Questioning the Bipolar Child Conundrum

No doubt, you saw this weekend's Sunday The New York Times magazine cover story headlined “The Bipolar Kid” or "The Bipolar Puzzle" – take your pick.

I read it on Saturday night online and then cringed when I saw it on Sunday morning, in print. Years ago, I interviewed Dr. Harold S. Koplewicz, director and founder of the New York University Child Study Center. He edited a breathtakingly beautiful and touching art book, titled Childhood Revealed, Art Expressing Pain, Discovery & Hope (New York University, 1999).

Why don’t art directors do their homework? Look to children’s art to illustrate stories about their inner feelings and difficult behaviours, instead of the hideous imagery featured in this story. Interestingly, in the Koplewicz book, bipolar disorder is not mentioned.

There are chapters on Depression, Eating Disorders, Anxiety Disorder, Psychosis, Attention Deficit Hyperactivity Disorder, Learning Differences, Pervasive Developmental Disorder and Autism, Post-Traumatic Stress Disorder, Abuse, Divorce and Children and Physical Illness.

Each chapter features art by children who have been diagnosed with these conditions. The commentary is sensitive, humane and thoughtful and the art is used as a clue as to what is bothering the child. It’s the key to their behaviour, their pain, their perceptions of the world, the feelings they may not be able to express in words.

Curiously. There is no chapter on Bipolar Disorder. The Bipolar Kid hadn't yet been invented.

Back in the late 1990s, no one believed that children could develop Bipolar Disorders. These conditions usually surfaced in people in their late teens or early 20s. Childhood bipolar disorder hadn’t yet been documented or discovered. 

Drug companies weren't manufacturing and marketing psychotropic drugs by the dozens for every possible emotional problem under the sun, and psychiatrists weren’t shovelling pills into kids like they do today, either.

Other forms of therapy were used. Art Therapy, Music Therapy, Play Therapy. Ah, but who has time for that, when you can just pop a pill – or six.

Back then, the world was a different place and psychiatry-by-prescription wasn’t the standard therapy it is today, for adults or children.

I found Jennifer Egan’s story troubling.  Philip Dawdy gives an excellent 12-point analysis of the problems with the piece.

In my favourite, number 5, he observes that "the boy who opens the story, James, is 10-years-old and to me appears to be desperate for a place to put all his aggravation and impulses. What's remarkable to me is that there's no indication in the article of whether or not his parents had tried to stick him into sports of any kind. That's just odd. I'll go out on a limb here: I think kids like James should be forced to play football or hockey or learn how to box--some kind of intense contact sport--as part of their treatment plan."

Dawdy, who has a bipolar diagnosis himself, but no longer uses any medication at all, closely follows the ongoing controversy raging about whether bipolar disorders do exist in children, the psychiatrists who promote this notion and the drugs use to treat these kids, and the ethical troubles some of them have been getting into with the FDA. You should have a look at his critique.

As far as I’m concerned, parents should avoid having their children diagnosed with mental disorders and medicated for them, if possible. Keep their kids out of the mental health system and find other approaches for support.

It’s not healthy for the psyche of any child to be put into the mental health system. Who wants to be considered to have a "disability" of any kind. There's too much ignorance, fear, discrimination and prejudice around mental health issues, today. Kids don’t function well when their labelled in a way that makes them feel different. It makes them feel insecure. They feel deeply that there’s something intrinsically wrong with them. Those feelings run deep and last long. I don't know if they ever go away.

Who’s benefitting? The child? The parents? The teachers? I wonder.

I lost my kidney function and my physical health to Lithium, but the emotional damage was far worse. I am deeply insecure on some levels because of my 48-year-history of dealing with the diagnoses of several mental illnesses. It’s inevitable. It's also a bit of a Catch-22. I’m well adjusted to it, but still, the label did its dirty work.

People working in the Recovery movement constantly say much of their work with psychiatric survivors involves helping them recover from being labelled.

Sometimes, I wonder what would have happened to me if I hadn’t been sent to a psychiatrist at 12. But that’s fruitless. You can’t turn back the clock.

NOTE: In yesterday's New York Times, Benedict Carey reported the results of a new U.S. government study showing that many of the newer antipsychotic drugs used to treat children with schizophrenia – the same drugs mentioned in the Sunday Magazine story, Zyprexa and Risperdal, to treat children diagnosed with bipolar disorder – are no more effective than the older, and possibly safer, antipsychotics. One of the most serious side effects of the new drugs, serious weight gain, puts children (and adults) at risk of developing diabetes. "Half the children in the study stopped taking their drug within two months, either because it had no effect or was causing serious side effects, like rapid weight gain," Carey wrote. "As much as 15 pounds or more in eight weeks," according to one of the co-authors of the study.

When will this madness end?

Comments

[EA]

I lived my whole childhood in misery, making my first suicide attempt in the 4th grade. I was always crippled by my emotional problems. When I was fifteen I was hospitalized, and the doctors said there was nothing medicine could do for my problems. I was released and given antidepressant...which in less than a week I swallowed all of them in attempt to kill myself. I never went back on medication, and lived miserably until last year when I was again hospitalized. This time I was diagnosed as Bipolar I. I am on Seroquel, and it makes living every day bearable, keeps me from going into insomiac mania, and also helps me with my depression times. I know I've been suffering from this same demon my whole life, finally now I get some relief, and perhaps could have had a better time of it growing up if I could have been diagnosed and treated from childhood. I'm lucky I lived long enough to get treated! Say what you want about diagnosing Bipolar children, but I was one who is now adult. My symptoms have never changed and have been the same the whole time--fyi for anyone who is researching this subject. It's easy for you to form your opinion, but obviously you know nothing of the suffering a Bipolar child goes through. There ARE bipolar children, and just because science only recently advanced enough to recognize this doesn't mean we should crawl back into the cracks we were languishing in unnoticed and untreated.

[Merely Me]

I came over from Phillip's blog. I have mixed feelings on this issue which would take an entire post to relate. You have a great site and very thought provoking posts. I will definitely have to come back to read more of you.

[Ana]

Hi Sandy!
I came from Susan's and I'm always commenting in Philips's Furious Seasons.
I'm very touched by EA's comment but when he claims:
" There ARE bipolar children, and just because science only recently advanced enough to recognize this doesn't mean we should crawl back into the cracks we were languishing in unnoticed and untreated."
I cannot sympathize.
If science had advanced on what the brain and diagnosis is concerned I'm sure we were not having this discussion.
Nothing is known about the brain and treatments are being made on hypothesis and diagnosis on lists of symptoms.
I would also would have to write an entire post on this.
Good to know your blog Sandy.
Yes! We cannot turn back the clock. Me too would have done some things different.
But we are fine. Let's just try to prevent other people wanting to go back in time.
Yours truly,
Ana

[susan]

Hey Ana! Glad you found Sandy's site!