Can children with Aspergers also get diagnosed with Bipolar Disorder?

Question

Could you tell me if some children with Asperger's also get diagnosed with Bipolar Disorder? Our daughter has always had mood issues but we can usually identify causes, such as sensory issues, anxiety or overstimulation. We have just had an IEE FBA done on my daughter at school. The school has not been implementing her BIP, and she has been running the show. She is in 7th grade. The school district is so out of compliance with IDEA 2004. None of the Teacher's or staff are trained.

This behavior specialist wants us to go to a Psychiatrist to get a "clean diagnosis." We have had numerous testing done on her over the years. She was diagnosed at 4 years with ADHD, then at 5 with PDD-NOS. We took her to University of Texas Health Science Center and they diagnosed "High Functioning Autism" at 6 years. The doctor told us that it was essentially the same as Asperger's.

Answer

A diagnosis of both Aspergers and Bipolar is especially problematic because there are fundamental differences between ‘Aspergers mood states’ versus ‘mood states of a child without Aspergers’. Four specific domains need to be considered in the process of diagnosis:

• ‘Psychosocial masking’ make some unusual behaviors seem like disorders when they are not.
• ‘Intellectual distortion’ involves confusion in communication; a person may say he is afraid instead of angry.
• ‘Cognitive disintegration’ may interfere with proper diagnosis since a child may exhibit odd behavior in response to seemingly insignificant occurrences.
• ‘Baseline exaggeration’ differences suggest that unusual base behaviors can interfere with proper diagnosis.

Bipolar Disorder (BD) can be misdiagnosed as Aspergers (AS) because BD can present itself via symptoms such as obsessive compulsive behavior, odd habits, and bouts of rage. Children with BD and AS both have symptoms that lead to lacking social development skills, educational issues, behavioral issues, and anger issues.

BD can also be present in conjunction with AS. Typically, this is the case. It is unknown, however, if the BD is a result of the AS, or if the same neurological issues that cause AS are related to the chemical imbalances in the brain thought to be the cause of BP. Answers to these questions will likely come to light as research in neurological, technological and psychiatric areas continue to progress.

Medication treatments for BD and AS are quite similar. There are no medications for AS; however, medications exist to treat the symptoms of AS. Since the symptoms of AS (e.g., depression, obsessive compulsive disorder, and anxiety) are the same symptoms often experienced with BD, the medications used in both instances are the same.

Counseling treatments are also commonly used for both BD and AS, used in conjunction with medication or alone. Most AS children do not need medication. Counseling is required, however, to help the child cope with her disability. Counseling treatments for BD are considered necessary, with or without medication. These treatments can help the child learn to recognize and correct irrational emotions or behavior.

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