'Bipolar Spectrum'

The primary differences of opinion around the diagnosis relate to what exactly defines a bipolar disorder and what constitutes a mood swing:

Classic definition: The classic definition of bipolar disorder includes major depressive episodes that last at least two weeks and periods of mania or hypomania that last at least seven or four days respectively.

Expanded definition: Over the last decade a number of experts in the field encourage expanding the diagnosis to include mood changes that are much different – moods that change quickly (within moments to hours) and that are often triggered by a particular stimulus. Some feel that this kind of mood regulation problem is related to bipolar disorder – and this has led to the birth of the “bipolar spectrum” concept.

The concept of a bipolar spectrum has taken hold with great strength in the world of child psychiatry. As a result, all kinds of angry and emotionally unregulated children have been diagnosed as having bipolar disorder, and more adults in this range have been included as well.
These types of mood regulation problems are real problems – with real brain wiring issues – and deserve to be carefully evaluated and treated. The problem is that many conditions and problems other than bipolar disorder can also cause these regulation problems. Families of children and adults with this clinical picture suffer greatly, but whether or not it is helpful to lump all of these people in the “bipolar spectrum” is another question.