I don't know how I feel about children being diagnosed with bipolar disorder and then being prescribed anti-psychotics. It seems incredibly risky and to describe either and adult or child's life as being over because they have been diagnosed as bipolar disorder is awful!

You might be interested in this episode of This American Life: http://thisamericanlife.org/Radio_Episode.aspx?episode=207
Act 2 is about a child who is diagnosed as bipolar.

I saw this article in the Times and almost forwarded it to you, then realized that you would be all over it. This is a mess, as you say. Lying about the disclosure, relying on pharma for the money for the studies, all bad enough. And while I think it is a travesty that it takes too long to come up with a diagnosis of bipolar (on average) the bigger travesty is that we seem to think that children have this disorder. I would not rule it out, but it seems very knee jerk. And medicating a pre-teen is wrong unless there is no other reasonable alternative.

But I am glad Colorado was nice.

I feel as though I've directed you to the exact same place before...sorry if I've repeated myself!

I think that labeling children bipolar and feeding them drugs is outrageous.
I have bipolar I and I didn't have any of the symtoms of bipolar until I was a teenager. I would think if someone would research the childhood histories of bipolar adults it would shed light on the fact that a large majority of them never had characteristics of bipolar disorder until after puberty.
There's another population of children getting feed the same drugs. They're children with Autism.
They use these adult psyc. drugs to try and control "behaviors".
Seroquel and Abilify are commonly used together and in combination with other drugs.
One of the things I've wittnessed while working with children with autism is that when one drug doesn't work or stops working the doctors add another. My common sense would tell me if it's no longer helping stop using it and try something else. What happens is over time you have a drug cocktail that's unsafe for anyone.
I think a lot of negative behaviors in children can be modified without drugs. The problem is that it takes a huge educated effort, a lot of patience and consistency.

Liz,
You do a great job!

Another Scary Story: http://www.ajc.com/health/content/health/stories/2008/06/04/mental_0605.html

Everyone seems to believe that without pharma money research will dry up. I disagree. Take away pharma funding, NIH money will be spent researching real diseases. There wouldn't be money for the Biederman's to make up diseases and line their pockets.

The lack of transparency and oversight when it comes to the testing, manufacturing and product information of the large drug companies is Orwellian. While I rely on many medications to keep me stable, I am aware of companies that run clinical trials off-shore (e.g. Pfizer), to avoid certain standards and other unsavory practices. To medicate children with any of the drugs that I have been prescribed over the years seems dangerous at best and possibly lethal at worst.

Biederman's troubles are a good thing and there should be no confusion about the ethical and moral sins he has committed. It is one thing to openly work for a drug company and support their products but it is much more slimy to accept drug company money, make off- label recommendations for medications and then LIE ABOUT THE INCOME TO THE VERY ACADEMIC INSTITUTION WHOSE AFFILIATION MAKES YOUR OPINION VALUABLE IN THE FIRST PLACE.
Various medical systems (like Penn's) have barred drug companies from providing such incentives as lunch to their clinical staff. Such rules are meaningless and are similar to arresting the corner drug dealer while allowing the drug importer/kingpin to continue in business.

Biederman should lose his academic affiliation with Harvard (and other universities?) given his clear violation of their own financial reportage rules. Whether the old-boy academic network is capable of addressing this situation honestly remains to be seen. Keep us up to date.

BTW- dipping your toe into the clinical side of mental health should give you the persepctive to accomplish the bigger things you no doubt will.Good luck.

I'm skeptical of blanket "treat no child" stands. It is certainly true that doctors need to do a better job of diagnosis and that we all need better drugs. Still, I think it's cruel to withhold needed drugs from children saddled with the burden of bipolar disorder. I think the decision should be made child-by-child.
The real problem, in my view, is that the treatment of mental illness in general lags behind the treatment of all other types of illness.

I appreciate your concerns about diagnosing children with bipolar disorder and then prescribing antipsychotic drugs. I’ve seen the statistics and it is clear that these drugs are over used.

But let’s be careful not to over react. There are some kids who really benefit from these drugs. I know because I am the father of one of these children and I’m telling you, the drugs saved his life. The drugs gave him the pause he needed from his crazed thinking and helped him find the space to stabilize his mind.

Note that his mother and I resisted the drugs for a long time. We are both chemists and understand the havoc such drugs can play on a developing mind and body. But watching his delusional psychotic episodes and destructive behavior … we knew drastic action was needed.

After three hospitalizations, hours of therapy, and a vast array of drugs, we are all doing OK now. He is drug free and leading a normal teenage life. But there were times a few years ago when I had to mentally prepare myself for my beloved child not surviving to adulthood. I had serious doubts that he would make it. But “made it” he has, and the bipolar diagnosis and the drugs were PART of the solution.

Bravo, Liz. While I don't doubt that there are children who suffer from mental illnesses, I think that children in this country are being vastly overdiagnosed, not to mention horrendously overmedicated. And though the medical profession has come a long way in a relatively short time (I can remember the days when, for example, children with autism were pretty routinely institutionalized and therapy consisted of outfitting them with a football helmet so they wouldn't hurt themselves if they spent hours banging their heads against a wall, which some did) we still have quite a long way to go. I believe that one day, many years from now, people will look back on today's treatments as barbaric experiments. (I know I have been a walking BPII drug experiment for the last 14 years.) Again, I understand that some children have benefitted from medication, but sometimes I think this society is trending toward drugging people into submission ... children, teens, adults alike.

My daughter was diagnosed with bipolar disorder at age 16. If that diagnosis had come earlier, say at 11 or 12, it may have prevented a lot of her suffering and not knowing what was wrong with her, which she clearly was aware there was. Visits to several therapists resulted in absolutely nothing but a waste of time, money and emotional energy.

I will say, however, that earlier treatment would have been a good thing for her, had the medication been effective. It took over two years for the right medication to finally be tried for my daughter. Before that, lithium ruined her skin, caused severe weight gain. Another medication (I don't recall which, she went through so many) made her hair fall out.

I have strong feelings that early diagnosis can be a very good thing for children and their families. The treatment options, however, is where it gets tricky. To medicate or not to medicate and if so, with what drugs. How young is too young?

As a teacher, I have seen at least three children over the years that clearly fit the profile of bipolar and all three had bipolar in their families and other family MH problems as well. These children were so troubled, that regular schooling was impossible for them. In one case, the parent seriously considered giving her five year old son up to foster care. She simply could not care for him through the rage and violence he displayed daily. What a hell for a child to be in. Were I his mother, I would have felt no other option but to try medications.

The trouble is, that a lot parents leave treatment up to the experts and don't take an active enough role in decisions about treatment.

I don't believe that medication for children profoundly affected by mental health issues is a bad thing. The diagnosis doesn't even have to play a part, as long as the most troubling symptoms are dealt with.

Where do you draw the line is a frequent question that I don't have the answer to. But that medication can be a lifesaver (literally) is nothing to be sneezed at.

Thank you.