http://www.post-gazette.com/pg/07322/834548-109.stm

Pittsburgh Post Gazette
Bipolar kids or bad parents?

At the urging of parents, doctors are medicating far too many kids who
just need a better upbringing, according to
Dr. Elizabeth J. Roberts who is a child and adolescent psychiatrist and
the author of "Should You Medicate Your Child's Mind?"
Sunday, November 18, 2007

On Dec. 13, 2006, 4-year-old Rebecca Riley died, drowning in her own
lung secretions. Her death was the direct result of psychiatric
medications which had been prescribed to her for a presumed diagnosis of
bipolar disorder -- a diagnosis first given to her when she was only 2
years old.

In September 2007, researchers at Columbia University reported that
there had been a 40-fold increase in the number of children diagnosed
with bipolar disorder from 1994 to 2003 -- an increase which has shown
no signs of slowing.

Worse than the current frenzy to diagnose children with bipolar disorder
is the practice of medicating kids as young as 2 with the kinds of
psychiatric medications that were once prescribed only to psychotic
adults. The shocking reality is that the use of these potent
anti-psychotic drugs in children increased more than 500 percent between
1993 and 2002.
This dramatic rise in childhood bipolar disorder has spurred a raging
debate in the mental health field. Some psychiatrists insist that this
incredible increase is entirely due to the identification of mentally
ill children who had been previously overlooked.

Yet a 4,000 percent increase in childhood mental illness, specifically
bipolar disorder, is simply implausible and difficult to justify based
solely on improved diagnostic techniques. To the contrary, in the
30-plus years that I have been treating, educating and caring for
children -- half of that time as a child psychiatrist -- I have found
that the approach to diagnostics in psychiatry clearly has deteriorated
over time, not improved.

There was a time when doctors insisted on hours of evaluation with a
child and his parents before venturing a psychiatric diagnosis or
prescribing a medication. Today many of my colleagues brag that they can
complete an initial assessment of a child and write a prescription in
less than 20 minutes. Many parents have told me it took a previous
doctor less than five minutes to diagnose and medicate their child.

How, then, is it possible that in 2007 doctors are now able to identify
hundreds of thousands of previously missed cases of bipolar disorder in
children by reducing the time they spend with patients from multiple
hours to just a few minutes?

On the other hand, there simply is no possible way that the number of
children who actually have bipolar disorder has increased from
approximately 20,000 to 800,000 in a nine-year period. Yet the arguments
of skeptics are being dismissed by academics in psychiatry. Research
psychiatrists appear to be more invested in defending their research
conclusions -- funded by pharmaceutical companies -- than engaging in a
meaningful discussion to examine these preposterous demographics.

What I find more astounding than the claim that there are 800,000
American children with bipolar disorder is the fact that there are that
many children whose conduct is so aberrant that their parents are
seeking psychiatric treatment for them.

The symptoms, which are regarded as evidence of bipolar disorder,
usually are what most people recognize as ordinary belligerence.
Children who have anger outbursts, who refuse to go to bed, who are
moody and self-centered under the current standard of care in child
psychiatry are being diagnosed with bipolar disorder. To most rational
human beings, these behaviors describe an ill-mannered, immature and
poorly disciplined child. Nonetheless, the temper tantrums of
belligerent children are increasingly being characterized by doctors as
the mood swings of bipolar disorder.

The over-indulgent parenting practices of the past 20 years have created
a generation of dysfunctional children who are becoming increasingly
more entitled, defiant and oppositional. In a poll by Associated
Press-Ipsos, 93 percent of people surveyed said that today's parents are
not doing a good job when it comes to teaching their kids to behave.

According to Dan Kindlon, a Harvard psychologist, 50 percent of the
parents he interviewed described themselves as more permissive than
their parents had been.

The permissive parents of spoiled children seek refuge from blame by
using the excuse that their child's angry outbursts are the result of a
chemical imbalance. Since a psychiatric condition is completely beyond a
parent's control, a diagnosis of bipolar disorder is the perfect alibi.
Once a child has been diagnosed with bipolar disorder, a parent feels
absolved of guilt or responsibility for the child's misbehavior and
therefore, the parents' discipline practices cannot be called into
question.

Parents looking for a psychiatric explanation for their child's
misbehavior will find an abundance of support in the media and on the
Web for the conclusion that their child's temper tantrums are due to a
psychiatric disease rather than the result of bad parenting.
Psychiatrists, for their part, are more than willing to accept, without
question, the assessment offered by a parent. Doctors have found it
easier and less contentious to comply with a parent's wish to have their
child diagnosed with a psychiatric condition than to confront the parent
with the notion that their own weak parenting is the root cause of the
child's aberrant behavior.

Using the diagnosis of bipolar disorder, doctors then justify the
sedation of these children with powerful psychiatric drugs. Even though
some children treated with anti-psychotics may be temporarily sedated,
their belligerent attitude continues unchanged. Of the many children I
treat every year who had been previously diagnosed with bipolar
disorder, not one of them stopped throwing tantrums after being treated
with psychiatric medications. Yet doctors continue to misdiagnose and
overmedicate children to appease frustrated parents in spite of the many
serious, permanent or even lethal side effects.

Tragically, as in the death of Rebecca Riley, her parents administered
the multiple medications prescribed by their psychiatrist for Rebecca's
"bipolar disorder" until the meds killed her. A few weeks ago, in an
interview on 60 Minutes, Rebecca's mother told Katie Couric that she now
believes that her four-year-old daughter had been misdiagnosed, had
never been bipolar, and that Rebecca was simply mischievous.

When it comes to misdiagnosing and overmedicating children, doctors have
an unwitting, though not unwilling, accomplice -- the parent.
Ultimately, it is the parent who is the gatekeeper for their child's
health-care delivery. It is the parent who pursues psychiatric treatment
for their child, fills the prescriptions and administers the
medications. Parents have a duty to protect their children from the
folly of this disastrous approach to childhood behavior problems.

Instead of grooming, feeding and educating the next generation of
Americans to be the fittest, brightest, most competent contributors on
the planet, we have indulged, placated and spoiled our children into
dysfunctional misfits. We are teaching our children to use a psychiatric
diagnosis to excuse their antisocial behaviors. This will inevitably
lead to a greater reliance on psychiatric medications, which
unfortunately do not endow an individual with improved self-control or
maturity.

Under the guise of treating childhood bipolar disorder, the spoiling of
American children not only undermines their healthy social development,
but it also puts them at great risk for the serious medical
complications inherent in the use of psychiatric medications, including
death.

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