From Charles:

There has been a remarkable increase in the awareness of bipolar disorder recently. This is partly due to pharmaceutical/academic campaigns such as the infamous Lilly campaign much maligned by the likes of David Healy in the UK, but it is also due I think to a genuine desire by psychiatrists and sufferers alike to blow away the stigma and misunderstanding associated with the label of BPD. The recent television documentary on the subject presented by the commedian Stephen Fry, in which he discusses in great detail his own illness, had a great impact on awareness in the UK.

As a researcher into bipolar disorder in the pharmaceutical industry I have listened to many discussions about "early onset" bipolar disorder. I have never heard comments that might justify the charge of disease mongering, but I have myself considered whether there might be a prodromal state of bipolar disorder that might be treated in order to prevent the emergence of the full blown disorder. For example, if a child's family history suggests that he or she is at risk of BPD, then would it be worthwhile considering lifestyle changes or career counseling to avoid the stressors that can precipitate the illness? Easier said than done!

However, I do agree that medication would probably not be the best approach... yet. The problem is that we know so little about the aetiology and development of BPD, and given the plasticity of a child's brain we risk alot giving medications that we know can alter brain chemistry and function. We've got a very long way to go with BPD; however, I'm hopefull that we are making some progress. There certainly needs to be more informed debate on the subject of childhood mental illness, because if the adult disorder does arise from changes occuring during adolescence or earlier then there may be a much better chance of applying a correctional treatment at that stage.