Bipolar Disorder: A Family Secret

Hannah Tennant-Moore — Sat, 13 Sep 2008 20:55:00 GMT

What would you do if your 10-year-old daughter said to you, “I can’t take it anymore. I don’t want to be me. I don’t want to feel anymore. Why aren’t you doing anything about this?” Or if your normally loving son threatened to slit you open with a knife? Naturally, you would want to do anything in your power to make your children better, but what if that meant giving your six-year-old lithium? Or sending your 10-year-old away to a therapeutic residential school?

In deference to the many parents who face these challenges day after day, I highly recommend Jennifer Egan’s piece on bipolar disorder in children. She traces several families’ struggles to cope with children who rage against the world from the time that they can talk, and offers a comprehensive portrait of the uncertainties surrounding bipolar diagnoses in kids.

Until relatively recently, it was believed that bipolar disorder only affected adults. Now nearly all leading child psychiatry experts agree that children can suffer from the disease—but they mostly all disagree about how to diagnose childhood bipolar disorder. Most experts believe that it is over-diagnosed, in part because managed care usually only pays for one brief psychiatric evaluation a year and because of the highly questionable yet widely popular book The Bipolar Child.

Diagnosing mental health problems in children is further complicated by the fact that many of the symptoms of bipolar disorder overlap with the symptoms of ADHD (Attention Deficit Hyperactivity Disorder). And mania is not as clear-cut in children as in it adults--it's often normal for children to act grandiose or have terrible temper tantrums.

James, one of the kids Egan writes about, was diagnosed with ADHD, OHD (Oppositional Defiant Disorder), and bipolar disorder by the time he was eight. With so much uncertainty about the disease, even parents whose children have seemingly clear-cut episodes of mania—stealing strangers’ cell phones or wearing outlandish clothing—followed by clear episodes of depression remain uncertain about their children’s treatment.

Once a child is diagnosed with bipolar disorder, he and she is prescribed strong medication with harsh side effects. Making the decision to give such drugs to kids is a huge weight of responsibility on a parent’s shoulder—and this decision requires trusting a doctor whose personal biases will inevitably influence her diagnosis and prescribed treatment.

At the very least, I hope that Egan's article will bring greater awareness to this issue. As one of the mothers interviewed said of her son's horrible temper tantrums, "It's like a dirty little secret. It's like having a husband who beats you, only it's a kid. It's your own."

Image: New York Times

Botox Kills Kids

Kelly Mills — Mon, 11 Feb 2008 12:40:00 GMT

Yes, it clears up those frown lines for a while, but could there be a darker side of Botox, aside even from the weird face paralysis and all that? In a word, yes. In fact, four children using Botox or a related drug have died, and there have been at least 180 documented cases of serious side effects in kids and adults, including severe difficulty breathing and swallowing, which can lead to a kind of pneumonia. One drug watchdog group wants a more serious FDA warning issued for Botox, as well as providing physicians with guides to give to all patients warning of the problems associated with the drug.

Now the children who died were not concerned with the ravages of time, but were using the drug for an "off-label" use, the treatment of muscle spasticity associated with cerebral palsy. Off-label uses for drugs are not uncommon. However, I have a funny feeling that even if cosmetic-use patients are given detailed information about the cases of side effects and death, it won't deter many of them from going forward with the pursuit of a more youthful look...

Strollerderby : side effects

Bipolar Disorder: A Family Secret

Botox Kills Kids