Parents describe the child as being stubborn, strong-willed, or simply a pain in the neck. When this pattern creates significant problems in function — at school, at home, with friends, or during activities — a doctor or therapist may suggest a diagnosis of ODD, which is described in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, as:
"A pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least 6 months . . . and is not exclusively directed at siblings."ODD's irritable mood and behavioral difficulties — not doing as one's told — can overlap with mania. Although this is often a confusing area, the child with ODD demonstrates these symptoms chronically and not episodically. Furthermore, ODD doesn't include other manic symptoms such as energy changes and grandiosity.
ODD is a problematic diagnosis in many regards, because its core symptoms are nonspecific. Irritable mood and defiant behavior can be associated with a wide range of developmental and psychiatric conditions.
Your child needs a careful medical and psychiatric evaluation to help understand the mechanisms underlying these difficult symptoms. Bipolar disorder/mania is one possible explanation, but others can include unipolar depression, attention deficit hyperactivity disorder, language disorders, autism spectrum disorder, and trauma, among others.
