Furious Seasons

June 18, 2007

The Bipolar Child: Meet Joe Biederman

Following up on my post of yesterday, here's a link to the Boston Globe's excellent piece on the Harvard bipolar child mafia and the controversy around the diagnosis and treatments. I'm a bit confused why one blogger deems this the reporter's attempt to put a "positive spin" on the bipolar child paradigm. Maybe the article doesn't go far enough for the anti-psych crowd, but I think it's reasonable, judicious and quite deadly.

My usual practice is not to quote from others' published material at length, but this time I am pinching more copy than usual. The article is just too juicy.

"From his perch as one of the world's most influential child psychiatrists, Biederman has spread far and wide his conviction that the emotional roller coaster of bipolar disorder can start "from the moment the child opened his eyes" at birth. Psychiatrists used to regard bipolar disorder as a disease that begins in young adulthood, but now some diagnose it in children scarcely out of diapers, treating them with powerful antipsychotic medications based on Biederman's work.
"'We need to treat these children. They are in a desperate state,' Biederman said in an interview, producing a video clip of a tearful mother describing the way her preschool daughter assaulted her before the child began treatment for bipolar disorder. The chief of pediatric psychopharmacology at Mass. General, he compares his work to scientific break throughs of the past such as the first vaccinations against disease."

Seroquel research is comparable to Salk's polio vaccine? Please. I don't doubt that Biederman and the other Harvard mafiosi see kids who are in pretty rough shape. That's very typical of big public health hospitals. Why their skewed patient base gets to guide an entire field is beyond me however. Biederman and his crew are very influential.

"'They are by far the leading lights in terms of providing leadership in the treatment of children who have disorders such as bipolar,' said J. W. Carney Jr., lawyer for Dr. Kayoko Kifuji, a Tufts-New England Medical Center psychiatrist who temporarily gave up her medical license after Riley died on Dec. 13, 2006. 'Dr. Kifuji subscribes to the views of the Mass. General team.'"

I'd say that's a pricey subscription. The Riley referred to is Rebecca Riley, who was killed in Decemeber 2006 by an overdose of Clonidine, while also taking Seroquel and Depakote. She was diagnosed with ADHD at two-years-old and with bipolar disorder a little later.

Enter critics within the psych world.

"Psychiatrists too often prescribe these medications, which carry side effects such as weight gain and heart disease risk, without addressing problems in the children's lives, said Dr. Gordon Harper, director of child and adolescent services at the state Department of Mental Health. He likened the approach to 'tuning the piano while the subway is going by'.
"Biederman's critics chide him for not speaking out against misuses of a diagnosis that he has helped inspire. Among leading authorities on bipolar disorder, the Mass. General team has proposed the most aggressive treatment for the broadest group of children, they say, and Biederman should take responsibility when treatment goes wrong. At a conference on bipolar disorder at Pittsburgh's Point Park University last weekend, one speaker, Dr. Lawrence Diller, a California behavioral pediatrician, contended that Biederman bears some blame for Riley's death.

"'I find Biederman and his group to be morally responsible in part," said Diller, whose popular book, "Running on Ritalin," accused psychiatrists of over treating another childhood condition, attention deficit hyperactivity disorder. 'He didn't write the prescription, but he provided all the, quote, scientific justification to address a public health issue by drugging little kids.'"

Wow, in the polite little world of medicine, that's some hardcore talk. Biederman to the defense:

"Biederman rejects the idea that Riley's death is a cautionary tale, accusing critics of exploiting a tragedy to fan fears about psychiatry, a profession that has long faced prejudice. 'The fact that she had XY drug or XY treatment is irrelevant to what happened....If this child had the same outcome from treatment for asthma or seizures, we wouldn't have this frenzy,' said Biederman in an interview at Mass. General's Cambridge mental health clinic.
"Though Biederman acknowledges that distinguishing bipolar disorder from ordinary crankiness and flights of fancy in young children is challenging, he insists there is no ambiguity in the patients at his practice. 'People have to wait a long time to see me or my colleagues....It's not that somebody comes to me after their child has a temper tantrum. They do things for years that are dangerous. These are things that profoundly affect the child,' said Biederman, putting them at risk of academic failure or even suicide.

The drug's are irrelevant to what occurred? Maybe Biederman could use some meds himself. You know the ones that tamp down narcissistic tendencies:

"Biederman dismisses most critics, saying that they cannot match his scientific credentials as co author of 30 scientific papers a year and director of a major research program at the psychiatry department that is top-ranked in the "US News & World Report" ratings.
"The critics 'are not on the same level. We are not debating as to whether [a critic] likes brownies and I like hot dogs. In medicine and science, not all opinions are created equal,' said Biederman, a native of Czechoslovakia who came to Mass. General in 1979 after medical training in Argentina and Israel. He now lives in Brookline.

I've always been staggered by the arrogance of researchers in all branches of science throughout my career. Biederman takes the cake. His talk is a bit like a prostitute bragging on how many tricks he or she turned a year, which is to say it's not impressive at all. Here's Biederman's Google Scholar round-up and here's his list of publications from the Mass General website. And here's how Biederman talks after a short term study of Zyprexa in kids.

"Biederman was disappointed that he could not do more comprehensive studies, but he saw no reason to delay treatment. 'At least the line of drugs I'm talking about gives some relief,' he said. 'The only way to understand the side effects is in the context of the seriousness of the illness.'"
"As bipolar disorder received increasing media attention, Biederman and Wozniak's research was often cited as the scientific rationale for diagnosing and treating the disease aggressively. Another leading researcher, Dr. Barbara Geller of Washington University in St. Louis, adopted a more restrictive view, requiring that children have a series of specific symptoms such as reduced need for sleep before she would diagnose the disorder. But the Mass. General team used broader categories, saying that children who are extremely irritable or aggressive might be bipolar. Skeptics said those symptoms were too common, leaving too much room for dispute over who is really sick."

Diagnostic criteria you could drive--or diagnose--a Mack truck through. Here comes another critic, tellingly from a top medical school on the West Coast, where psych docs seem a bit more cautious about the bipolar child paradigm. I guess only prestigious docs give 200 mgs. of Seroquel to four-year-olds.

"Dr. Biederman's staff 'can do the same diagnostic interview on 100 children and come up with five or 20 bipolar disorders, and I might do the same thing and find only one or none,' said Dr. Jon McClellan , a psychiatrist at the University of Washington who chaired a panel of the American Academy of Child and Adolescent Psychiatry that recently concluded there is no proof that children under 6 can be diagnosed with the disorder. He says he has received no money from the pharmaceutical industry for years."

And here's another skeptic, from Harvard no less:

"Dr. Steven Hyman, who was then director of the mental health institute and is now provost at Harvard University, said he remains very concerned about the growing use of 'big gun' antipsychotic drugs such as Zyprexa, Risperdal, and Seroquel on children. In the Massachusetts Medicaid program, the number of people under 18 receiving at least one of the 'atypical antipsychotic' drugs rose from 6,943 in 2002 to 9,123 in 2005, a 31 percent jump, before declining to 8,343 in 2006. Hyman says that none of the drugs has the approval of the Food and Drug Administration for use in bipolar children, and doctors prescribe them based on their individual judgment.
"'We don't know the first thing about safety and efficacy of these drugs even by themselves in these young ages, let alone when they are mixed together,' said Hyman."

Enough said.

Posted by Philip Dawdy at June 18, 2007 12:05 AM

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Comments

A frightening story.

Dr Biederman may be a top American pyschiatrist, but that doesn't mean too much. As we know, bipolar is difficult to diagnose and psychiatrists often get it wrong...mixing up bpolar, schizophrenia, melancholic depression, ADHD,...why would it be any different for kids?

Posted by: James at June 18, 2007 12:48 AM

Wow, just wow. What do his credentials have to do with answering his critics? I always find people who use age or credentials as their sole argument the least credible.

It also doesn't matter that he co-authors 30 publications a year. Once you get to be a top dog like that, you hardly have to partake in any research yourself, just have your underlings do all the work, and then they put your name on the paper.

Posted by: Julia at June 18, 2007 12:53 AM

In recent years the practice of paying eminient docs to put their names on journal articles that have really been churned out by pharmaceutical marketing departments has been made public. I would say that Biederman's list kind of smacks of this practice since he appears to be the lead author in just about all the articles he lists and the drug companies probably salivate to get him on work that endorses their products. In some cases the doctors barely read the drafts before getting big bucks to have their name listed as the lead author. David Healy and others have written about this practice.

Posted by: Sara at June 18, 2007 08:27 AM

I have been waiting for a kick ass journalist to write this for 8 years. Thank you!!

The massive influence these people have: I totally agree with them being at fault for the massive mis diagnosis of innocent children, and placing them [such as my daughter]on psych meds..this influence reaches far and wide into the bp kids org website influencing parents, and The Bipolar Child book. All of this self appointed fearmongering group of so called experts basically created a monopoly in the psych world of information that trickled down in a twisted way to doctors and parents.

That team has just had a rude awakening. I have met psychiatrists in elite hospitals speak with that arrogance that Biederman does, and it is like dealing with the devil himself the way they defend themselves.

I have to say one thing: that man is sick. That's my personal opinion, but this is disgusting.

I have suffered, my family has suffered, and most importantly my daughter suffered her entire young life being told she was bipolar by doctors who believed this Harvard shit.

Posted by: Stephany at June 18, 2007 10:52 AM

I miss Freud. Jesus.

Posted by: flawedplan at June 18, 2007 11:18 AM

The original publication in the Globe only had the first two or three paragraphs on the front page. Thus a casual reader of the paper would not have see the real info, but just the glib PR that the shrinks' office put out.

Posted by: Sickmind Fraud at June 18, 2007 04:52 PM

Seems Biederman was a member of the same debating club as E. Fuller Torrey:

- You support forced drugging?

* Only MindFreedom calls it forced drugging! MindFreedom members live high on the hog on government subsidies. My patients eat out of garbage cans.

- Again, you support forced drugging?

* No! It's not forced! Most patients agree to take their meds when they are informed that they must. Nothing forced about that.

- Your research is sponsored by Big Pharma?

* Yeah and I am the greatest!!!

What a pack of losers. Hie me to the vomatorium, please. Philip, I love your website but I'm going have to stop reading it, I think.

Posted by: Francesca Allan at June 18, 2007 06:00 PM

Ivory tower discussion aside, what do we do for these kids? Call it bipolar, call it oppositional defiance, call it aspergers, I don't really care. How do you help the kids who are struggling with mental illness?

Posted by: molly_g at June 18, 2007 08:22 PM

Molly g wrote "How do you help the kids who are struggling with mental illness?" There is no way children today are suffering from mental illness. Mental illness is for adults only.
http://www.szasz.com/iol5.html
CHEMICAL STRAITJACKETS FOR CHILDREN

Posted by: Mark(p.s.2) at June 18, 2007 11:45 PM

molly, i promise to get to your question as soon as i can.

Posted by: Philip Dawdy at June 19, 2007 12:07 AM

Molly,

The problem is that emotional problems in children are caused by their environments. But if you remove a child from its environment, you place it in a much worse environment usually.

We can't change individual current parenting styles but we can change the school system. How, I don't know.

If you look at people with mental retardation, you can see how good parenting makes a difference, as does ignorant or bad parenting, in whether a child who is born different becomes a problem. Perhaps people who find their children who may have been born with less than placid personalites or may be responding to their environments to be troublesome, should turn to the folks who have done a good job dealing with children different from the "norm" without torturing the children with brain damaging medicines and stigma that will legally preclude the child from every becoming employable or in any way living an independant life.

It's a good question.

Sally

Posted by: Sally at June 19, 2007 05:39 AM

In response to Francesca Allen's post:

I'm a member of Mindfreedom, though I speak only for myself in this forum. I do call it "forced drugging. I do not receive government subsidies. I have no knowledge of anyone connected to Mindfreedom living high on the hog from government subsidies, though I do think this would be a good investment of my tax dollars were it the case. Francesca Allen wrote "my patients eat out of garbage cans," I might point out that eating out of a garbage can will cause psychosis and dangerous behavior regardless of what medication a person is forced to take for obvious reasons such as food poisoning and the delusions, desperation, and panic a human experiences while actively in the physical condition of starving to death. What these "patients" need before any medical evaluation or psychiatric evaluation is at a minimum, food.

Allen's post in its entirety read:
Seems Biederman was a member of the same debating club as E. Fuller Torrey:

- You support forced drugging?

* Only MindFreedom calls it forced drugging! MindFreedom members live high on the hog on government subsidies. My patients eat out of garbage cans.

- Again, you support forced drugging?

* No! It's not forced! Most patients agree to take their meds when they are informed that they must. Nothing forced about that.

- Your research is sponsored by Big Pharma?

* Yeah and I am the greatest!!!

What a pack of losers. Hie me to the vomatorium, please. Philip, I love your website but I'm going have to stop reading it, I think.
Posted by: Francesca Allan at June 18, 2007 06:00 PM

Posted by: Sally at June 19, 2007 10:23 AM

Sally, I think if you read my comment again, and then perhaps read my other comments, you would see that we are very much on the same side. I am vehemently opposed to forced drugging and drugging children and psychiatric labelling in general. The quotes "living on subsidies" versus "eating out of garbage cans" is from E. Fuller Torrey. (I guess my satirical writing needs some work, as I have never been so completely misunderstood as I have been here.)

Posted by: Francesca Allan at June 19, 2007 10:38 AM

Francesca,

My apologies. I think it's my sense of humor that is lacking not your satirical writing.

Sorry....Sally

Posted by: Sally at June 19, 2007 07:32 PM

Sally, I certainly hope the comment section is not why a person would stop reading this blog. Commenters [all of us]have opinions, which leads to dialogue and discussion, but certainly doesn't reflect on any blog author on any blog.

Personally, I disagree with children being medicated as babies, toddlers etc. though one cannot deny that bipolar is diagnosed in adults, and teens, and parenting does not create psychosis, or any other mental illness. Yes, environment can be a large factor, and unfortunately there are environments not good for kids, but mental illness is still without a cure and a reason for existing. I have strong opinions on psych meds used in kids, and I also take psych meds.

Posted by: Stephany at June 20, 2007 06:37 AM

If people want to consider a biochemical/nutritional approach to treat bipolar disorders and other behavioral disorders the Pfeiffer Treatment Center outside of Chicago has had remarkable success with treating disorders based on individual chemical analysis. contact them www.hriptc.org .

Posted by: Martha at August 2, 2007 05:46 PM

Interested to know your views on this since you read the Papolous book and if they have changed any.

Posted by: susan at August 3, 2007 01:23 AM

I don't know if the Bipolar Book question was for me, but in case it was :

I read it in 2001. My daughter had been dx from OCD >BP by then, and that was the book where I couldnt see anything match with her dx. What I got from the book was antidepressant reaction information[that can apply to anyone] and at the time my daughter was raging 6 hours a day on 150mg of Zoloft[plus other meds]. I read the page outloud to the psych and told the psych I thought I saw a pattern of everytime her agitation increased, the psych increased the ZOloft. I wrote my own "abstract" about it and the doc agreed it was the Zoloft, and told me he was going to look at how he medicated kids after that.[that was a inpatient psych telling me that, not the outpatient who placed her on Zoloft].
So what I got from the book mostly was an eye opening to how it was the medications causing raging not childhood bipolar disorder.

Once off of Zoloft she stopped raging. She was very miserable, lost a lot of school time, and that was when she was 13.

By age 18 and after being inpatient at several hospitals all psychiatrists dismissed bipolar.

Just as I had been trying to tell the psych all of those years that she didn't "match" the protocol that was out there, which is all connected- the BP childbook authors were at one time a part of CABF bp kids and Biederman as well.
Large group of people influenced a generation of children, in a trickle down effect into psychiatrists offices.

Now, some psychs are backing off of medicating kids, and that is what I am glad to see happen. The main protocol for dx'ing childhood bipolar disorder comes from Pharma funded studies and a few people who have names in articles, peer reviewed abstracts, etc.
It's time to question it all.
I don't know if this helped or made sense at all, but I do know there isnt much out there for parents to read who might be concerned, and when there are few resources, one can start to believe the source and that source[s]can have quite an impact.

Posted by: Stephany at August 3, 2007 11:21 AM

Stephany, I love your comments, always and learned so much from you.

I had addressed my comment to Phil. I had sent him a copy of their latest edition to him recently and was curious to know what he thought of it.

I wish I had a second copy of it to send to you as well.

Posted by: susan at August 3, 2007 03:04 PM

I think treating to a diagnostic label is one of the big problems in psychiatry. This need to compartmentalize everything leads to wrong treatment. Many patients become activated on SSRI's and can become suicidal and homcidal. This family is alos passed out like candy with little regard for safely or consequence. We have mentally retarded kids that are on Paxil and become highly sexualized. The parents refuse to believe that the psychiatrist would put them on something that would cause this.

Posted by: Bill at June 10, 2008 01:37 PM

Until now, I had never heard of this jerk Biederman.

The man is a megalomaniac and a menace to medicine.

Someone please knock him from his pedestal before he slaughters any more kids.

What a thoroughly evil man he must be to sacrifice children's lives on the altar of Big Pharma.

Posted by: Slic at July 1, 2008 03:37 PM

By the time I was 3 years old I was already diagnosed with generalized anxiety disorder and ADD and encouraged to take meds. My parents waited until I was 7 or so before the medication cycle began. Soon enough antipsychotics, stimulants, antidepressants and many more cocktails began until I finally got off all meds in May 2008.

Posted by: Princess at March 6, 2009 10:09 PM

You people are all brainwashed and spoonfed lies by psychiatrists and psychiatrists of big pharma. There is no such thing as so called "mental illness" in children nor adults. Bad behavior is not a disease or a health problem. Psychiatrists kill 65,000 people a year in the U.S alone with psych drugs and other psych treatments and fraudulent diagnosis. Psychiatric drugs damage the brain, body, and mind permanently and there is no turning back after that. Psychiatists are the rats and vermin of society destroying our civilization. By supporting and agreeing with psychiatrists you are destroying our society. THINK before you speak. I am an expert on psychiatric fraud and a victim. Being logical goes a long way. The destruction of our civilization is by psychiatrists. Time to end them is NOW.

Regards,
Antipsychiatrist Expert.

Posted by: Joe Petrucci at March 23, 2009 07:27 AM