October 03, 2007

The Bipolar Child: A Fight Breaks Out

The "60 Minutes" piece on bipolar disorder in children and the Rebecca Riley case continues to generate responses, including one by John McManamy, whom most of you know authored a book on living well with bipolar disorder and depression. McManamy felt the CBS piece maligned parents of bipolar children and he said so on his blog. He called Katie Couric as dumb as Oprah and so on. Coming from someone of McManamy's stature in mental health circles, that's interesting. Couric's piece was far from perfect but it was also far from stupid.

But the good times waited until a few people commented on his blog post on Couric. It appears that McManamy thinks anyone criticizing the bipolar child paradigm is an antipsychiatrist, a baseless slur he uses to try and discredit others such as myself and, as you'll see in a second, another blogger on these issues.

First, McManamy had to dispense with someone who left a mildly critical comment on his post:

"Incidentally, the loudest voices against treating kids come from the same people who are against treating adults. Everything to them is a drug company conspiracy. Maybe we should do nothing and let these kids jump out of moving cars (and practically every mom I've talked to has a jumping-out-of-car story). The news media has bought into the anti-psychiatry party line, hook, line, and sinker."

That sort of speaks for itself. Then, Stephany who authors the soulful sepulcher blog and lives in the Seattle area left McManamy a response, which in part reads:

"My daughter was misdiagnosed at age 11 with bipolar disorder, and at age 18 and after several experts at leading hospitals, the diagnoses was removed. After 6 years of being medicated with dozens of drugs, many changing with what new drug was on the market, she is one unique example of why it is important to medicate children with caution. In no way am I judging any parent, and the Rebecca story is heartbreaking. Her story is unique as well. I am glad that the parents in 2007 have information at hand to make informed choices, and understand medications that I did not have in 1999. My daughter was on Zyprexa in 1999-2005 and we had no way to know about the weight gain or diabetes connection[she gained 50 pounds by age 13] because Eli Lilly buried the data. This is a very difficult road to be on as a parent, I've walked it for 8 years, saw medications activate my daughter into violent aggressive behaviors, and saw it change with removal of medications. Now at age 19, she has "psychosis NOS" as a primary dx and no one knows if she has brain damage from all of the medications trialed on her, because I listened and trusted a doctor. Her illness whatever it is, may have emerged on its own, or not. She was fine until age11 and took a bed wetting pill, an anti depressant. From there it became immediate dx of OCD to Bipolar to Austism and now psychosis.

"I felt the Couric show was evenly balanced, and to medicate a 2 year old with these chemicals is something I must say is frightening, after seeing first hand side effects with my daughter."

She went on, but that's the gist. McManamy responded:

"Hi, Stephany. Were we watching the same 60 Minutes? Balanced? Was there any segment showing kids successfully diagnosed and treated with the illness? Was there any segment showing what it's like when a kid is not treated? Was there any segment explaining how to distinguish BP from ADHD? Was there any segment with a panel of parents of bipolar kids? Was there any segment with a spokesperson from the Child and Bipolar Foundation. Sorry, the 60 Minutes I saw was two-thirds sensationalist Rebecca Riley shock-horror, and fraught with serious factual errors.

"For that matter, was there any segment with you in it, explaining how your daughter's idiot psychiatrist misdiagnosed her and over-medicated her?
Did 60 Minutes make any attempt to educate its viewers?

"I am looking forward to a reasoned response from you, not the ad hominem remarks you have posted about me on your own blog and Furious Seasons."

I was not the only reader flabbergasted by his handling of Stephany. You see, McManamy is not only a pompous ass for attacking a single mother who has clearly seen the dark side of the bipolar kiddos paradigm, but he's single-handedly gone after the one parent who has fought harder for her kid than any single parent I have ever seen in my 18 years in mental health circles in three different states and my seven years or so of reporting on these issues in two states. I have seen dozens and dozens of cases of patients rotting in state hospitals and residential facilities whose families have simply given up on them and left them in the hands of the state. I know they've all fought fights similar and different to Stephany's, but eventually they give up. It's understandable, except to Stephany.

Stephany doesn't want her daughter to be jammed into some ward in Western State Hospital--where Frances Farmer was once a patient--because when her daughter was briefly at the same hospital a year or so ago, another patient tried to sexually assault her. Stephany's daughter is about as defenseless and innocent as a 10-year-old and one of the most profound cases of psychosis that I know of. Guess what? The State of Washington is currently trying to send her daughter back to Western and Stephany is fighting them tooth and nail in court. She wants her daughter at home.

That's who McManamy attacked and he owes her an apology--publicly. Besides, Stephany knows all the kids trying to jump out of cars stories--and has several daughter running into traffic stories and daughter trying to jump into Puget Sound stories to go along with those.

It's always discouraging to watch an alleged big shot pound on someone else, especially someone else in the patient community. I don't understand that sort of thing, but then I don't understand how McManamy could idly sit by and not say word one on his blog or website about the on-going scandal around the atypical antipsychotics. You don't need to be an anti-psychiatrist to appreciate that there are huge problems on that front--I'm merely critical of the psych establishment and I get it. And as for his "drug company conspiracy" jibe, perhaps he might want to ask himself why companies like Lilly and BMS are settling legal claims involving their drugs, and why several other states are suing AstraZeneca and Janssen/J&J, and why Congress is investigating Lilly and AZ, and then perhaps take a look-see at certain drug company documents, and see if he'll ever be able to use that trash talk again.

I'll leave it at that.

Posted by Philip Dawdy at October 3, 2007 12:03 AM
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Comments

Philip, what can we do as health care consumers do to help Stephany? Do you know where we can phone or send letters to to help her?

It's valiant that she loves her child so much to do all she is doing, but I think it's time for a grass roots effort to help her.

thanks.

Posted by: concerned for a child at October 3, 2007 03:35 AM

One thing I've noticed about some people who claim their children have bipolar disorder is that they'd often rather talk about themselves than the child and seem more concerned about their welfare with stories like "he flew into rages" and wouldn't sleep and it was hard for me as a parent.

And let me tell you, if your 2 year old jumps out of a moving car, or even your four year old, it's because as a baby, they don't understand the danger and in the case of a 2 year old, because you are breaking mandatory car seat laws. So many of these BPD child stories are like that, the old, my baby kept trying to crawl through open flames until I drugged her up. My advice to that sort of person is put out the fire dipshit and don't have any more children.

Many things make Stephany different from these people, among them, the compassionate and loving way she talks about her daughter and worries about the experiences her daughter is having. Anyway Stephany rocks, and McManamy is the sort of self professed bipolar who keeps us all entrenched in stigma with his "I'm a proud mental defective" lack of personal responsibility goup.

Posted by: Sally at October 3, 2007 03:56 AM

I have read John Mcmanamy’s newsletter and blog over the years and I must say I was surprised at the diatribe he directed at Stephany and his intolerance of other people’s viewpoints and experiences. Bottom line: meds can indeed be highly effective and positively transform lives and they can also be extremely dangerous and fatal. Whether it’s the lack of real long term studies, the suppression of information by some of the big pharmaceuticals and the known risks and side effects of many of the psych meds prescribed to a younger than ever subset, anyone who has a child with a diagnosis of bipolar disorder should not be afraid of the solid information, questions and healthy skepticism shared on this blog and others. To quote Mr. Mcmanamy, “knowledge is a necessity.” Why he is so emotional and defensive?? Frankly, I have lost some respect for him and he needs to really “listen” to and respect other’s experiences. That he hasn’t yet replied to Stephany’s last post in a more reasoned and thoughtful manner says it all.
Re: Stephany, I feel her rage/outrage, mistrust, frustration, grief re: the misdiagnosis of her youngest daughter at age 11 and the unfathomable "damage" & suffering that has resulted. It is gross medical negligence beyond my imagination. I humbly acknowledge that I can NEVER truly understand her pain. I don't know how she has survived this nightmare but I do understand a mother's righteous indignation and love for her child to continue to do everything humanly possible to fight for her life. That would also refer to other mothers/parents who have found that the medication is indeed the only thing that has helped their child maintain even the smallest semblance of a normal existence. Every child/case is uniquely different and armed with knowledge and responsible psychiatry, we parents can decide the best course of action and then, monitor their progress carefully. We know our children better than anyone else!

Posted by: booknan at October 3, 2007 08:38 AM

Why is McManamy and others so afraid of change in Psychiatry? Sally is right when she speaks of McManamy continuing the stigmas associated with mental illness. Everytime someone utters a word critical of psychiarty they are dubbed anti-psychiatry and therefore no one should listen to what they have to say. It's very sad that a young girl lost her life because of psych medication. What's worse is others will loose their life or end up like Stephany's child because the system has not been forced to make changes. McManamy et al have as much blame here as the parents, psychiartists, researchers and drug companies. As long as they don't allow and demand change more children will end up killed and seriously harmed. Sometimes the stories aren't about protraying bipolar's as dangerous and evil but about the need for changing a system with serious problems.

Posted by: Jane at October 3, 2007 10:44 AM

It is both heartbreaking and infuriating to read this.

It really doesn't take an anti-psychiatrist to see that this country is filled with medical professionals willing and able to over-medicate and misdiagnose. Whether that be mental disorders or medical ones, for every one good doctor, there will be a hundred with ill intentions.

John McManamy is a hypocrite, but I am less concerned about him than I am about Stephany and her daughter's case.

She has shown that she is strong, but the strength of an individual can only go so far against a system that is intent on making our decisions for us. She needs the support of many voices, voices that will rise above the pound of a gavel.

Lets let Mr. McManamy have his small-minded insults and concentrate on helping this family stay safe together.

Posted by: Venustar at October 3, 2007 11:52 AM

http://www.furiousseasons.com/archives/2006/11/

I was reading your archives and was interested in your 11/07/2006 post about John McManamy's book. Has something happened since to cause "bad blood" between the 2 of you? Just curious. Actually, I was checking the archives to see if you commented on a Consumer Reports article on the use of anti-psychotics in treating schizophrenia and bipolar disorder
http://www.crbestbuydrugs.org/PDFs/AntipsychoticsFINAL.pdf

I was unaware that CR reviewed prescription meds. For people looking for some good info that is less-medical-ese (sp?), this is a decent article which states that there was not enough evidence to recommend any AP or older class anti-psychotics for the treatment of bipolar order.

Posted by: booknan at October 3, 2007 12:27 PM

Hello,
First, I want to thank Philip for this, I'm actually speechless. I have fought long and hard, and never in my right mind did I think I was someone like he describes. I just do what I need to do, and am humbled by this post, beyond words.

Thank you to everyone voicing concern about my daughter.

Today, after a very long and early morning--found out that Western State Hospital is in fact about 10 days away.

Thank you my friends, there are no other alternatives for long-term care and that is what needs to change.

I'm not giving up.

Posted by: Stephany at October 3, 2007 03:28 PM

I'm going to put this out there right now.She needs an exception to the "rules" and needs to go to the teen age appropriate setting, if she goes anywhere mandated by the state, it is the CLIP facility that Jack McClellan knows of---she needs a place to be free most of all, and one thing imperative for all to know is Western State Hospital is the ONLY long-term care facility available in western washington, and is a dumping ground for elderly patients, TBI patients, and worst of all young hearts like my daughter. There must be a change, and it means starting with housing. Housing that is not a homeless shelter/home/ or Western State. I walked the ground of Western State, Ive seen it. Lived it. It's brutal and and complete and total insult to the phrase "long term care." that in itself is bullshit. Everyone in the mental health system knows it. I will leave it at that for now. BECAUSE she was released due to sexual assault, and my letter to the Governor, I am expecting my daughter to receive better care than she did the first time, because Governor---you haven't done a damn thing to change what I saw 2 years ago.

FUNDING. With my daughter at my side, I can promise changes and I mean NOW.

Get ready, because I'm back---that CEO parking place? My name is on it--like it was in March 2006. Want to get rid of me? then find my daughter a place to live, that YOU can sleep at night as if she was your own.

See you in court.

Posted by: Stephany at October 3, 2007 04:19 PM

I have to say one more thing, re: the McManamy issue. When a person advocates in an arena that I exist, this is when I focus, straight forward. I've been attacked-oh by far worse. The very people w/in the system.Hell, as she was called the most psychotic person ever to be in the U of Wa ER--the social worker berated me in public telling me I was a bad mother who stops treatment.

Ive walked alone for a long time, and I will continue to walk regardless of arrogant/ignorant commentary by a person who knows nothing of my life, and has never walked into mental health court in his tennis shoes demanding to approach the bench. It's okay, live and learn.

I will leave it at that.

Posted by: Steph at October 3, 2007 04:51 PM

I was really disgusted with McManamy's response to Stephany. I don't know how anyone can read Stephany's story and not feel the agony of her struggle to find decent, compassionate care for her daughter. Shame on you, Mr. McManamy.

The bottom line is people who have been harmed have every right to be angry. I have every right to be angry about the care I received, and I offer no apology for the way I feel.

Posted by: Lisa at October 3, 2007 07:54 PM

I have seen friends hurt and their lives put on serious hold because of careless presriptions, especially by GPs who dished out Paxil like it was so much candy. You betcha consumers have a right to be mad.

Stephany, I'm sending you strength.

Posted by: flower girl at October 3, 2007 11:21 PM

Thank you for good wishes and strength everyone; today I was able to push back the state hospital.I'm still in the fight.

Posted by: Stephany at October 4, 2007 04:57 PM

Being that this comment thread is still continuing at bipolar connect, I added this comment there today, as a result of once again seeing McManamy cast commentary on media and bloggers re: respecting parents. This issue reaches so much further than picking apart the Katie Couric interview. Quite possibly people do not understand that people and children ARE in fact misdiagnosed and medicated for no reason. I personally do not care what another parent does. I'm trying to tell my daughter's story, for that one parent who might question the diagnoses. Like I did. It's a living hell I've been in for 8 years, read all the books, have had countless times I've saved my daughter's life from side effects to dangerous car jumping attempts...you name it, been there done that.
~
The Mother in Jail in my opinion is what people do not seem to be alarmed about--everyone has an opinion about Katie Couric and the interview--I'm more alarmed the parent is charged with murder, via medications prescribed by a psychiatrist. What was also left out of the interview, if one wants more dimension to it --is the Child protective services part of the story. Many people dropped the ball w/ regard to Rebecca Riley, and I find it appalling that the mother sits in jail as a result. Accountability is needed in many areas. I truly hope another tragic case like Rebecca's never ends up on any talk show. Because that means not one more child dies from medications prescribed for adults. My daughter saw 9 psychiatrists--and in McManamy's first comment he left to me here, asked why "the idiot" psych or myself or daughter wasnt on 60 minutes. Well, there would have been a panel of 9 psychiatrists, one neuro-doc, me and an interview from a locked down psych ward from my daughter, if she could talk or understand what was happening. What if her "idiot" psychiatrist was Biederman? Did you ever wonder who her psychiatrists are/have been? You[McManamy] might not want to cast stones so quickly if you did.
Maybe the bipolar connect site could start a fund for the parents to make bail.

Posted by: Stephany at October 7, 2007 02:11 PM

Thanks for this information about Bipolar disorder and depression.

Posted by: Sue at October 21, 2007 09:02 PM

October 23 is the big court date, that could possibly determine my daughter's outcome.Unless I can keep moving that damn mountain, I dare say I hate this system.

Posted by: Stephany at October 22, 2007 01:29 AM

As of October 29, my daughter was discharged from the inpatient psych hospital to a group home, that gives her the freedom she deserves. We won the court battle, and she is not residing in Western State Hospital.

Posted by: Stephany at October 31, 2007 01:27 PM
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