidence of cycling of mood.  A fortunate fact, which some may see as unfortunate, is that many of the newer mood stabilizing drugs used have fewer side effects, so many doctors and families are more comfortable trying a medication.  If the medication improves the child’s academic success, social relationships and competency and makes them feel happier about who they are, then great.  But remember that response to a medication does not clarify a diagnosis. 

Clear as mud? Obviously we have a long way to go to get a real handle on Bipolar Affective Disorder, but my hat is off to Ken Barlow for putting a friendly, familiar and real face on this sometimes scary and often confusing diagnosis