Q. As a child, I rang every bell on your list of "warning signs" for children's behavior. I also told parents and family members about the "bad thoughts" I had; i.e., I was convinced my younger stepbrother was going to kill me. I just scared the hell out of them and stopped mentioning it.

I was taken to several doctors and their concerns were dismissed. I remember so often they would look at me, equal measures of fear and concern in their eyes, "What is wrong with our daughter?"

My stepmother even told one doctor she believed I was bipolar, and her concerns were dismissed.

I often wonder how my life would have been if I'd been properly diagnosed and medicated at a young age. Nothing makes me angrier than to hear someone dismiss a child's diagnosis of bipolar disorder, because the symptoms can manifest at a very young age.

Thank you for your wonderful, informative article. Parents need to know the signs so they can seek help.
-- via e-mail

A. Thank you for the gift of your experience and for sharing the lessons you have learned with our readers. You are not alone.

Mental illness causes fear and shame, so it is often hidden, yet it is far more common than many think: More than 10 million Americans have bipolar disorder, and 15 million, depression (roughly 6 percent of adults in any given year).

How many of us -- even if we ourselves are spared -- go through life without knowing at least one friend or family member who is affected?

Far too many adults and children today suffer from psychiatric illness that goes undiagnosed and untreated. In addition to stigma, treatment resources are scarce, and in many states, insurance companies still discriminate against people with mental illnesses by providing less coverage for these diseases than for others.

Unfortunately, many others suffer from over-diagnosis, misdiagnosis, over-treatment, and ineffective ones. Why? Our over-stretched federal budget has little room for investment in mental health research and training, so we have become over-reliant on Big Pharma with its bottom line vested interest in maximizing drug sales whether we need them or not, whether they work or not, whether they are safe or not.

Properly diagnosing children with psychiatric illness is challenging and fraught with risks. In your case, as in many others, a missed diagnosis may have led to years of needless suffering.

When even very young children benefit from early detection and treatment, not only can they and their families be spared from an experience like yours, but they are also less likely to need as extensive mental health treatment, special education, and other resources. If we start early, there will be more to go around for everybody.

Diagnosing bipolar disorder in children continues to stir up controversy. The negative effects of a diagnostic label, and exposing children to medications whose long term effects remain unknown, are legitimate concerns.

Only in the last few decades have we recognized that children too can suffer from depression and, even more recently, bipolar disorder. The symptoms of bipolar disorder in children are often confused with those of Attention Deficit Hyperactivity Disorder (ADHD), anxiety disorders and post traumatic stress disorder (PTSD), for example in children who have been abused or molested.

Hyperactivity, distractibility and irritability may be present in both ADHD and bipolar disorder.

But children with bipolar disorder will also be euphoric (elated mood) when there's no obvious reason for it, with exaggerated ideas of their own powers (grandiosity). They are likely to sleep little while children with ADHD may have trouble settling for bed, and those with PTSD may be frightened about bedtime.

Both bipolar disorder and PTSD can also lead children to be preoccupied with sex and behave provocatively. If you are concerned about your child's behavior, be sure to bring your concerns to the pediatrician's attention right away.

If you don't feel you are being taken seriously, ask the doctor to explain his or her reasoning as to why this isn't a problem. A referral to a mental health professional specializing in children can help you determine whether you need to worry or not, and what to do when your child needs help.

Please see the Parents Guide for more information at www.pbs.org/frontline/medicatedchild.

Dr. Brazelton heads the Brazelton Touchpoints Project, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is director of Special Initiatives at the Brazelton Touchpoints Center. Learn more about the Center at www.touchpoints.org.

c.2008 T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.