I found this week’s cover story in the New York Times magazine on “The Bipolar Kid” troubling. Despite the apparently reflective subhead, “What Does It Mean to Be a Manic-Depressive Child?” the article didn’t answer that question. By page two of the article we learn that experts don’t agree on what characterizes manic depression in kids and many say the “the illness looks significantly different in children.” And the prime expert quoted in the article says that mania, one of the twin poles that define manic depression, actually looks not like” elevation” but like “irritability” in kids.
Huh? If you don’t know what characterizes a disease, how do you know what counts as having it? And if you redefine the terms that had been used to characterize the disease, what does it even mean to say someone has it? This is classic bad science.
That’s bad enough. But the heartbreaking part is that labeling these kids with this pseudo-diagnosis sets them on track to medication with psychoactive drugs with major and often devastating side effects. Drugs like Lithium are nerve agents that cause Parkinson-like damage to the brain. Bad enough to do that to a grownup, whose brain is fully formed and can give meaningful consent to such treatment. But to do this to the forming brain of a child is barbaric.
The children described in the article are seriously disturbed—and disturbing. My heart went out to the little sister of a rage-filled boy, who clearly had been abused and traumatized by him since birth. And I could imagine that when a child is that out of control and violent, especially if you have other children, you would feel desperate to find some way of controlling him. Drugging him no doubt seems preferable to putting him in a padded cell for the rest of his life. But to call the drugging “treatment” and claim you have a scientific diagnosis becomes an excuse to treat thousands of much less disturbed children with these drugs. No surprise, that’s exactly what’s happened. A recent study cited in the article found a fortyfold increase in the number of children diagnosed with manic depression between 1994 and 2003.
Huh? If you don’t know what characterizes a disease, how do you know what counts as having it? And if you redefine the terms that had been used to characterize the disease, what does it even mean to say someone has it? This is classic bad science.
That’s bad enough. But the heartbreaking part is that labeling these kids with this pseudo-diagnosis sets them on track to medication with psychoactive drugs with major and often devastating side effects. Drugs like Lithium are nerve agents that cause Parkinson-like damage to the brain. Bad enough to do that to a grownup, whose brain is fully formed and can give meaningful consent to such treatment. But to do this to the forming brain of a child is barbaric.
The children described in the article are seriously disturbed—and disturbing. My heart went out to the little sister of a rage-filled boy, who clearly had been abused and traumatized by him since birth. And I could imagine that when a child is that out of control and violent, especially if you have other children, you would feel desperate to find some way of controlling him. Drugging him no doubt seems preferable to putting him in a padded cell for the rest of his life. But to call the drugging “treatment” and claim you have a scientific diagnosis becomes an excuse to treat thousands of much less disturbed children with these drugs. No surprise, that’s exactly what’s happened. A recent study cited in the article found a fortyfold increase in the number of children diagnosed with manic depression between 1994 and 2003.
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