Wednesday, September 05, 2007

PSYCH MEDS ARE NOT HEALTH FOODS SO GET IT RIGHT

The most emailed article at THE NEW YORK TIMES as of this morning is “Bipolar Illness Soars as a Diagnosis for the Young”. It says the number of American children and adolescents treated for bipolar disorder increased 40-fold from 1994 to 2003. That makes one wonder what is going on.

The article says, “Many experts theorize that the jump reflects that doctors are more aggressively applying the diagnosis to children, and not that the incidence of the disorder has increased. In the study, researchers from New York, Maryland and Madrid analyzed a National Center for Health Statistics survey of office visits that focused on doctors in private or group practices. The researchers calculated the number of visits in which doctors recorded diagnoses of bipolar disorder and found that they increased, from 20,000 in 1994 to 800,000 in 2003, about 1 percent of the population under age 20. The spread of the diagnosis is a boon to drug makers, some psychiatrists point out, because treatments typically include medications that can be three to five times more expensive than those for other disorders like depression or anxiety.”

It goes on to say “In addition, drug makers and company-sponsored psychiatrists have been encouraging doctors to look for the disorder since several drugs were approved to treat it in adults.
“We are just inundated with stuff from drug companies, publications, throwaways, that tell us six ways from Sunday that, Oh my God, we’re missing bipolar,” said Dr. Gabrielle Carlson, a professor of psychiatry and pediatrics at the Stony Brook University School of Medicine on Long Island. “And if you’re a parent with a difficult child, you go online, and there’s a Web site for bipolar, and you think: ‘Thank God, I’ve found a diagnosis. I’ve found a home.’ ”
Some parents whose children have received the diagnosis say that, with time, the label led to effective treatment.
“It’s been a godsend for us,” said Kelly Simons of Montrose, Colo., whose son Brit, 15, was prone to angry outbursts until given a combination of lithium, a mood stabilizer, and Risperdal, which was often given to children “off label,” several years ago. He now takes just lithium and is an honor roll student.
Other parents say their children have suffered side effects of drugs for bipolar disorder.
Ashley Ocampo, 40, of Tallahassee, Fla., whose 8-year-old son is being treated for bipolar, said that he had tried several antipsychotic drugs and mood stabilizers and that he had improved.
“He has gained weight,” Ms. Ocampo said, “to the point where we were struggling find clothes for him. He’s had tremors and still has some fine motor problems that he’s getting therapy for. But he’s a fabulous kid. And I think, I hope, that we’re close to finding the right combination of medications to help him.”

There is no doubt the truth will remain elusive.

I spent part of this Labor Day at the home of one of my two sisters. One of her two sons was in from Texas and as always family stories were being told. I was a difficult child and I had a hard time in school which means there are plenty of stories to tell about me. The question has to be asked was my bipolar illness starting then or was my troubles caused by the childhood sexual abuse which I did not tell anyone about or was there another cause. Maybe I simply hated school. Maybe it was the fact that I was the youngest of three kids and we were the children of both the principal of the school and the pastor of the church we attended. My point is how do you make a diagnosis or decide the cause or causes of my behavior?

I have said before on this blog that a mental health professional including a psychiatrist does not have much to go on but what he or she is told by the person being diagnosed. In the case of children the parents may be used for the main source of information for making the diagnosis.

Be honest here. Does any parent really know what a child has going on in their mind? Can any parent do more than tell you what their child did not what they were thinking or their motive? Will they always tell it accurately or will they sometimes make it sound worse wanting the doctor to give their child something so they can get some relief? Will the child be honest with the doctor or will he or she tell the doctor what the parents have said they must tell?

My point here is that making a psychiatric diagnosis is not like taking a x-ray to see if your child has a broken arm. The best child psychiatrist on planet earth can’t do any better at making a proper diagnosis than the information he or she is able to gather from the answers they get and the observations they can make in the brief time they spend with the child and parents or parent.

I know my life would have been easier if I had decided earlier in my life that I was going to take my medications on a daily basis and not just when I felt like it. I am not against medications. I want them used properly. Also, I sometimes have this dream that Bill Anthony was born years earlier and Psych Rehab was there to help me years ago.

Psychiatric medications are not health foods so it is important to get it right. The stigma of a label and the side effects of the meds make this no joking matter. Children with behavioral problems and disorders need all the tools available, and they need the best trained professionals we can come up with. Whatever the study shows it shows we need to know more. Our children deserve the most accurate diagnosis they can get not just designer drugs.













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