Furious Seasons

November 06, 2007

Overmedicated Kids And The Bipolar Child In The LA Times

Well, well, the Los Angeles Times finally comes very late to the game--about 9 months after the New York Times, Boston Globe and the St. Petersburg Times (and two years after me)--to take up the question of the overmedicating and overdiagnosing of children and the bipolar child paradigm. It's a very long article, which I cannot even begin to summarize here except to say that I think the reporter did a good job and I am pleased to see the Times get off its long-held "medication for all psychological problems" kick. (I've excoriated the paper before here.)

The unnamed parent with a bipolar tween interviewed by the paper strikes me as intelligently giving voice to many of the quandaries around the bipolar child paradigm, such as:

"'I don't want to face her as an adult and say I didn't do everything I could to make her well. I feel like I'm answering to her future self,' Katie says. 'But so much of this is a crapshoot. No one wants to feel that their child is a guinea pig.'"

Having been an adult guinea pig, I feel her pain (which I've written about here).

The article also does a good job of getting at the question of whether we are creating lifelong patients and lifelong pharmaceutical junkies, as well as whether we have lost our tolerance in American culture for a bit of oddness among our youth.

"The trend, say these critics, threatens to turn kids like Katie's daughter--a preteen whose behavior is certainly odd but whose school life remains on track--into potentially lifelong patients.
"And, they add, it has changed the way Americans think about children. Critics warn that as psychiatric diagnosis and medication of children becomes more widespread, teachers, well-meaning neighbors and relatives, and parents themselves are becoming less willing to accept youthful misfits for who they are and to help them adapt without prescribing drugs or attaching labels.

"'We are suffering . . . from a shrinking tolerance for the broad limits of normality,' says. Dr. Stanley Turecki, author of "The Difficult Child" and a practicing psychiatrist in New York and Massachusetts."

In fact, the reporter put something so brilliantly that I wished I had written it myself, so I'll repeat it: "Critics warn that as psychiatric diagnosis and medication of children becomes more widespread, teachers, well-meaning neighbors and relatives, and parents themselves are becoming less willing to accept youthful misfits for who they are and to help them adapt without prescribing drugs or attaching labels."

That is a vastly important point, one with implications for decades to come much less the here and now. One day a couple of years ago, I was having lunch with my friend and mentor Adam Hochschild (he was a prof of mine at Cal) and he asked me what was my central frustration with the mental health paradigm in America, aside from the fact that it doesn't work very well.

"We have lost our ability to accept that it's OK for people to be fucked-up and a little bit weird," I told him. "I think that's bad for us as a culture and as a people."

He agreed with me.

Posted by Philip Dawdy at November 6, 2007 12:03 AM

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Comments

This is an excellent post! and opens the discussion to the words "quirky" or "lives life to the beat of their own drum". "Happy-go-lucky". I'd rather know/see people like that then drugged up without their personalities!

Posted by: Stephany at November 6, 2007 06:44 AM

Medicating a growing and changing brain in kids is risky in my opinion, and this article discusses kids' behaviors that are explained via natural brain growth.

Scientists say teen brain is still maturing, key to understanding behavior.

From the article:

"Experts say that even at ages 16 and 17, when compared to adults, juveniles on average are more:

- impulsive.

- aggressive.

- emotionally volatile.

- likely to take risks.

- reactive to stress.

- vulnerable to peer pressure.

- prone to focus on and overestimate short-term payoffs and underplay longer-term consequences of what they do.

- likely to overlook alternative courses of action.

Violence toward others also tends to peak in adolescent years, says psychiatrist Dr. Peter Ash of Emory University. It's mostly likely to start around age 16, and people who haven't committed a violent crime by age 19 only rarely start doing it later, he said."

Parents wanting to medicate mood, aggression? think about developmental stages such as walking, and talking--teen behavior is a natural progression toward adulthood, that shouldn't be medicated unless severe illness warrants. Just my opinion.

Posted by: Stephany at December 3, 2007 11:26 AM

you are sad, yes it IS over-diagnosed but there are those youth who DO have it.
Should we NOT medicate them and just let them kill themselves and take others with them?
(think COLUMBINE, think VIRGINIA TECH... you get my point)
You do a diservice to the mental health community by trying to invalidate the seriousness of this disease.

Posted by: momofbipolar at November 25, 2008 05:53 AM

momofbipolar,

Poor examples. Eric Harris, one of the Columbine killers, was on Luvox.

And there are reports that the Virginia Tech killer was on an SSRI. Unfortunately, if I remember correctly and I don't swear I do, my wonderful state will not release the information. Someone please correct me if I am wrong.

I want to qualify what I say by mentioning I don't think the drugs are the total story in both cases. But they are not best examples as I feel that while the drugs aren't the whole issue, they sure didn't help either as one who has reacted quite violently to SSRIS.

In Cho's case, I feel that his family denying what I feel were his problems with autism or AS and having the public school system totally misdiagnose him as mute, led to alot of frustration and outrage. Even though I never wanted to be criminal thank god, I can relate as someone who grew up with an undiagnosed LD.

When you have what is a neurological disability being misrepresented, believe me, it is quite depressing.

By the way, Philip has posted information on this site saying that the statistic rates for alleged bipolar suicidality are questionable. I have also not heard of situations where people who commit suicide due to bipolar disorder kill other people as well. Isn't that kind of stigmitizing folks? Not that suicide is great mind you but just saying.

Personally, I believe BP is legitimate. But when you overdiagnose it like Biederman and his friends have, that is how you invalidate the seriousness of it. And I say that as one who feels my type of LD which is a non verbal learning disability is way overdiagnosed which I never thought in a million years would happen.

Posted by: aa at November 25, 2008 10:07 AM