Treating Bipolar Illness

Boy, talk about a surge. A psychiatric study published today finds that the number of American children and adolescents who were diagnosed with or treated for bipolar disorder skyrocketed by 400 percent from 1994 to 2003. As the New York Times reports in a page-one story,

Bipolar disorder is characterized by extreme mood swings. Until relatively recently, it was thought to emerge almost exclusively in adulthood. But in the 1990s, psychiatrists began looking more closely for symptoms in younger patients.

Some experts say greater awareness, reflected in the increasing diagnoses, is letting youngsters with the disorder obtain the treatment they need.

Other experts say bipolar disorder is overdiagnosed. The term, the critics say, has become a catchall applied to almost any explosive, aggressive child.

I’m not a mental health expert; I can’t weigh in on either side of this debate except from my non-psychologist’s perch. But a spike of this magnitude makes me raise my eyebrows, particularly considering there’s no scientific consensus on the issue.

Like anybody, I have my opinions, informed by some limited (admittedly anecdotal) exposure: I think, generally, that American children are overmedicated, and I suspect that behavior-altering pills, in many cases, are a quick fix for confused, ill-equipped or otherwise too-busy parents. I am certainly wary of the pharmaceutical industry and its aggressive marketing tactics–I’m certain that they’re scheming to tap this new demographic.

That said, I recognize that depression and related mental disorders are very real, and that children sufferers are particularly vulnerable, since they can’t be expected to identify, cope with or treat their behavioral problems on their own. If psychiatric drugs give these kids some measure of relief and grant them the ability to socialize and develop and regain control of their lives, I’m all for it. I also think that heightened sensitivity and a better understanding of such disorders will promote early detection for those young sufferers who are prone to violent behavior, whether that violence is directed at themselves or others. I think of the tragedies that could have been avoided had professionals properly diagnosed and treated Virginia Tech shooter Seung-hui Cho; or 19-year-old Michael Tate, who has pleaded insanity in a murder trial in Colorado (he is facing life without parole); or the thousands of juveniles who commit suicide in the United States every year.

More pills is not the answer–unless you’re in the R&D department at Pfizer. We shouldn’t necessarily be treating an increasing number of children for psychological disorders we don’t yet understand. But we should be sure that those who need help are getting it.

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3 responses to “Treating Bipolar Illness

  1. First things first, welcome to the blogosphere! I gave Juvienation a plug on Grits, fyi.

    On the subject of the post, I’m no medical expert, either, though I have a little background on health and mental health policy matters. On bipolar disorder, though, I don’t think it’s really a question of the pill culture so much as improved and more widespread means of diagnosis. Bipolar is a serious mental disorder, it’s not comparable to a kid with ADHD taking Ritalin. Though not out of the realm of possibility, I’d be surprised if merely “explosive, aggressive” behavior earned the diagnosis from any credible behavioral health professional.

    If I’m not mistaken, I also think in the last 15-20 years, the earliest age where bipolar was considered diagnosable has been lowered into the teens, when for a long time it was considered more of an adult-onset phenomenon. Several years ago I read an article arguing many teen suicides may result from undiagnosed bipolar disorder, which if I recall was part of what spurred lowering the diagnosable age.

    Finally, in the late ’90s a new generation of bipolar meds replaced lithium (which contained more significant, detrimental side effects), and that allowed more people to stay on bipolar medication without disruption.

    That combination of reasons might explain the increase. Cheers!

  2. Bipolar disorder has become a popular diagnosis, although not all “professionals” in the psychiatry/psychology field are good diagnosticians. There are a number of diagnosis I see frequently applied to juvenile offenders: mood disorder NOS, intermittant explosive disorder, and the ubiquitous ADHD. I think that some of our mental health professionals forget about “normal adolescence.”

  3. Pingback: Treating Bipolar Illness, Cont. « Juvienation

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