Thank you for saying everything that I ever wanted to say about this but ten times better than I ever could. I have been viciously attacked for pointing out the disturbingly rapid paradigm shift surrounding the diagnosis of bipolar disorder in children. I have felt the need to bite my tongue on this subject for too long.

The main attack I've gotten is, "how dare you criticize my parenting?" and you know what, yes, I do dare to criticize your parenting. I am criticizing your parenting. But that's a good thing. By criticizing the parenting practices of others- our neighbors, our own parents- we learn to be good parents ourselves. Or rather, we learn to be the parents we want to be.

I don't criticize parents for seeking professional help for children that seem completely disturbed and out of hand. I mostly blame doctors for the aggressive promotion of these labels when they are new, unverifiable and controversial.

The writing on bipolar disorder in kids is actually almost laughable. "Does your child refuse to go to bed and want to stay up all night on the computer?", "does your child wet the bed?" It's sickening that "bad" behaviors specific to childhood have been pathologized as chronic mental illness. seriously these doctors have forgotten what it's like to be a kid. or rather, they don't know what it's like to be a kid today.

The most disturbing bit of information I've read was by an M.D. who wrote an article on this for Salon- he writes prescriptions for kids, and is not against medicating kids, just somewhat more conservative and critical of it than others- who said that he had an 18 month old boy brought to his practice with a mom that wanted him placed on drugs for bipolar disorder. He refused, but he checked up on the child and later found out that the infant had been placed on lithium and risperdal. This is unethical. period. no argument.

I am also afraid of the way that being diagnosed with a lifelong mental illness will effect children's feelings of self worth for the rest of their lives. I hear these kids who can rattle of a series of acronyms to describe themselves: "i have OCD, ADHD, BPD and these are my triggers, gotta do something for my generalized anxiety".. i find it incredibly disturbing that these kids have internalized all this rhetoric about psychosis and depression, and worry that a bunch of adults prodding them about hearing voices and feeling anxious or manic won't generate its own fears and anxieties.
from an early age, being told by every authority figure in your life- doctors, parents, teachers- that you are insane and sick in the head and you must always take these meds that bloat your body and make you shake and maybe make you feel suicidal and worse? the argument the pro-drugs for kids people always give is that the lives of these kids have already been interrupted and that the drugs give them hope. just because these kids lives have already been "destroyed" by behaviors doesn't give adults the right to continue to destroy their lives with their absolutist labels and anti-psychotic drugs.

my final thought is actually a question i wanted to put out there. I have spent a large part of my life living and being educated in europe. my boyfriend is from scandinavia. in Europe, the subject of childhood mental illness is incredibly controversial- much more so than it is here. I have never known a european child or teenager who has been on any psych medication or given such a diagnosis. as a side note, there is also no direct to consumer advertising of psych meds there. my question is, why do you think that is? i find the implied answer of those who wholeheartedly support the diagnosis of chronic mental illness in children very insulting- that is that Europe's medical care is somehow far behind that of America. I think that's a myth born out of american fears of the European universal healthcare model. But I want to know your answer to this question, because it needs to be addressed. Is there something wrong with American society? Or is Europe hopelessly backwards?

sorry this was long. I'm just tired of having to be quiet about this and am happy to have a forum to exchange thoughts and ideas.

Wow, that was a gooooooood post, Dawdy! As far as research on childhood bipolar goes, there isn't much evidence to support the diagnosis -- it is very easy to take a child with a bad temper with a behavior disorder (oppositional-defiant or conduct disorder) and slap a label of bipolar on the kid. The meds (antipsychotics in particular) will mellow the kids out somewhat; after all, these are tranquilizing meds. But the cost of doing so is very high, both financially and health-wise. Weight gain, anyone? Lots of it? Until a few years ago, nobody was really talking about bipolar children, yet now the talk is everywhere. You can bet that it will just keep coming until the market is saturated.

I'm not saying that bipolar does not exist in youth, just that according to research with which I am familiar, it is very uncommon.

Keep up the excellent work sir!

p.s. "the kids are alright" is a great song in my opinion because keith moon is the god of thunder.

I'm a psychiatrist, and you are dead right.Mental illness in kids is diagnosed excessively, not even because we believe it, but because we understand that we have no chance of changing the child's environment (TV/naps/parents divorce/violence/3 liters of soda/etc), so we "do what we can." Not an excuse, just an explanation.

But you should ignore all the talk about "FDA indications." They are meaningless. I've written a lot about it (http://thelastpsychiatrist.com/2006/09/what_is_off_label_usage.html
and http://thelastpsychiatrist.com/2006/11/the_charade_is_revealed_we_are.html for example) but the short of it is that labels are neither exclusive nor inclusive. They are simply descriptive. If I "label" my wife as blonde, it means I checked to see if she was blonde, and she is. It doesn't mean she isn't a sniper or is cancer-free or isn't on fire. The label one describes one single situation. However, psychaitrists and the FDA then use this indication in horribly inappropriate ways.

Click on this site I linked to my name:(am not affiliated with it)

"TeenScreen lures kids as young as 9 years old into doing the suicide survey by offering them free movie passes, food coupons, "I completed TeenScreen" stress balls and pizza parties, if they consent to the procedure."

"Yet psychiatrists continue to pound the public with misleading and fraudulent statements that these so called mental disorders are biochemical or neurological conditions. That is false. They are simply a list of behaviors that psychiatrists vote into existence and insert into their billing bible, the Diagnostic and Statistical Manual of Mental Disorders.

This has led to over 8 million children in the U.S. taking mind-altering psychiatric drugs."

Most everyone here knows I am a bipolar mother of 3 grown kids. My kids, like me stayed outside all day playing "until the street lights come on", rode horses, did art classes, all play musical instruments, and we all volunteered hours of time in Food Banks, and Humane Society.
I took my youngest to a psychiatrist at age 11 due to "intrusive thoughts" that were homicidal and suicidal.
Never heard her talk like that before that day, when she was 11. The doc dx her OCD within 30 minutes, and within days told me to admit her to a psych ward, where she came out dx Early Onset Bipolar Disorder, and loaded up on medications.
No one ever asked if she was on another medication. She happened to be on one for bedwetting she was briefly taking for summer camp. That med is, what I feel, the catapult that shot us into the psychiatric world.
As a parent who believes in childhood's and who was a 'stay at home mom', we played, rode bikes, it was great.
Life changed once psychiatric world entered mine.
Now that she is grown, the majority of psychiatrists all believe "something would have emerged anyhow".
What came first the meds or the illness?

Was this a medication induced illness?

Parents like me:

do you regret seeking psychiatric help for your child?

do you think the meds helped?

do you think they would have needed meds anyway?

I truly hope, that more doctors will rise up to the occasion and think before medicating such young children. I challenged the docs from day one, and here is how it went for me:

Doctors pressure parents, once the child is on medications, they challenge your questioning the meds, and use scare tactics: "your child could be faced with suicide look what happens when people go off of their meds".
Serious brainwashing to parents is what happens.
I feel my daughter's brain grew addicted to the meds and though she is mentally ill, I believe her brain was damaged from all of the medications.

Dawdy,

There seems to be a third debate that I rarely see addressed in the mainstream press, which addresses the role of toxins, infections, lack of proper nutrition, and environmental pesticides in causing a rise in some of these symptopms.

So while the debate usually is a dual one, tacking between those that just uncritically accept the dramatic rise in mental illness, and those that are appalled at this tide, pointing out that there is over-diagnosis, there are many also who are thinking about this issue along an entirely different axis.

And that the dramatic rise is due to environmental causes and parents are engaging in extensive alternative interventions to deal with these behavioral symptoms.

You see this especially with a certain class of mothers of autistic kids but it is also commong with kids who have ADD.

So I guess I am wondering about your thoughts on this "third way."

And thanks for all the posts!

g

Where ever this discussion leads:
Please, take action, do not just talk.
Clear the path for others.