Q. I am a 34 yr old female with the diagnosis of major depression and borderline personality disorder. My daughter is a 10 yr old mild right hemi. (she was a 26wk , 1lb12oz preemie due to maternal toxemia and had a grade 3 IVH at or around the time of birth) She has an explosive temper and I never know what is going to set her off. She can be ranting and raging one minute and a completely different person the next. I've always assumed that her anger is related to her physical disability and just always sort of dealt with it. She also has precocious puberty, so all the hormonal changes factor into it also.

In the past she has been diagnosed with ODD and I've suspected OCD but that has been ruled out. (the OCD). I've recently read that bipolar kids are frequently misdiagnosed as ODD, OCD, ADHD, etc. I've also read that when bipolar kids are misdiagnosed and given either anti-depressants (like prozac) or stimulants(like Ritalin) there are some very serious adverse affects. My daughter has never been medicated and is completely against it, reminding me often that "I'm the sick one" not her. How likely is it that she may have early onset bipolar disorder and are kids with hemi paresis more likely to be bipolar?

  A. There is a ton of overlap between bipolar, OCD, ADHD, and borderline personality. All of these diagnoses are really just symptom clusters and not real diseases. Your daughter may also be a borderline. I am not aware of any specific lesion resulting in hemi paresis in the brain causing bipolar disorder. I would have her treated with medications if she will accept them, and if not, she probably will not do very well.