Good breakdown of the article Philip, but then you're a journalist who writes frequently on mental health issues and has as well had your own experiences with the mental health system. Do you think it is odd that this article was written by a novelist with, as far as I can tell, no training as a journalist and no special knowledge of psychiatry or psychology beyond the most superficial Oprah, Dr. Phil, pop psychology hoopla who normally writes things like celebrity profiles of Madonna for GQ?

The article notably wasn't written by a health writer, highly regarded in his field who is able to write critically of psychiatry and medications but is still firmly in the mainstream such as Benedict Carey, a New York Times reporter many readers of this blog are likely familiar with. Notably, Mr. Carey has an article in the New York Times today entitled "Risks Found for Youths in New Antipsychotics" http://www.nytimes.com/2008/09/15/health/research/15drug.html?ref=health

As I read the New York Times on the internet these days, I'm not sure but I suspect that Mr. Carey's rather scientific, documented article is much less likely to be read, buried in the paper, than the superficial piece of unscientific fluff that is Ms. Egan's article which was the cover story of the Sunday New York Times Magazine. Troubling.

I will end by pointing out this horrifying and bizarrely unscientific bit from Egan's article, a theory that pretty much contradicts much of basic evolutionary theory (that so many folks used believe back in the days before Sarah Palin, apparently evolution is now defunct). Still here's the bit that troubles me: "One intriguing hypothesis involves a genetic phenomenon known as “anticipation,” in which genes become more concentrated over generations, bringing a stronger form and earlier onset of an illness with each successive generation. Another theory is “assortative mating,” in which a more mobile and fluid society, like ours, enables the coupling of people whose mutual attraction might be partly due to a shared genetic disposition to something like bipolar disorder, thus concentrating the genetic load in their offspring.

Given these uncertainties, http://www.nytimes.com/2008/09/14/magazine/14bipolar-t.html?pagewanted=4"

One might counter that natural selection might indicate that if there is a higher incidence of people who have say sub threshold bipolar disorder, it's because society desperately needs to change, or even be troubled by the eugenic implications of that theory, nah, that was back in the bad old days of science.

I was struck by "the author almost always front loads an article with what they consider to be the truth, or at least the most plausible version of reality"

This is very true. The classic form of newspaper journalism is the inverted triangle, in which you dispense the most salient (to your point) information first, knowing that many (most?) readers will tune out before getting anywhere near the end. Editors often "edit" by simply lopping off the end paragraphs. So yes, usually dissenting (from the author's) point of view don't appear in the first third to two thirds of any article. Placement is everything. The author maintains a false innocence by placing unwelcome facts nearer the end of an article.

I'm so glad my journalist father taught me how to read a newspaper. It's what's not published and where it's positioned that matters.

If you are a Digg member, please digg it.

What chance do you suppose there would be for a long article like this to be published in the Times or Newsweek if that article took a seriously critical stance vis a vis pediatric bipolar disorder? My guess is that chance is so small as to be zero because what we are seeing is the dominant paradigm and anything in opposition is ignored.

I have heard both the assortitive mating and next-generation-earlier bipolar arguments countless times. Imagined by paarents being attracted partly because of that. Thought of my father's one psychotic episode at age thirty two and my children's onset of manic depression each at age 20. Though I do not believe either of these theories has been nailed down in respected journals, you know what?

THEY HAVE NOTHING WHATSOEVER to do with the pediatric bipolar quackery. Those who are pushing this (and pushing drugs) are hanging on to any possible thread in order to prove their case. As they load children up on lethal drugs and take their money to the bank, I hope they will know that they have already done a BAD JOB with adults who have this condition for real, and try dealing successfully with that instead.

The stories of these families were heartbreaking to read. Whatever the cause life in these households is miserable. It seems like pills is a pretty narrow place to start. What about dietary changes? Or alternative therapies like acupuncture or has anyone else heard of the acupressure technique called EFT (Emotional Freedomg Technique)?

I have firsthand experience with some of the medications mentioned in the article and they are frightening and powerful. As an adult it was scary and overwhelming enough to go through side-effects and ultimately a medication-induced manic episode and breakdown. I can't imagine being a child and having to go through it.

Do these pills ever really work for people long-term? It seems like they work for a while and then just shit the bed and so then it's switching and more switching and more switching. How much can the brain handle? Especially the brain of a child.

If you want to know how a child's growing brain and body is as a result of these meds watch the PBS Frontline "Medicated Child" program free online.

You'll see enough involuntary head movements and pain and suffering to wonder why these drugs (mainly antipyschotics now) are being fed to children, without long term studies.

Again I say, as a repeat record: my daughter is a 9 year study and the end result is devastation. She's alive, and that's where I have to begin each day now.

In 1999 when a psychiatrist told her she was "lucky to be born when you were so that Zyprexa could be here to help you" ....if she could talk about it now, (she's nonverbal)I'm sure she'd have a lot to say about those 100 lbs and mis diagnoses.

Oh well, it's a Biederman slide into homebase w the NY Times, and America will be shocked when they have entire families being medicated for Pediatric bipolar, MDD and anxiety all ages, and all on Abilify, Seroquel for starters.

I fear for those people and kids, too bad I can't send in a vid of my daughter before and after and current.

Now this is a good, no, make that great posting, and it exemplifies your work. Thanks for Comment 1 being just that: the role of therapy for kids as much as adults has to be noted and sold.

I hope this thread does not get twisted.

Enough adults are over-diagnosed with bipolar these days that we certainly do not need to add children to the numbers.

It is the diagnosis de jour, it seems.

What about the relationship between No Child Left Behind and the rise of mood disorders in children?

Our children are bored (they play very complicated video games and watch complex narratives on tv - and yet, are still being taught using 19th century colonial teaching methods), stressed beyond belief (NCLB, metal detectors in the schools, no recess, and tests tests and more tests) and aren't being to taught to recognize and manage their own emotions.

Little wonder they are distraught.

Also, you mostly covered this in 12, but Egan is completely misses the circular logic of her own story. Parents w/ Bipolar increase the diagnosis of their kids w/ BP, but adults are being /retroactively/ diagnosed! What a racket.

Finally, the attitude exemplified by Liebenluft -
“People do the research and gradually, the data speak.” is fraught with problems. Data doesn't speak for itself. Its infused and inflected with value judgements throughout its life. That's an issue with his perspective, not the reporting, but still.

Great rundown,
cheers

Do any of you have a child with mental health issues? In fact, do those of you who are commenting even have children? My son's been in therapy for 2 years. I've taken parenting classes because I thought it may be me. My son is in sports...so you can't pound me like you did the other parents about getting the kid into sports. I refused meds for my son for a year and half. We started meds 7 months ago and I stand by my decision. My son is doing fantastic now. No bad side effects from meds either. I've been studying both adult and Pediatric Bipolar for 3 years. It is not something I took lightly. I had to be convinced. And I AM convinced that Childhood Bipolar exists.

My mother was treated for bipolar (called manic depression then) in the 60's & 70's. In & out of mental institutions after suicide attempts, threats to kill us (her 4 children), very bizarre & abusive behavior (she was delusional). She was treated with medications, ECT's & a lobotomy was even being considered before she successfully committed suicide after many attempts.

I do believe there is a strong genetic component & ,of course, being raised in such a chaotic environment (with an alcoholic father, too) there is the added environmental influence but I had my first suicide attempt at 15 & began to have delusional thinking (paranoid thoughts).

It wasn't until I was put on the new anti-psychotics Abilify & Lamictal about 10 years ago that these delusional thoughts left me & I began to employ the tools I was learning in therapy (Dialectical Behavioral Therapy) plus individual therapy. Before these medications I could not dispel those thoughts. They were REAL to me. The therapist, the psychiatrist, my husband, no one could convince me that they were not real.

I could not believe how wonderful it felt to be free of those disturbing & sometimes paralyzing thoughts. I wondered : Is this how everyone else feels? It was incredible. I was afraid it would go away. I felt so free.

I still have a long way to go retrain my thinking process as I am a very fearful & negative person due to childhood experiences, but now I am able to take steps in a positive direction. Before the new medication I was making no progress & I was in therapy for years (& had been on numerous other meds).

I have 2 children (one born 2 1/2 mos. premature due to my smoking & drinking while pregnant--abusing alcohol is very common in untreated or incorrectly treated people with bipolar). Both of them had bouts with depression in their early 20’s where they had to be on anti-depressants & in therapy, but after one year they were able to get off medication & do well--completing college & graduate school & going on to successful careers & personal lives.

My daughter's depression has returned periodically, but she has not chosen to take medication again due to fear of stigma (she is in the law profession). My son has never had the depression return. My daughter has made the decision to not have children so as not to pass on these genes; my son has not expressed an opinion to me on this issue.

As far as people with bipolar seeking out others with the disorder consciously or unconsciously to mate with, I think that is highly unlikely. And if you are dating or thinking of getting into a relationship with someone with the disorder, I would not recommend it. Even with treatment, it is never "cured" & in many, if not most cases, relapse is possible & medications may have to be adjusted. Stress, sleep deprivation, many factors can "trigger" a cycling of mood even if one has been stable for years & is medication compliant much as can happen to a diabetic. Careful monitoring of the mood must take place as the diabetic monitors his blood sugar.

I think it's really sad that people are choosing not to have children to avoid creating human beings that they think would have genes for mental illness. A lot of people assume (and biopsych pushes it hard) that if something seems to run in families, ipso facto it must be genetic / "have a genetic component." But lots of things run in families without being genetic, and so far there is no credible scientific evidence that any 'mental illnesses' are genetically presupposed.

Forget forced sterilization; what we have now is eugenics through propaganda.

S.G.

It's so sad to see a post like yours. Your mother was apparently brutalized by psychiatry. Who wouldn't have delusions after years of "talk therapy," drugs, est and imprisonment. And what else would she learn but to teach you to behave like her, and what else could you do but copy her, your role model? If only someone had provided her with empathy and support. Seeing the injustice and suffering in this world is a wonderful and courageous thing. The tragedy is when sensitivity and compassion are labeled illness and honest grief distorted into illness by psychiatry. Your low self esteem is sad to see but I applaud your courage in reaching out here. Your unhappiness is valid. Turning it inward is wrong. There's no such thing as a chemical imbalance in your brain. I hope you come to realize this. Thanks for your comments. (I know FP, I hear your ilk labeling me as patronizing, but still you gotta see my point - this poor soul is posting about being unworthy to mate with while reporting a suicided mother - gotta love a "helping" industry that put her there)

All I can say after reading S.G.'s painful sharing and then Sally's "comment", is what the hell is wrong with you, Sally, to accuse people like S.G. and me to write such alleged negative things, and then you abuse us with your tripe?

Believe me when I say this to you Sally, again, you say you have no regard for me or my profession, PLEASE, never go to a mental health care clinician, if I may speak for the field at large.

S.G.: thank you for sharing, and I agree with what you have said overall. You have your experience, and it is valid, as you wrote. Don't let anyone else invalidate it just because they didn't have it. That is why I enjoy psychiatry, because it is about individuals and the beauty of the grayness to experience. Every shade has it's own unique quality. AMEN!

This commentary site is black and white; ironic, as I type it, eh?

"When you are out and you realize that a storm is forming around you, do you wonder if you'll be hit by lightning?"

First of all, I do not find any of the posts (so far!) hurtful or patronizing. I just think people are expressing their differences of opinion & it seems to me in a much more respectful way than you can find in most places on-line so thanks for that!

But I think I may not have expressed myself very clearly in that my mother had symptoms of mental illness BEFORE she had any psychiatric treatment. Her first symptom was when she called my father at work one day out of the blue (I was 3 & I learned this years later; I never knew her "well") & told him she was going to kill the children & then kill herself. He called the police & rushed home. That started the whole ordeal. She was psychotic & thought we were tainted with the devil's blood. She had religious delusions.

People rarely go to psychiatrists or go on psych meds if they don't have any problems in the mental health arena! I wouldn't go on meds if I were feeling fine & were not having suicide attempts & paranoia & having difficulty functioning. I knew I was not feeling & thinking like the rest of the people around me. I think I was one of the lucky ones in that I KNEW something was wrong with me. I wanted to get help. I didn't want to end up like my mother.

Do I want to be on these meds? No. Do they scare me? Yes. But suicide attempts & irrational thoughts & deep depression & no joy are no way to live. Believe me. If you have not experienced it, please don't judge me for not wanting to go back to living like that.

UndertheThresher,

You make good points, eugenics through propaganda is what we seem to have even with folks like S.G. who has raise apparently happy healthy thriving children while battling stigma which argues against the eugenic biopsych message. The idea of advising people labeled bipolar to avoid relationships saddens me. This story which argues that parents who have no "genetic" mental illness produce children with such an illness also seems to argue against this idea. The idea that some people are just born bad is patently immoral.

Ugh, I MUST really be bad at expressing myself. NO ONE told me or my daughter to not have children due to the genetic aspect of bipolar disorder (which I gather--astute me--many of you don't think is scientific). My daughter simply has had struggles with depression (severe enough to have to take a medical leave from univ. her 2nd semester of jr. yr.) & has witnessed my difficulties (to put it mildly) raising children while I was having such intense internal mental disarray (don't want to call it mental illness--what then?).

She has seen the struggles I have had to get to try to parent & get to an even keel. She is a professional (law prof) & knows that being a mother is a huge commitment & if one is struggling with internal issues oneself, is it fair to bring a child into that situation?? Was it fair for me to be brought up in the situation I was? Was it fair for her? Isn't she making an informed decision? I think she is. She is looking at her life, her capabilities & the consequences for the child.

I think she is being a caring individual, not a brainwashed person.

S.G., thanks for the clarification. I just picked up where you said you "you believe there is a strong genetic component" and your daughter "made the decision... so as not to pass on these genes". Sadly, there are people out there who decide to forgo having kids based on some jello-shaky claims. (Though now with the depacote messing up the women and the paxil messing up the men, a lot of people will be spared such difficult decisions.)

I'm glad to hear the both you and your daughter are making thoughtful (and non-brainwashed) decisions, and I hope people tell you on a regular basis that raising two successful kids is no mean feat, even more so for anyone who themselves came from a really messed-up home environment.

You may be right that people "rarely" see psychiatrists or take the drugs if they don't have mental-health problems. Just don't forget the rare people, like me, who never wanted anything to do with psychiatry but found ourselves on the wrong end of a whole lot of coercion and force.

I can certainly understand not liking the drugs, and not wanting to be on them, but taking them anyway because life without them is even worse. I think you'll find this to be the majority view here at the Furious Season comment section, regardless of what the extremists and the haters would have us believe.

No one has posted here for a while, so maybe no one will see this, but I feel a need to comment on some of the themes here.

My son was recently diagnosed with Bipolar Disorder and ADHD. He's 7. It's been clear that something is wrong for some time. He's not "normal" - whatever that is. His mood swings can be quite severe - from happy to violent "on a dime." He could not concentrate, make friends, or participate in sports. Yes, he tried. He couldn't understand the rules or the meaning of teamwork. He would hurt kids without knowing he was hurting them. And by the way, he has a higher than average IQ.

I am a single mother. I make a below-average to average income. Thank God I have health insurance. He doesn't have a dad - I adopted as a single mother. I have had him since birth, and have very little family history on him. So I had no pre-conceived belief that he would have BPD or ADHD. Nor do I have a ton of money to "waste" on neuro-psych testing.

He had extensive neuro-psych testing. He tested positive for ALL BPD points (not just a handful). He has a psychiatrist, a cognitive behaviorist and a play therapist/psychotherapist.

We have NOT started him on BPD meds, because of the latest information linking Claritin with BP symptoms. We have to wait until after allergy season is over and he is off Claritin (he also has allergy-induced asthma).

We HAVE started him on ADHD medication, and it is a world of difference. He can concentrate at school. He can participate in non-team sports (and hopefully start team sports in the spring). He DOES take lessons for swimming, skating, karate and gymnastics.

He has an excellent team of doctors/therapists, combined with a fantastic school administration. We are very lucky.

He still exhibits BPD symptoms, but all are in agreement that we will not start BP meds until we are sure there is no Claritin left in his system. Then we may have additional neuro-psych testing to see if the diagnosis should be changed.

ALL are in agreement that the best approach is structured physical and mental activity, combined with therapy that emphasizes behavior modification and coping techniques to get his aggression and anger under control.

ALL are in agreement that he cannot use either diagnosis as an excuse to not try his best at all times.

And, by the way, ALL are in agreement that BPD is overdiagnosed in children, but still think he has it.

I just had to say all this to those of you who SEEM to think that the only people whose children receive this diagnosis are wealthy people with bratty kids. And to those of you who think that all psychiatrists are hot to push medication as the only answer (his is quite clear that medication is useless without therapy). And to those of you who think that all therapists are idiots who don't know what they are doing.

i think it called transcranical magnetic stimulation by emotion system in between occipital and behavioral like " face and voice "

SingleMom: My heart goes out to you. Your son has been blessed to have you go to such lengths to help him. I needed help as a teen & didn't receive it. My parents were "otherwise occupied" (with alcohol issues & my mother's bipolar) & did not tend to us children so I'm jealous!!

I hope YOU get some support as well, though. Maybe look into NAMI (National Alliance on Mental Illness) Family-to-Family class or a support group. You have faced a lot of trauma in this yourself. Take care.--S.G.