Diagnoses of children with pediatric bipolar disorder (PBD) have surged in recent years. This article explores three alternative explanations for the increase in these diagnoses: (a) PBD had previously been unrecognized and underdiagnosed by clinicians; (b) the symptoms of PBD are largely a result of iatrogenic effects and side effects of psychostimulant medications, for example, Ritalin and Adderall; and (c) changes to the diagnostic system now classify previously normal behaviors of childhood as symptoms of PBD. After reviewing the evidence, this article concludes that the increase in diagnoses is primarily due to the iatrogenic effects of psychostimulant medications and to the changes to the diagnostic system, and is not a previously unrecognized or underdiagnosed illness of unknown origin.
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