Danielle Asks... My 4 year old son was diagnosed with bipolar disorder about six months ago…he is currently on Seroquel, and the doctor added lithium today. I am scared that my baby has to be on these medications at such a young age and I am wondering if there is anyone out there with children (or yourself) that started these meds so young.

Purple Tablets Asks... I'm a female of child-bearing age… who has been diagnosed as Bipolar II. The message that the different doctors have given me so far has been "don't get pregnant." (In fact, one offended me so much with how she delivered this message that I cancelled my follow-up appointment and got a new psychiatrist!)

Shelli Asks... My ex refuses to believe that our son is bipolar. He insists that our boy tried to choke his half-sister to death and that our son speaks of his "evil-other side" but he fights with me about giving the boy medication. Could he be so stupid as to think our boy is just mean? Since he is medicated he is a calm and kind teenager. Have you ever heard of one of those? The ex even commented one time that our son was "like a different child" when he was visiting after he started his Seroquel but still refuses to believe the diagnosis. What can I have him read or look at to help with his disbelief?

The bipolar diagnosis is on the rise. You can read it in the media and readily observe it by talking to people you know. More people than ever (and significantly more children than ever) carry the label. According to results of a study published in the Archives of General Psychiatry (September, 2007) entitled, “National Trends in the Outpatient Diagnosis and Treatment of Bipolar Disorder in Youth,” we’ve seen a 40-fold increase in the diagnosis of bipolar disorder in children and adolescents between 1994 and 2003. During this same period, the bipolar diagnosis in the adult population nearly doubled.

In Part I of this two-part series, we examined the role that genetics likely plays in the onset of bipolar disorder and learned that genetics contributes up to 80%, with environmental factors contributing about 20% or more. (This means that if someone has bipolar disorder, the cause of it is 75-80% due to genetics. It does not mean an individual in a family with a history of bipolar has a 75-80% chance of developing it. See Part I for statistics on the inheritability of bipolar.) It appears that for most people there needs to be some environmental factors that "turn on" the genes responsible for one's vulnerability to bipolar disorder. Many of these environmental triggers may occur early in life and may include things such as: