March 25, 2025 • 14 mins
Do you have patients with severe ADHD who are just not getting better? Did you know that they *might* have undiagnosed bipolar?
In this episode, Dr. Fallucco and Dr. John Walkup talk about how to distinguish bipolar disorder in children and teens from ADHD. They provide clinical pearls for clinicians and share examples from kids and teens with bipolar.
Some Key differences between ADHD and BIPOLAR highlighted include :
- the nature of relationships in ADHD vs. BIPOLAR
- Kids w/ ADHD tend to be fun, likable while kids with BIPOLAR have more serious problems in relationships, including with their own parents
- extreme impulsivity
- Kids and teens with Bipolar have more extreme, intense impulsive aggression and emotional reactions
** Early identification and consultation with psychiatry is key to helping support these kids and families best.**
Check out our website PsychEd4Peds.com for more resources.
Follow us on Instagram @psyched4peds
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dr. Elise Fallucco (00:00):
Welcome back to Child Mental Health for
(00:01):
Pediatric Clinicians.
I'm your host, Dr.
Elise Fallucco, childpsychiatrist, and mom.
This week we're continuing ourconversation with Dr.
John Walkup about bipolardisorder in kids in teens.
In our previous episode, number50, go back and listen.
'cause we talked about red flagsthat children or teens might
(00:24):
have to let us know that theymay have bipolar.
This episode we're gonna shareclinical pearls about how do you
tell the difference between kidswith bipolar and kids with a
DHD.
I wanna start this with aquestion for our listeners.
How many of you have patientswith severe A DHD who you feel
(00:45):
like are just not getting betterand sometimes feel like maybe
they're getting worse?
I think this episode may bereally helpful for you.
Why?
Many kids with bipolar go about10 years before they're finally
diagnosed, and in the meantime,they're being treated most often
for A DHD.
(01:06):
And so it's these kids with moresevere A DHD where we really
should be thinking about couldthis possibly be bipolar?
So to answer this question,we'll be discussing with Dr.
Walkup.
How do you tell the differencebetween A DHD and possible
bipolar?
Which kids should you possiblysuspect for bipolar?
(01:28):
What specific things should youask and look for?
And finally, we're gonna sharedetails from real clinical cases
of kids and teens that'll helpyou better recognize.
High risk kids, and ultimatelythe goal is to help recognize
these kids early so that theycan get referred for treatment
and evaluation and ultimatelyhave much better long-term
(01:51):
outcomes.
So now let's dive into theconversation with Dr.
Walkup.
John, how common is bipolar inpediatrics?
Dr. John Walkup (02:02):
It's not common.
It's 1 percent of kids or less.
Because if you look at theliterature, it takes about a
decade to get diagnosed.
But I think what happens isthese kids are in pediatric
practices and they are havingtrouble and the easiest
diagnosis to give them is ADHDbut it just, doesn't grab them
(02:24):
doesn't fit the picture verywell.
The kids we want to think aboutare the kind of early pre
pubertal kids they don't reallyfit ADHD by history, and they're
different, and they're reallybeginning to run into functional
problems, and they havequalitative differences in some
of these characteristics.
Dr. Elise Fallucco (02:44):
Since kids with undiagnosed bipolar could
be walking around with adiagnosis of A DHD, let's talk
about what types of things wouldmake you worry about bipolar in
somebody with a diagnosis of aDH.
D.
Dr. John Walkup (02:57):
You know everybody loves the ADHD kid
even though he's not onstimulants.
They're fun, they're funny,they're in the world with you,
you can relate to them, theyjust have a hard time managing
themselves.
Dr. Elise Fallucco (03:08):
they're fun loving, they're class clowns
they're very likable typically.
Dr. John Walkup (03:13):
but The bipolar kids burn up relationships in
the way that no other disorderburns up relationships.
People are tired of them.
They wear out relationships.
And and so they even wear outtheir relationship with their
parents.
And it's very hard for parentsto Give up on their kids a
little bit, but these are kidswhere parents are on that edge
where they just, they don'tunderstand their kid.
(03:36):
They can't manage their kid andthe lack of engagement and the
lack of responsiveness.
The lack of respect for therelationship, all of that kind
of goes out the window withbipolar disorder, because again,
these folks are above it all.
Dr. Elise Fallucco (03:50):
think clinically of some of the kids,
especially teenagers withbipolar who I've treated That
rings true, like being in theroom with some of them, when
they're not very well controlledand struggling is hard because,
they're very irritable.
And irritable plus impulsivityis not a great combination.
And so I've had some of themjust insult me in the room.
(04:11):
Like it's not a big deal.
Multiple times, actually,usually on what I'm wearing,
which is probably fair.
They don't care that I'm here tohelp them, and that maybe they
should be a little bitrespectful, it doesn't matter to
them
Dr. John Walkup (04:26):
Increasingly the bipolar kids I see are
coming in because they don'tcare.
School doesn't matter, peersdon't matter, consequences don't
matter, they feel immune to theworld around them.
And so they make decisions thatcost them a lot, and they get
themselves into a ton of troublebecause they're pursuing their
appetites.
But they just don't care.
Dr. Elise Fallucco (04:46):
Yeah, I want to stop you on the don't care
part, I also see commonly in ourteenagers, it doesn't matter, I
don't know why I'm studying, whydo I have to take Spanish in
high school?
Some of that I think of issomewhat developmentally typical
but you're talking about a moreextreme thing like, honestly,
I'm better than all of this andI can fail out of school and
(05:06):
it's not a big deal.
And so what I got in troublewith the law.
Dr. John Walkup (05:10):
Yeah.
It's an obliviousness maybe, asopposed to this kind of feigning
of lack of caring about kind ofnorms and expectations, right?
That's what you're talking aboutin the teenage years.
But these are kids who've justthey're above it all and stuff
just doesn't matter to them inthe way that it matters to other
kids.
And they won't even posit theargument that it's not
(05:31):
important.
They'll just.
Live a life where they act likestuff doesn't matter and the
consequences that come with thatare pretty significant
Dr. Elise Fallucco (05:38):
So they act like they're above it all not
because they have any sort ofdeep philosophical beliefs about
required language courses inhigh school
Dr. John Walkup (05:48):
Exactly
Dr. Elise Fallucco (05:50):
So you're saying that some of the things
that distinguish kids withbipolar from kids with A DHD are
that the kids with bipolar don'tcare about consequences and they
live like that.
You're also saying they burn uprelationships, meaning that they
have a hard time keepingrelationships with their friends
and even with their parents.
(06:10):
So now let's talk about how doesimpulsivity look different in
kids with bipolar compared withkids with A-D-H-D-I.
Dr. John Walkup (06:19):
The impulsivity for people with bipolar disorder
is very different than theimpulsivity that you see with
ADHD.
Dr. Elise Fallucco (06:26):
So impulsivity in ADHD is more the
kind of blurts out answers can'tkeep their hands to themselves,
when they're really at the endof their rope, they're more
likely to, maybe toss out someinsults or potentially it could
be a little bit of impulsiveaggression, getting into fights
at school when provoked, whereasthe impulsivity that we would
(06:47):
see with bipolar is much, muchmore extreme.
I almost think about the nervoussystem, like with our.
Deep tendon reflexes are likeyou're, when you use the special
hammer to hit your knee, that akid with ADHD would have, a,
maybe a little bit of a briskreflex, and would respond to
provocation or some stressor ortrigger.
(07:08):
Whereas a kid.
With bipolar has major obvioushyper reflexivity.
Like you don't even, you get thehammer, like slightly near to
the tendon and they're kickingsomebody in the next room, even
the slightest provocation, asyou put it can send them over
the edge.
Dr. John Walkup (07:26):
It's speed, it's intensity, it's end point,
and it's qualitativelydifferent.
And bipolar patients aren't evenhyperactive sometimes.
They're just extremely impulsiveand goal driven around, around
their grandiosity and theirappetites.
and I just, I think once you seeit, you get a feel for it.
And what we're trying to do withpediatricians is we're trying to
(07:48):
get them to have a feel for thatunrecognized bipolar disorder.
Dr. Elise Fallucco (07:53):
Right.
Dr. John Walkup (07:53):
And it's those kids that we want the
pediatricians to take a stepback from and just say, Ooh, is
this one of those kids?
Let me call my psych consultantand just put this kid on their
radar this is a kid I'm going toflag and monitor a little bit
more closely because this kid'sgot some of those early
subsyndromal symptoms of mania,grandiosity.
Dr. Elise Fallucco (08:14):
We're trying to help pediatric clinicians
figure out which are these casesthat could possibly be high risk
for bipolar or be early signs ofbipolar.
So let's anchor this with anactual clinical case.
I'm thinking of a teenage girlwho was really interested in
art.
And so she would stay up allnight working on these pictures
(08:36):
and these abstract paintings andIt would be like three in the
morning and she didn't even feeltired, but was like I should
probably take a little break andwould sleep for an hour or two.
And again, wake up andimmediately it's I've got to get
back to the paintings.
And then she would bring thepaintings to the session.
And it was very interesting.
It's not like she's havingtrouble falling asleep because
(08:56):
she's worried.
It's not that she's so hyper somuch.
It's that she has a goal, whichis making these paintings, and
that's overriding everythingelse and seems more important.
And, immediately when she popsawake, she's back to the goal.
Dr. John Walkup (09:10):
And the thing that's tough for some parents
sometimes is sometimes thatartwork is quite extraordinary.
I've seen stuff by six, sevenand eight year olds.
That I look at and I'm like, Ohmy gosh, the mind that's
creating these beautiful thingsis really quite extraordinary,
but they can't stop and they'readded for extended periods of
time and it stops beingsomething that's part of a
(09:33):
creative process.
It's more like they just haveto, they have to ooze out this
stuff and just do it everywhere.
And I think those cases areeasier, but even those cases
don't get diagnosed.
And sometimes what happens isthey get defended.
She's a great artist, forexample.
We don't want to kill theartistic capability, but the
kid's not sleeping.
They may not be doing what theyneed to be doing in school.
(09:55):
They've lost balance orperspective.
And so the art may be at theextraordinary level, but it's
their functioning is at theimpaired level.
Dr. Elise Fallucco (10:04):
Yeah.
And that's what we have to lookat that.
If it were really just part of acreative process, we wouldn't
necessarily think that theywouldn't be able to function in
other settings at school or atwork or, wherever they are.
So any last words of wisdomabout bipolar for our pediatric
colleagues?
Dr. John Walkup (10:20):
It's really this group of kind of floaty,
not very functional, talented,little off putting, High
appetites, that group of kids,you should just have this little
index of suspicion that maybethere's something going on and
you call your consultant.
You put a flag on the chart.
(10:41):
you're just going to want towatch this a little bit closer
and begin to think aboutcollecting vignettes and stories
about who this kid is becausethe pattern gets put together
through vignettes and stories.
It's not.
I want to be Superman, but it's,I want to be Superman and I'm
only sleeping four hours.
I wake up on a instant I'mparticularly provoked by sexual
(11:05):
behavior on television.
And I'm thinking about being amillionaire someday.
Okay, now we've got littlevignettes that are all beginning
to come together.
And oh, by the way, he's hastrouble making friends.
He could start friendships, buthis friendships don't last very
long because he burns them up.
There's just things like that,that I want pediatricians to be
(11:25):
sensitive to.
Because if we get to these kidsreally early, We can probably
treat them in a low intensityway and bring them down and then
spend some time working withthat family to understand what
the kids struggle really isgoing to be and then we can put
together a life plan for thosekids.
Dr. Elise Fallucco (11:44):
Thank you for all of your clinical pearls
and words of wisdom about, whatis and what isn't bipolar and
what can we do to make sure thatWe get on top of things early
and if need be, refer them forevaluation.
Dr. John Walkup (11:59):
That's the dream.
Get to them early.
That is the dream.
This is why we do what we do.
And I think it's also helpfulbecause I know all clinicians
can get really frustrated whenyou have these kids.
You're like, I think it's ADHDand we're trying to treat them.
And some parts are gettingbetter, but not, and we're still
having all of these problems.
And I don't know what this is.
And so this is helpful to beable to do a clinical evaluation
(12:22):
and try to determine, is this akid that could be possible
bipolar
Dr. Elise Fallucco (12:26):
And as a final recap for our friends and
colleagues of the podcast, Hereare things that distinguish kids
with bipolar from kids with justa DH.
D.
One, their relationships.
Kids with bipolar are much morelikely to have trouble in re
relationships or to burn uprelationships, whereas kids with
(12:48):
A DHD tend to be generallylikable and usually not have as
many problems maintainingfriendships.
Two kids with bipolar live likethey don't care about the
consequences.
Three kids with bipolar havemuch more extreme impulsivity
than kids with A DHD.
(13:09):
They tend to be much morereactive with their emotions or
even potentially withaggression, and this can cause
bigger problems.
And then four, something that'sunique to kids with bipolar are
that they have this intensedrive.
To do whatever is theirpleasurable activity.
Like the case that we gave waspainting, but it really could be
(13:32):
whichever idiosyncratic interestthat a child or teenager may
have, and this drive overrideseven their need for sleep if you
were bopping around and did nottake notes on this episode, but
you wanna remember some of thekey features, please visit our
website psyched for peds.com.
So that's P-S-Y-C-H-E-D, thenumber four peds, where we will
(13:57):
have little posts on thedifference between A DHD and
bipolar.
Please also become a friend andcolleague of Psyched for Peds,
where we will go ahead anddirectly email you this every
time we have an episode thatcomes out.
We hope you'll join us next timeon the pod.
Take care.
Welcome back to Child Mental Health for
(00:01):
Pediatric Clinicians.
I'm your host, Dr.
Elise Fallucco, childpsychiatrist, and mom.
This week we're continuing ourconversation with Dr.
John Walkup about bipolardisorder in kids in teens.
In our previous episode, number50, go back and listen.
'cause we talked about red flagsthat children or teens might
(00:24):
have to let us know that theymay have bipolar.
This episode we're gonna shareclinical pearls about how do you
tell the difference between kidswith bipolar and kids with a
DHD.
I wanna start this with aquestion for our listeners.
How many of you have patientswith severe A DHD who you feel
(00:45):
like are just not getting betterand sometimes feel like maybe
they're getting worse?
I think this episode may bereally helpful for you.
Why?
Many kids with bipolar go about10 years before they're finally
diagnosed, and in the meantime,they're being treated most often
for A DHD.
(01:06):
And so it's these kids with moresevere A DHD where we really
should be thinking about couldthis possibly be bipolar?
So to answer this question,we'll be discussing with Dr.
Walkup.
How do you tell the differencebetween A DHD and possible
bipolar?
Which kids should you possiblysuspect for bipolar?
(01:28):
What specific things should youask and look for?
And finally, we're gonna sharedetails from real clinical cases
of kids and teens that'll helpyou better recognize.
High risk kids, and ultimatelythe goal is to help recognize
these kids early so that theycan get referred for treatment
and evaluation and ultimatelyhave much better long-term
(01:51):
outcomes.
So now let's dive into theconversation with Dr.
Walkup.
John, how common is bipolar inpediatrics?
Dr. John Walkup (02:02):
It's not common.
It's 1 percent of kids or less.
Because if you look at theliterature, it takes about a
decade to get diagnosed.
But I think what happens isthese kids are in pediatric
practices and they are havingtrouble and the easiest
diagnosis to give them is ADHDbut it just, doesn't grab them
(02:24):
doesn't fit the picture verywell.
The kids we want to think aboutare the kind of early pre
pubertal kids they don't reallyfit ADHD by history, and they're
different, and they're reallybeginning to run into functional
problems, and they havequalitative differences in some
of these characteristics.
Dr. Elise Fallucco (02:44):
Since kids with undiagnosed bipolar could
be walking around with adiagnosis of A DHD, let's talk
about what types of things wouldmake you worry about bipolar in
somebody with a diagnosis of aDH.
D.
Dr. John Walkup (02:57):
You know everybody loves the ADHD kid
even though he's not onstimulants.
They're fun, they're funny,they're in the world with you,
you can relate to them, theyjust have a hard time managing
themselves.
Dr. Elise Fallucco (03:08):
they're fun loving, they're class clowns
they're very likable typically.
Dr. John Walkup (03:13):
but The bipolar kids burn up relationships in
the way that no other disorderburns up relationships.
People are tired of them.
They wear out relationships.
And and so they even wear outtheir relationship with their
parents.
And it's very hard for parentsto Give up on their kids a
little bit, but these are kidswhere parents are on that edge
where they just, they don'tunderstand their kid.
(03:36):
They can't manage their kid andthe lack of engagement and the
lack of responsiveness.
The lack of respect for therelationship, all of that kind
of goes out the window withbipolar disorder, because again,
these folks are above it all.
Dr. Elise Fallucco (03:50):
think clinically of some of the kids,
especially teenagers withbipolar who I've treated That
rings true, like being in theroom with some of them, when
they're not very well controlledand struggling is hard because,
they're very irritable.
And irritable plus impulsivityis not a great combination.
And so I've had some of themjust insult me in the room.
(04:11):
Like it's not a big deal.
Multiple times, actually,usually on what I'm wearing,
which is probably fair.
They don't care that I'm here tohelp them, and that maybe they
should be a little bitrespectful, it doesn't matter to
them
Dr. John Walkup (04:26):
Increasingly the bipolar kids I see are
coming in because they don'tcare.
School doesn't matter, peersdon't matter, consequences don't
matter, they feel immune to theworld around them.
And so they make decisions thatcost them a lot, and they get
themselves into a ton of troublebecause they're pursuing their
appetites.
But they just don't care.
Dr. Elise Fallucco (04:46):
Yeah, I want to stop you on the don't care
part, I also see commonly in ourteenagers, it doesn't matter, I
don't know why I'm studying, whydo I have to take Spanish in
high school?
Some of that I think of issomewhat developmentally typical
but you're talking about a moreextreme thing like, honestly,
I'm better than all of this andI can fail out of school and
(05:06):
it's not a big deal.
And so what I got in troublewith the law.
Dr. John Walkup (05:10):
Yeah.
It's an obliviousness maybe, asopposed to this kind of feigning
of lack of caring about kind ofnorms and expectations, right?
That's what you're talking aboutin the teenage years.
But these are kids who've justthey're above it all and stuff
just doesn't matter to them inthe way that it matters to other
kids.
And they won't even posit theargument that it's not
(05:31):
important.
They'll just.
Live a life where they act likestuff doesn't matter and the
consequences that come with thatare pretty significant
Dr. Elise Fallucco (05:38):
So they act like they're above it all not
because they have any sort ofdeep philosophical beliefs about
required language courses inhigh school
Dr. John Walkup (05:48):
Exactly
Dr. Elise Fallucco (05:50):
So you're saying that some of the things
that distinguish kids withbipolar from kids with A DHD are
that the kids with bipolar don'tcare about consequences and they
live like that.
You're also saying they burn uprelationships, meaning that they
have a hard time keepingrelationships with their friends
and even with their parents.
(06:10):
So now let's talk about how doesimpulsivity look different in
kids with bipolar compared withkids with A-D-H-D-I.
Dr. John Walkup (06:19):
The impulsivity for people with bipolar disorder
is very different than theimpulsivity that you see with
ADHD.
Dr. Elise Fallucco (06:26):
So impulsivity in ADHD is more the
kind of blurts out answers can'tkeep their hands to themselves,
when they're really at the endof their rope, they're more
likely to, maybe toss out someinsults or potentially it could
be a little bit of impulsiveaggression, getting into fights
at school when provoked, whereasthe impulsivity that we would
(06:47):
see with bipolar is much, muchmore extreme.
I almost think about the nervoussystem, like with our.
Deep tendon reflexes are likeyou're, when you use the special
hammer to hit your knee, that akid with ADHD would have, a,
maybe a little bit of a briskreflex, and would respond to
provocation or some stressor ortrigger.
(07:08):
Whereas a kid.
With bipolar has major obvioushyper reflexivity.
Like you don't even, you get thehammer, like slightly near to
the tendon and they're kickingsomebody in the next room, even
the slightest provocation, asyou put it can send them over
the edge.
Dr. John Walkup (07:26):
It's speed, it's intensity, it's end point,
and it's qualitativelydifferent.
And bipolar patients aren't evenhyperactive sometimes.
They're just extremely impulsiveand goal driven around, around
their grandiosity and theirappetites.
and I just, I think once you seeit, you get a feel for it.
And what we're trying to do withpediatricians is we're trying to
(07:48):
get them to have a feel for thatunrecognized bipolar disorder.
Dr. Elise Fallucco (07:53):
Right.
Dr. John Walkup (07:53):
And it's those kids that we want the
pediatricians to take a stepback from and just say, Ooh, is
this one of those kids?
Let me call my psych consultantand just put this kid on their
radar this is a kid I'm going toflag and monitor a little bit
more closely because this kid'sgot some of those early
subsyndromal symptoms of mania,grandiosity.
Dr. Elise Fallucco (08:14):
We're trying to help pediatric clinicians
figure out which are these casesthat could possibly be high risk
for bipolar or be early signs ofbipolar.
So let's anchor this with anactual clinical case.
I'm thinking of a teenage girlwho was really interested in
art.
And so she would stay up allnight working on these pictures
(08:36):
and these abstract paintings andIt would be like three in the
morning and she didn't even feeltired, but was like I should
probably take a little break andwould sleep for an hour or two.
And again, wake up andimmediately it's I've got to get
back to the paintings.
And then she would bring thepaintings to the session.
And it was very interesting.
It's not like she's havingtrouble falling asleep because
(08:56):
she's worried.
It's not that she's so hyper somuch.
It's that she has a goal, whichis making these paintings, and
that's overriding everythingelse and seems more important.
And, immediately when she popsawake, she's back to the goal.
Dr. John Walkup (09:10):
And the thing that's tough for some parents
sometimes is sometimes thatartwork is quite extraordinary.
I've seen stuff by six, sevenand eight year olds.
That I look at and I'm like, Ohmy gosh, the mind that's
creating these beautiful thingsis really quite extraordinary,
but they can't stop and they'readded for extended periods of
time and it stops beingsomething that's part of a
(09:33):
creative process.
It's more like they just haveto, they have to ooze out this
stuff and just do it everywhere.
And I think those cases areeasier, but even those cases
don't get diagnosed.
And sometimes what happens isthey get defended.
She's a great artist, forexample.
We don't want to kill theartistic capability, but the
kid's not sleeping.
They may not be doing what theyneed to be doing in school.
(09:55):
They've lost balance orperspective.
And so the art may be at theextraordinary level, but it's
their functioning is at theimpaired level.
Dr. Elise Fallucco (10:04):
Yeah.
And that's what we have to lookat that.
If it were really just part of acreative process, we wouldn't
necessarily think that theywouldn't be able to function in
other settings at school or atwork or, wherever they are.
So any last words of wisdomabout bipolar for our pediatric
colleagues?
Dr. John Walkup (10:20):
It's really this group of kind of floaty,
not very functional, talented,little off putting, High
appetites, that group of kids,you should just have this little
index of suspicion that maybethere's something going on and
you call your consultant.
You put a flag on the chart.
(10:41):
you're just going to want towatch this a little bit closer
and begin to think aboutcollecting vignettes and stories
about who this kid is becausethe pattern gets put together
through vignettes and stories.
It's not.
I want to be Superman, but it's,I want to be Superman and I'm
only sleeping four hours.
I wake up on a instant I'mparticularly provoked by sexual
(11:05):
behavior on television.
And I'm thinking about being amillionaire someday.
Okay, now we've got littlevignettes that are all beginning
to come together.
And oh, by the way, he's hastrouble making friends.
He could start friendships, buthis friendships don't last very
long because he burns them up.
There's just things like that,that I want pediatricians to be
(11:25):
sensitive to.
Because if we get to these kidsreally early, We can probably
treat them in a low intensityway and bring them down and then
spend some time working withthat family to understand what
the kids struggle really isgoing to be and then we can put
together a life plan for thosekids.
Dr. Elise Fallucco (11:44):
Thank you for all of your clinical pearls
and words of wisdom about, whatis and what isn't bipolar and
what can we do to make sure thatWe get on top of things early
and if need be, refer them forevaluation.
Dr. John Walkup (11:59):
That's the dream.
Get to them early.
That is the dream.
This is why we do what we do.
And I think it's also helpfulbecause I know all clinicians
can get really frustrated whenyou have these kids.
You're like, I think it's ADHDand we're trying to treat them.
And some parts are gettingbetter, but not, and we're still
having all of these problems.
And I don't know what this is.
And so this is helpful to beable to do a clinical evaluation
(12:22):
and try to determine, is this akid that could be possible
bipolar
Dr. Elise Fallucco (12:26):
And as a final recap for our friends and
colleagues of the podcast, Hereare things that distinguish kids
with bipolar from kids with justa DH.
D.
One, their relationships.
Kids with bipolar are much morelikely to have trouble in re
relationships or to burn uprelationships, whereas kids with
(12:48):
A DHD tend to be generallylikable and usually not have as
many problems maintainingfriendships.
Two kids with bipolar live likethey don't care about the
consequences.
Three kids with bipolar havemuch more extreme impulsivity
than kids with A DHD.
(13:09):
They tend to be much morereactive with their emotions or
even potentially withaggression, and this can cause
bigger problems.
And then four, something that'sunique to kids with bipolar are
that they have this intensedrive.
To do whatever is theirpleasurable activity.
Like the case that we gave waspainting, but it really could be
(13:32):
whichever idiosyncratic interestthat a child or teenager may
have, and this drive overrideseven their need for sleep if you
were bopping around and did nottake notes on this episode, but
you wanna remember some of thekey features, please visit our
website psyched for peds.com.
So that's P-S-Y-C-H-E-D, thenumber four peds, where we will
(13:57):
have little posts on thedifference between A DHD and
bipolar.
Please also become a friend andcolleague of Psyched for Peds,
where we will go ahead anddirectly email you this every
time we have an episode thatcomes out.
We hope you'll join us next timeon the pod.
Take care.
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