Our expert says:
The diagnosis of "early onset bipolar" is far from formally recognized and its criteria not agreed internationally ; the diagnosis is still controversial to many. And frankly, though your son may have seen an excellent specialist, very highly complex psychiatric diagnoses should be made by a highly trained specialist child psychiatrist, not a neurologist. Neurologists are not usually trained in child psychiatrisy diagnostics, and only if they have pursued this field with special training they undertook theemselves, might they have adequate specialist skills in this particular field.
So I would recommend you get for your son a second opinion ( NOT with someone recommended by the neurologist, who would be more likely to have similar opinions ) but with a recognized child psychiatrist in your area, for a full review of the complex combination of diagnoses that have been made, and make treatmnent proposals.
Of course your despair, based on your earlier experiences, is understandable, but not as appropriate as it feels.
Years ago, in your brother's time, and even recently, childhood and young teen depression was not properly recognized and treated. If your son does indeed have early signs of bipolar disorder, and it is monitored and treated as necessary, he should be able to lead a normally enjoyable life.
What you describe does not sound, to me, like manic episodes, and I am personally sceptical of diagnosing Bipolar Disorder in the absence of clear and unquivocal manic episodes. I am also yet to be convinced that the increasingly complex classifications of Bipolar Disorder are useful in terms of deciding treatment, or even making more useful predictions of likely long-term outcome.
Have your boy see a good local child psychiatrist for a thorough assessment, and a discussion of diagnoses, treatments and long-term management with you.
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