One thing that always happens after one of those shows is the forums (fora?) and boards and blogs all over the place become very busy with people posting and arguing the same old tired stuff.
It always devolves to the same place: the "Antis" and the "Pros." People say, "We're drugging our children," when it is of course not our children, because it is not their children.
When I respond to these, if I do, I have stopped taking an opposing view for the most part (unless I can't help it), and try to ask some questions. The one that is burning my mind is this: How and why is it that there are a few medical diagnoses and their treatments that are considered public domain, and therefore open to public debate, while dozens and dozens of others are not?
Can you imagine commentary like we get about AD/HD, Bipolar, etc. and medication being bandied about if it were, say, asthma? or an endocrine disorder?
Sheesh.
DocBets,
I don't think this country, this world has yet accepted that the brain is an organ like any other organ in the body. You are so right; why do we still have this sense that if one tries hard enough, they can overcome psychiatric or brain disorders? Why is there no outrage that 2 year olds often need multiple doses of antibiotics for frequent ear infections? Or that children need asthma meds, etc etc?
I'm with ya!
Terry
It just occurred to me that many have "explained" the inequities about this subject in terms of, "As long as it's the body, people accept medication, but not the brain."
Not so. People with seizures are never criticized for taking medication. I think it's because it seems to be about behavior. People forget how much "behavior" is involuntary. And they were never informed that much of what they do habitually is possible because they have capacities for linear, habitual behavior.
Yep, it's because it's behavior. And, there are many professionals in our field who still call AD/HD a "behavior disorder," which it is not. No more than the stomach flu is a behavior disorder because it makes people vomit.
(I know, that was a stretch.)
I am the mother of a 9 yr. old with ADHD, OCD, Asthma and life-threatening food allergies.
It was my understanding from watching the Frontline program (once), that the discovery of Pediatric Bipolar was made by one physician who compared ADHD with Bipolar in the DSM and noticed enough overlap so as to conclude that Pediatric Bipolar exists. Therefore, some kids with ADHD actually have Bipolar, although it was previously thought to only manifest itself in early adulthood. I hope I got that right.
Pediatric Bipolar may or may not exist, but just because a big shot at Harvard believes it, doesn't necessarily make it so. I would not overlook the fact that doctors and researchers, while probably good intentioned, also have other motivators. The desire to be important in ones field, to be highly recognized and published, to discover, treat and/or cure disease and justify the federal and pharmaceutical industry grants, may play some role in coming up with new conditions, like Pediatric Bipolar. Just as the media has tendencies to "put on a show" to attract viewers, perhaps researchers are under pressure to "put on a show", too.
Dr. Biederman appears to be a highly respected and outstanding person in his field, and I do not intend to be disrespectful toward him, however, I do think parents do need to be skeptical about Pediatric Bipolar diagnosis for their children, and I'll tell you why...
The week after I saw the Frontline program, I was sitting with my son's relatively new therapist. Incidentally, this therapist is very experienced, came highly recommended and is located in probably the most respected child psychiatry practice in our area. I mentioned to the therapist that my son had said lately that he wakes up feeling like "he didn't sleep all night".
So, you probably wonder if she asked me, "Does your son appear tired during the day?"
No, she didn't ask me that.
Or "What time does your son go to bed?"
No, she did not ask me that question.
How about, "What is your son's bedtime routine like?"
Nope, no questions about that.
Perhaps something like, "Does your son play video games or do other stimulating activities shortly before bed?"
Huh uh, no questions regarding that.
Maybe, "Is your son allowed to drink caffeinated beverages? Does he drink soda with dinner or in the evening?"
No, didn't ask me that.
Possibly, "Does your son appear restless during the night? Does he awake at night that you are aware of? How many hours of sleep does he get in a typical school night?"
Hmmm.... that would be No, No and No. She did not ask me any of those questions.
So, what did my son's therapist ask in regard to this comment my son made?
She asked me, "Is there any bipolar in your family?" (Oh, brother!)
When I said, "No, and he's not bipolar." Her only other comment was that "not sleeping well could be a sign of bipolar". AND THAT WAS IT. Beyond that, she had no other questions or comments.
I took it upon myself to e-mail my son's teacher and ask her if he seemed tired during the day. She did not think that he did, nor did I notice it at home. And after a few days, my son didn't mention it again. He probably just didn't feel like going to school those couple of mornings... or maybe the asthma wasn't well controlled that week and he awoke feeling tired due to lack of oxygen in the night... or maybe he just had a little insomnia (shocking!).
Besides, when something is bothering my son, he always goes right into the typical 4th grade drama-king mode...."Ahhhh! I didn't sleep all night!!!" (Yeah, whatever... you aren't bipolar, kid, so get out of bed and get dressed for school.) End of disorder.
I get so outraged thinking about this. I am glad that I watched that Frontline episode, which prepared me for the idiotic response from my son's therapist, one of the most respected in the business, over this incidental sleep "problem".
In my opinion, that should have been just about the LAST place the therapist should have gone under the circumstances. There would be several other questions to ask and things to try before even considering adding another major diagnosis, which would no doubt require major, expensive drug therapy, to my son's "plate". I am so glad that Frontline and other news magazines do these shows, even if they are more one-sided than some would like. At least it gives parents who want to hear more than one opinion a place to do some additional thinking and jumping off place to do research on their own.
As I mentioned earlier, Pediatric Bipolar may very well exist and be a perfectly useful and legitimate diagnosis for some children. I deal with bad behavior, tantrums, hyperactivity, poor school performance and the like every week with my son and I would never want to take anything away from a parent or child who has finally found an answer that makes sense and works for their family. I, too, wrestle with whether or not to add ADHD medication on top of all the asthma medication my son uses. I just wanted to say, beware. I feel like my son's therapist was trying to take my son and I down a road where she had no business going based on the information she had.
Plus, I think that if there are some kids with legitimate Pediatric Bipolar, what does it do to them when others are diagnosed with it just because it is the latest trend? I think it takes something away from those that are truly suffering with it. If everyone has it, then how seriously will your child's correct diagnosis be taken? I think this has happened with ADHD. Everyone has it now, so when you try to get the help your child truly needs, some schools roll their eyes.
Finally, you expressed that you were concerned that parents would become anxious about using medications for their child's ADHD and other disorders by watching this show. I say hallelujah! If, as a parent, you aren't anxious about medication for your child, whether you choose to use them or not, then there is a problem with your parenting, if you ask me. It is your job to be anxious about your child. Anxiety causes thinking to determine the best action. We need more thinking parents who don't blindly follow along with whatever someone with a bunch of fancy letters behind their name tells them.
So, let the information flow with all the hype and scary-sounding buzz words attached to attract an audience and sell advertising. If you watch it thoughtfully and boil it down, you might find something useful for yourself and your child. That is the beauty of this country; the people have a right to know. We don't have to rely on whatever our doctor or therapist wants to spoon feed us. I am teaching my son the same idea... we go to the best therapist we can, we listen to what they have to say/suggest and we compare it with our own research and what common sense tells us. Then, we develop a game plan from there. I want parents to know that just because a psychiatrist, psychologist, medical doctor, social worker or Frontline investigator makes a claim, doesn't make it true. Sometimes professionals jump on the bandwagon to the extent that if you mention "sleeplessness" to them, bipolar is the first place they go. Now, that's not right.
Hey Pam,
Bipolar is an interesting disorder. When I was 29, I saw a psychiatrist for treatment for depression and AD/HD. He chose to treat the depression first, but chose an anti-depressant that was used to treat depression and AD/HD. The anti-depressant was desipramine.
Within weeks, I experienced my first and only hypomanic episode. I won't go into the details, just trust me when I say the symptoms I experienced were extreme and significantly different from anything I had experience before or since.
I was then diagnosed with bipolar II and began treatment for bipolar disorder. I read everything I could on the subject, submitted to what I believed was appropriate treatment and attempted to move forward with my life. This continued for four years.
Then the doctor informed me that he had done all that he could do and offered to provide maintenance care. Not feeling fine, I found another psychiatrist.
That psychiatrist reviewed my medical records, my journal entries at the time of my original diagnosis, and my self reports. He concluded that there was a possibility that I had been misdiagnosed. He slowly, very slowly took me off the bipolar medication and told me that if I didn't have another hypomanic episode in five years, I could feel confident that I do not have bipolar disorder.
That was ten years ago.
Here's what actually happened to me. The desipramine caused the hypomanic episode.
In retrospect, what I find most interesting is that a year or so after I was diagnosed with bipolar II, I attended an educational lecture on depression and bipolar disorder. The presenter, a psychiatrist, worked at Harborview Medical Center in Seattle, Washington. When I heard him say that desipramine is known to cause hypomanic episodes in people who do not have bipolar disorder, I was stunned.
Here's the part that's so interesting: I never discussed this information with my psychiatrist even though I saw him for an hour every two weeks for four years. And even now, as I write this, I don't fully understand why. It's as if I so strongly accepted that I had bipolar disorder, I couldn't face the possibility that my doctor had made a misjudgement and that everything I had come to believe about my diagnosis and prognosis wasn't true. I also believed my doctor had harmed me unintentionally, and that the damage was irreversible. I didn't want to make him feel bad. In my defense, I must also say that the medication I was taking affected my cognitive abilities. My friends and family were so relieved when I got off the medication and returned to the person I was prior to treatment. They too regret that they didn't contact and express their concerns to the doctor.
That would not happen to me today.
I'm older now and a lot wiser. I, like you, question everything. Keep questioning Pam.
I have a number of friends who have bipolar disorder. There is absolutely no doubt in my mind that it's real.
I do believe bipolar disorder can occur in adolescents and children. But, if I were the parent of a child experiencing symptoms that extreme, I would do everything I possibly could to rule everything else out first including allergies, sensitivities, and vitamin deficiencies, reactions to other medications, other diagnoses, etc. before I would consider medication for bipolar disorder. And I would research and utilize any behavior therapies that seemed reasonable to me.
That said, if after doing all of the above, my child was still suffering, I would then put my child on a bipolar medication.
Some AD/HD children and adults need medication to function, at the very least, behavioral and educational interventions. I have so much respect for parents who go through this agonizing process and always, always put their child's needs first in an environment in which they are constantly being told by well-meaning and not so well-meaning people what to do or that what they are doing is wrong.
The research is clear, children with these diagnoses left untreated or under treated are at significantly higher risk for addictions and criminal behavior. I spent a couple of evenings reading the statistics on prison populations last year. It's heart breaking.
I have yet to meet a doctor that doesn't care about his or her patients, but sadly, they do make mistakes and sometimes provide inappropriate treatments, often times due to lack of information or misinformation, or lack of training.
Over the last eighteen years, I've learned to
- seek the best healthcare providers available and treat them respectfully
- learn everything I can about the condition and its treatment
- investigate other possible explanations for the symptoms
- explore all available treatments, both medical and alternative or complimentary
- commit to a team of treatment providers
- and finally, to evaluate and re-evaluate the diagnosis and/or treatment periodically.
Keep questioning Pam. With adequate information, you sound like the type of Mom who would do the right thing by their child.
Dear grandma lise,
Wow! Sounds like you had quite a rough time over that anti-depressant and subsequent misdiagnosis. I am so glad that you finally found answers and got your life back. Thank you so much for sharing your story with me.
Would you believe that I also was sent into a manic state caused by a medication? It was Effexor. It was prescribed to me for symptoms of PMS. I discontinued it cold- turkey, because I didn't think it was doing anything for the PMS. Little did I know, this was not a safe thing to do. I was up for 3 days straight, my mind racing... it was awful, as you well know.
I went back to the family doctor who prescribed the Effexor. In one brief, 15-minute appointment, he concluded that I was bipolar, and prescribed me a medication for bipolar!!! I was shocked. I had already considered the possibility that the Effexor was to blame as it started almost immediately after stopping that medication. I asked him if these symptoms could be due to the fact that I quit the Effexor cold-turkey. He looked me right in the eye and said, "No." I hate to say it, but I immediately felt like I was being lied to. He just looked like he was lying. Plus, I was quite old to be diagnosed with bipolar for the first time and I had been a patient in this practice (different doctor) since childhood, and I had never before experienced these symptoms.
I have no idea what his motive could have been for not examining me further or why he would not have immediately referred me to a competent psychiatrist for a complete evaluation if he suspected bipolar. I had insurance, so that wasn't it. Instead he just handed me a prescription for a psychiatric medication with no additional explanation or plan for further treatment. Not only that, he knew I was the only parent in the house with a small child!!! And can you believe that he NEVER ONCE followed up with me? It's been 4 years ago now, and his nurse has never once called. I still can't believe it. It doesn't seem possible that this happened, but it did. Of course, you probably understand, having been in a similar circumstance, and like you, I never reported this physician to anyone or questioned him again about his treatment of me.
I found out soon after leaving his office that the doctor was wrong. The Effexor literature clearly stated that hypomania, among other things, had been reported with abrupt discontinuation of the drug. Thank God, I did have enough presence of mind to go to my pharmacist and speak with her at length about everything that was going on. I never filled the bipolar prescription. Instead, I went back on the Effexor, and with the help of my pharmacist, I cut the dosage a little at a time until I could quit completely. I never experienced mania again. Then, I got a new family physician.
Sometimes I think that doctors overall are not spending enough time with patients to make a good assessment of each person's situation and instill much confidence in them. In my doctor's office, they schedule over-lapping appointments, keep you waiting forever, come rushing in long after the scheduled appointment time, and barely look you over. Then, they seem to want to just go with the first idea that comes to mind and take out their prescription pad and be done with it. I see it at the pediatrician, too, and I hear my friends complain about it with their doctors.
Too bad there aren't more doctors out there, like the one you finally found, who was willing to take the time to read your medical records, journal and self reports. What could be more important in treating an individual than doing that? It seems so simple, yet, I don't think it is happening in many cases...at least not mine or my son's.
I personally wrote a synopsis of my son's behaviors and symptoms for the psychiatrist/therapist that he sees. I'm pretty sure the psychiatrist never read it, and I had to ask the therapist more than once if she had read it, because every session she was asking me all the same questions that I had already answered in the report I wrote. I took a lot of time to write it and edit it. I made sure it was to the point and easy to read, so I don't think my writing was the problem. She just didn't take the time to read it. When she finally read what I had written, I could see a huge difference in her understanding of my child and she started asking some really relevant questions based on his specific history. Then, she began Cognitive Behavior Therapy geared toward his OCD. Now they have made great progress. Too bad we wasted four sessions at $180 an hour before she even read what I wrote.
In addition, we are working with the school on some accommodations for the OCD and ADHD. The psychiatrist doesn't think medication is urgent right now, so I will see how the accommodations work and take it from there. If he needs the medications, he will have them. His older half-brother took them in elementary school and seemed to outgrow the need for them. He stopped taking medication in Middle School and has now graduated from college and is doing well. His older half-sister is still taking them and they still help her a lot. My son is more borderline, so I choose to try some other things first, particularly with him being on other medications already for asthma.
I couldn't agree with you more on the points you made about what you learned to do over the years to ensure good treatment for yourself. It is a GREAT list of suggestions. I think everyone should copy it and tape it to the bathroom mirror or the corner of their computer or wherever it would be easy to refer to. It really sums up what action is needed when you find you have a medical problem. I feel so bad for people who can't do the research due to their poor mental state and/or they don't have friends and family to look out for them or their child. Scary.
Best wishes to you! Pam
Oh, Terry, you are so singing my song. At first I thought you were talking about the term "ADDer," which I hate because it's silly (and I know, you mentioned that, too). And yes, I'd rather not be described in terms of my chipped tooth either, even though that's one that can be fixed. And has been, twice already.
Not so many years ago (maybe ten), people were referring to Temple Grandin as an "autist," to others as "depressives," and I have one patient who, now that we've got her diagnosis right (AD/HD), no longer refers to herself as "manic-depressive."
"People with autism," is how it's said, now, for the same reasons you cite. Autism is not the sole defining feature of a person. People who have depression, or anxiety, are not anxietists, either.
While ADD does not entirely define me, it is always a mistake if I forget to remember that its unremitting presence in my life is a fact of my life. For if I forget that, I will, along with it, forget where my cell phone is, or something I was going to do, oh gee, which reminds me, woops.
More later.
I have read the responses so far and want to add the following about the Feingold Diet.
While it is congenial to think there are things we might do to remove the AD/HD, the fact is that since Feingold's research, AD/HD has been shown incontrovertibly to be a real, actual difference in how the brain is structured and how it uses essential brain chemicals.
Now, this doesn't mean that for any child, too much sugar, or carbohydrates, or bacon-lettuce-and-mayonnaise sandwiches, or just about anything, isn't a good idea. And, an excellent diet is imperative for any person coping daily with what amounts to chronic stress (listen, parents).
The Feingold Diet is exceedingly rigid and emphasizes the prohibition of certain foods and food substances, and we have learned a great deal since then about what foods build health. Studies that were done in an attempt to replicate Feingold's findings were inconclusive, but one thing stood out on most of them (and I apologize for not having the citation).
There were two variables most responsible for the reduction in "symptoms" and inappropriate behaviors: the increased domestic structure required in order to follow the diet, and the increased amount of attention paid to the children.
Hi Docbets,
You said, "There were two variables most responsible for the reduction in "symptoms" and inappropriate behaviors: the increased domestic structure required in order to follow the diet, and the increased amount of attention paid to the children."
I remember reading that study or another one and thinking the exact same thing- that the parents who were able to follow the diet had to re-structure their lives AND pay more attention to their child, thus the improvements.
I wonder if there have been studies that compare food elimination diets like Feingold with behavioral strategies which requeare similar structure within the home. Interesting...
Terry
Featuring Content From:
By using this service, you accept our Terms of Use. Please read them. The consumer health information on is for informational purposes only and is not a substitute for medical advice or treatment for any medical conditions. You should promptly seek professional medical care if you have any concern about your health, and you should always consult your physician before starting a fitness regimen. Copyright © 2012 Remedy Health Media, LLC. All Rights Reserved.
Terry, I also watched the show and I thought it was overall pretty negative on medication. As the parent of a grown child with Bipolar, I can tell you all about the problems with having not been diagnosed early, however, I am not sure about giving medication for bipolar at the age of 2?
That said, the concerns I had with the show are:
I am sure that the doctor they showed had more empathy and discussed the mother's concerns about medication with her, however, they showed that he basically didn't listen and did not give any thought to her concerns. I am sure that was mostly editing.
Also, I would like to have seen a little more information on complementary therapies, such as family and individual counseling to help cope with and find strategies for behaviors that go along with bipolar. There are many good therapists that will work with your family as well as the individual with bipolar to help find ways to live, function and thrive in this world with bipolar and to manage the symptoms. The show gave the impression that this was not going to help at all.
In addition, I think they interviewed doctors that researched medication for a living and then seemed to put them down for researching medication only (it is their job, isn't it?)
The end of the show had the three children that they focused on doing well, even though they were all still on medication, so despite their best efforts to "put down" medication, they didn't effectively make that point, since all of the children were still taking medications.
I agree that it would be nice to see someone talk about the good that medication has done for so many people.
Eileen