The bipolar child: myth or reality? MARCH 29, 2007 I’ve been fairly candid about my opinion of the increase in bipolar diagnosis: It’s bunkum. The more something gets into the public consciousness, the more people report it. It’s a zeitgeist contagion, and even I’m not immune.
Last night, I was talking to a mental health activist at the University of Pennsylvania. She said she always thought Sylvia Plath (pictured) was schizophrenic, but learned at a Mental Health Awareness Week Quizo (brilliant idea, BTW) that Plath was actually depressed. “Well,” I said, “today she’d probably be diagnosed as bipolar.”
Then I thought about it: Why did I say that? Nothing in Plath’s chronicle of her struggle or her history suggests bipolar disorder; I said it because it has become a reflex. It’s almost as though people are questioning the very existence of clinical depression. I’d hate for people to think, “Have I ever been in a good mood? I guess I’m bipolar!” And the increase in diagnosis among clinicians has more to do with big pharma than observable patterns of behavior (she said cynically).
In the recent past this flurry of bipolar enthusiasm has garnered media attention, due, in part, to the case of Rebecca Riley the little girl who was diagnosed with BP at age 2, and who died of an overdose of her psych meds. Her story is horrifying. I am completely opposed to using multiple psych meds in small children, and I’m extremely wary of attributing a 2-year-old’s behavior to a complex (and not fully understood) disorder like bipolar. Okay, I’m being cagey in case a p-doc challenges me. The truth is, I simply do not believe it’s possible to diagnose a toddler with mental illness.
When I was 9, I started exhibiting bizarre compulsive behaviors, which I won’t get into now, but which may arise in a future column. My mother was concerned, and had me talk to a friend of hers who was a psychiatrist, who believed the problem was not with my brain, but with my mind. She linked the behaviors to anxiety, and worked with me to identify the source of the anxiety. The behaviors disappeared.
Many years later, in my 20s, I began to exhibit similar behavior. I was diagnosed with OCD and put on Klonopin, a drug I became addicted to and stayed on until just a couple years ago, when I went through the hell of withdrawal. I cannot imagine how my growth–both physical and mental–would have been compromised had I been put on OCD meds as a 9-year-old. And yet, if the same episode took place today, I would most certainly be given drugs as the first line of defense. I’m so grateful that didn’t happen.
There will be a backlash to all this overdiagnosing and overmedicating, and I hope it begins with a serious reassessment of what we’re doing to generations of children when we put them on harsh psych drugs as small children. I know of kids who started meds at 5 and have never been off them, even through college. How do these people have any idea what’s truly wrong? How is it possible that their family practitioners keep calling the prescription in to the pharmacy without requiring a consultation with a psychiatrist–someone new to the case?
Ugh. I could go on and on, but you should head over to Furious Seasons, where there’s some heated debate on this subject. This is an issue that cannot be ignored.