November 28, 2008

Diagnosing Children with Bipolar Disorder

I am concerned that gifted, creative children, who march to a different drummer in our regimented society, are being misdiagnosed with bipolar disorder and threatened with a lifetime of dangerous medications and social stigma. Having that dire diagnosis imposed on you at age 6 severely compromises your ability to lead a normal life, marry, have children, go to college, have a career. How would you have reacted at age 6 if you were told you had a broken brain that could not be fixed, only treated with lifelong drugs with dangerous and/or unknown side effects?

Twenty years ago, psychiatry believed that bipolar disorder strikes in the late teens, that it was impossible to diagnose children or adolescents. Now psychiatrists occasionally diagnose bipolar disorder in four year olds, after too brief examination. Is diagnosing kids as bipolar sometimes an unthinking way to squelch kids who are divergent thinkers, who think too fast, talk too fast, question authority, get bored too easily in our increasing test-oriented schools?

Are other countries undergoing the same childhood bipolar epidemic or is this an American phenomena? When and how was the supposed epidemic of childhood bipolar disorder suddenly discovered? How many of the early pioneers were funded by drug companies? Have any longitudinal studies been done, comparing the life trajectory of kids diagnosed and medicated and of kids whose parents refuse medication? Is there any evidence that kids diagnosed as bipolar grow up to be adults with bipolar disorder?

Has the breakdown of the extended family and small, isolated families increased the number of kids in serious trouble? Why is there such a striking absence of social criticism about the so-called epidemic of bipolar children? For the last 30 years American society has conducted an experiment in having babies and toddlers cared for by a rapid turnover of strangers--not parents, grandparents, aunts, uncles, siblings, neighbors, friends. Babies as young as two months spend their entire days in group care, with almost inevitable disregard for their individual temperament and biological rhythms. Parents have no choice. Both mother and father work long exhausting hours without the support of nearby grandparents, aunts, uncles. Schools are obsessed with testing, neglecting the art, music, writing, sports, exercise, play that nurture a child's creativity.

I only have the questions, not the answers. But the psychiatrists writing the prescriptions too often are unwilling to admit they don't know the answers either. That these prescribed drugs work is not proof of the validity of diagnoses.If any of us took an atypical anti-psychotic, we might appear calmer and more obedient. We might also find it impossible to do our jobs satisfactorily.

Big Pharm runs advertisements on primetime TV and popular magazines to convince patients that atypical anti-psychotics such as risperdal are the magic bullets to make their lives wonderful. Antipsychotics used to be reserved for chronic schizophrenics. Now they are used to make Alzheimer's patients and children easier to manage.

How many psychiatrist prescribing drugs for young children have taken them? Is America in danger of regarding children as high-end luxury items that parents insist on purchasing and then demand that society should take some responsibility for them? Any decent society is committed to all children. We are the least child friendly society in the Western world. Is that why so many more of our children take psychiatric drugs? I question whether bipolar disorder can be distinguished from normal crazy behavior of children and teenagers.

No comments: