Childhood Bipolar Disorder

Prior to about 1994, childhood bipolar disorder was virtually unheard of.  DSM-III-R (1987), in the section on manic episode, states, “…studies indicate that the mean age at onset is in the early 20s.  However…a sizable number of new cases appear after age 50.”(p 216)  Of course a mean age of onset in the early 20’s could include young children.  The section on major depressive episode, however, contains the following:  “The average age of onset is in the late 20s, but a major depressive episode may begin at any age, including infancy.” (p 220)

If, in fact, the APA envisaged the possibility of bipolar disorder occurring in infancy, wouldn’t they have included some similar phrase in the mania section?

DSM-IV (1994) confirms the mean age of onset in the early 20s, but extends the range downward to “adolescence.”  There is no indication of this condition in younger children.

In 1994, Joseph Biederman, a Harvard psychiatrist, began to promote the concept of childhood bipolar disorder.  In this he was ably abetted by the pharmaceutical industry, with which he was financially entangled to a degree that destroys any semblance of credibility.  Biederman’s financial conflicts were exposed by Sen. Charles Grassley, who has long pushed for complete disclosure in this area.  The NY Times did a very interesting article on the subject, the first paragraph of which reads as follows:

“A world-renowned Harvard child psychiatrist whose work has helped fuel an explosion in the use of powerful antipsychotic medicines in children earned at least $1.6 million in consulting fees from drug makers from 2000 to 2007 but for years did not report much of this income to university officials, according to information given Congressional investigators.”

The complete article is well worth a look.

Some psychiatrists were alarmed by this development, and spoke out, but the majority (of course) played along.  After all, business is business.

Between 1994 and 2003, there was a 40-fold increase in the number of American children who received this “diagnosis.”  I haven’t been able to find more recent figures, but my impression is that it continues to rise.

Almost without exception, the presenting problem in these children is severe misbehavior and temper tantrums, secondary to ineffective parenting.

The “treatment” consists of drugs: anti-psychotics, anti-convulsants, and lithium carbonate.  The side-effects of these drugs in adults are listed below:

Major Tranquilizers

  • neuroleptic malignant syndrome (potentially fatal)
  • fever, stiff muscles, confusion, sweating, fast or uneven heartbeats;
  • tardive dyskinesia (an irreversible condition involving severely disfiguring and uncontrollable movements, especially constant chewing/grinding movements of the jaws accompanied by tongue protrusion)
  • drooling, tremor (uncontrolled shaking);
  • seizure (convulsions);
  • flu-like symptoms;
  • trouble swallowing;
  • penis erection that is painful or lasts 4 hours or longer.

Anti-convulsants

  • liver damage
  • birth defects in offspring (e.g., spina bifida)
  • pancreatitis

Lithium Carbonate

  • kidney damage
  • birth defects in offspring
  • tiredness
  • uncontrollable shaking
  • muscle weakness, stiffness, twitching
  • excessive thirst
  • frequent urination
  • seizures

The side effects in young children, whose organs are still developing, are unknown.  Tardive dyskinesia should cause particular concern, in that in the initial stages it is masked by the major tranquilizers, and so is usually quite advanced by the time it is detected.  The condition is irreversible.

The recent “epidemic” of childhood bipolar disorder is just the most recent example of disease-mongering by psychiatrists, but it is somewhat egregious, in that it involves exposing children as young as two years to extraordinarily dangerous drugs.  Even the APA, not noted for restraint in this general area, has expressed some concerns, and there have been indications that DSM-5 will caution against excessive use of this so-called diagnosis.  But don’t get too excited.  The word is that the revision, due out later this year, will simply offer suggestions for alternative “diagnoses.”  My guess is that the drug prescriptions, however, will continue unabated – or even increase.

The reason that psychiatrists can expand the scope of their diagnostic categories with such ease is that the diagnostic concepts have no validity in the first place.  Wood doesn’t become stone just because we say so. And ordinary problems of life don’t become illnesses just because financially-motivated psychiatrists say so.  Childhood temper tantrums are nothing more than childhood temper tantrums.  Re-defining these as symptoms of an illness is arbitrary, unwarranted and unproven.  For the past sixty years, the primary agenda of American psychiatry has been the medicalization of ordinary human problems in order to legitimize the administration of drugs.

The concept of mental illness is nonsense – but in the hands of psychiatrists, it is dangerous and destructive nonsense.

The psychiatrists, of course, say that they are trying to alleviate the previously unrecognized suffering of these children and their families, and that the dovetailing of their selfless devotion with their own financial interests is purely incidental.

But in fact, labeling children as bipolar and prescribing drugs as a substitute for learning to cope is simply one more step in psychiatry’s endless process of disempowerment.  The message they give to these families and to these children is – you can’t cope.  Come to us you huddled, helpless masses, and we will drug you – for money.