Thursday, April 23, 2009

Growing Up Bipolar - Recognition At Last

On May 28 last year, Newsweek published a cover story, entitled, Growing Up Bipolar. Reported Newsweek:

"Max Blake was 7 the first time he tried to kill himself. He wrote a four-page will bequeathing his toys to his friends and jumped out his ground-floor bedroom window, falling six feet into his backyard, bruised but in one piece."

Commenting on the article in a blog piece I did for HealthCentral, I wrote: "My God! I thought. This reporter actually gets it!"

Just about every parent of a bipolar kid I have talked to has told me a similar story. A number of parents have related to me stories of their kids trying to jump out of moving vehicles. Sadly, Max's story is all too typical.

Predictably, the story did not go down well with the antipsychiatry contingent. Philip Dawdy of Furious Seasons had this to say:

"It is also one of the worst pieces of journalism on the alleged disorder that I have ever seen."

In a later post, Philip Dawdy wrote:

"For those of you who want to read the thoughts of a defender of the disorder in kids, you can do no worse than John McManamy's post over at Health Central. He's been an extremely harsh critic of anyone who questions bipolar disorder in children, and his tone is often one of religious conviction."

In the year preceding the Newsweek piece, the media had been running accounts relating to the tragic death of Rebecca Riley, age 4, who died of an overdose of medications after being diagnosed with bipolar. The parents are awaiting trial for first-degree murder for allegedly overdosing their daughter with the sedative clonidine, and the prescribing psychiatrist is being investigated for malpractice.

The NY Times, 60 Minutes, and other outlets used the tragedy to discredit the diagnosis of early-onset bipolar. The following from 60 Minutes is fairly typical of the coverage:

Katie Couric (to Rebecca Riley's mother, in prison): "Did you ever think, 'Well, she's two and a half years old.' There's this thing called the terrible 2's. Did you think this could, in fact, be normal?"

In response, in a blog piece I wrote:

For years, parents of kids with bipolar have been fighting battles reminiscent of the first generation of NAMI parents. Back in the bad old days, psychiatrists blamed schizophrenia on bad parenting. Mothers were simultaneously lectured to love their kids more and discipline their kids more. Then the schizophrenia would go away.

Parents of bipolar kids have been getting the same treatment. Recently, thanks to books such as "The Bipolar Child," and the establishment of organizations such as the Child and Adolescent Bipolar Foundation, parents have been able to make headway with their clinicians and the school system. Many of these kids, and their families, now have hope in their lives.

Thanks to the sensationalism surrounding the Rebecca Riley tragedy, however, we now see the revival of stupid talk about child bipolar being a fad diagnosis, and that it is overdiagnosed. Worse, so-called pundits are claiming that what is being called bipolar is just normal child behavior.

Back to Philip Dawdy:

"I've noticed that tone to be consistent in late-diagnosis bipolars, as McManamy is. You've got to wonder what's driving that."

Where did that come from?

Last week, I was in Seattle for a four-day conference put on by the Association of Health Care Journalists, of which I am a member. During a luncheon, the AHCJ recognized "the best health reporting in print, broadcast and online media." Taking first prize in the large magazine category was Mary Carmichael for her "Growing up Bipolar" story. According to the judges:

"From the first sentence, this riveting story escorts readers into a nightmarish world of a young boy's mental illness. The writing soars with observational detail that shows, rather than tells, creating a narrative of survival and, ultimately, one of hope. Layered with multiple perspectives - the product of original reporting - the story tackles controversial issues that resonate long after the final sentence."

Say no more ...

Further reading from mcmanweb:

The Bipolar Child - What to Look For

According to Martha Hellander, Executive Director (as she then was) of the Child and Adolescent Bipolar Foundation, the problem is not overdiagnosis of bipolar in children. "To the contrary, we receive reports daily of families with children evidencing clear symptoms of being told flat out that 'children can't get bipolar disorder.''

The Bipolar Child - Treatment

An article in the South Florida Sun-Sentinel describes one family’s journey through hell, but finally - after finding a psychiatrist who made a correct diagnosis and treated their kid accordingly, mother Tina was able to say of her 13-year-old son: "I don't know this kid. He's a different kid. He's fun. I enjoy being around him ... Steven was getting A's where he used to get F's ... I never bonded with Steven. Now that he's stable, I'm learning to love him. I'm catching up on nine years."

The Bipolar Child - An Historic Book

Right off the bat, parents started using "The Bipolar Child" to educate their children’s clinicians and educators. A sampling of reader reviews on Amazon:

"With this book in hand, I approached my son's first psychiatrist who had been treating him for ‘generalized anxiety’ for over a year, regardless of our input about his therapy and meds not working. I told him that my son was a dead ringer for bipolar and that we had a history of Bipolar within our family. He insisted that our son was NOT bipolar. I immediately sought out another child psychiatrist that primarily treated BP children and we eventually had our suspicions confirmed. Without this book, I could not have done it."

Are We Overmedicating Our Kids?

Still, when it comes to antidepressants and mood stabilizers and antipsychotics, the best that psychiatrists can do for now is cite their own clinical experiences with these meds. Parents are entitled to take a skeptical approach and hold the doctor or psychiatrist to account for any medication he or she may recommend.


Tracey said...

At last....after 16years, my son and I might finally have the answers as to recognition of what his illness actually is. He's 16 now, so his whole life has been an ongoing torture for him, and for me. Within days of his birth I knew he was different, even though most of the problems he had weren't terribly unusual. Having already had two sons who were eight and six years older, I just knew with my whole being that this child was nowhere near normal. The ensuing years have been a nightmare of trying to find answers and some way of getting him the help he needs, and even up to now, no one has been willing to diagnose him with a real medical illness. Having read these articles, it's obvious to me Australia is a long way behind The United States as far as diagnosing and recognizing child mental illness. It's still very much a situation of mother's not being accepted as the experts on their child's behaviour, changes and patterns. With this new information, I now feel armed to to take up the battle for my son yet again and this time I will make sure he gets the diagnosis and treatment he so rightly deserves. When I was ready to give up, I was lead to this site. I can only thank
you for it being here.


John McManamy said...

Hi, Tracey. So glad you found this useful. I know what you're up against, as I have heard very similar stories from other parents. You can get a lot of support and practical help at the Child and Adolescent Bipolar Foundation website:

Best of luck to you. All the best ...

Krista said...

Hello, John! My son Konal was one of the original kids in the 20/20 piece in 2000. He is 14 now, and still receiving intensive treatment. We have had many ups and downs, and one of those is still the Bipolar diagnosis in Children. He needs a developmental evaluation for some issues and the child study program here refuses to take him due to the diagnosis.
Thank you for your work on this important issue!

John McManamy said...

Wow, Krista! I saw that piece when it originally aired and several times since. I wish everyone could see that piece, as it shows in no uncertain way that parents are not making this up. My only criticism of the 20/20 piece was no one reported that there was hope for these kids.

Anyway, look. I want to know all about how you and Konal and the rest of your family are doing, respecting everyone's privacy, of course. I think continuing your story will help a good many readers.

Please contact me at and we can follow up on this.