Tuesday, September 04, 2007

What's in a name?

A bipolar child by any other name would still have trouble in school, would have sleepless nights and unspeakable rages. But still, academia debates on, and drug companies shove diagnoses down throats:

“We are just inundated with stuff from drug companies, publications, throwaways, that tell us six ways from Sunday that, Oh my God, we’re missing bipolar,” said Dr. Gabrielle Carlson, a professor of psychiatry and pediatrics at the Stony Brook University School of Medicine on Long Island. “And if you’re a parent with a difficult child, you go online, and there’s a Web site for bipolar, and you think: ‘Thank God, I’ve found a diagnosis. I’ve found a home.’ ”


Check out the article. It's your 'day work' so to speak. I'll give you my take tonight...

6 comments:

Peggy said...

I saw that this morning, too. I printed out the article to read at my own pace. Should be interesting ...

Alison said...

It's so tricky, isn't it? It's hard enough when you're an adult and trying to explain to a therapist or doctor who doesn't really know you about what you're feeling and thinking. And even as an adult, it's hard to know that what you're feeling isn't normal. It could be. You start thinking that maybe you just don't handle things well. And so you run through a lot of medications and therapists and psychiatrists, and if you're lucky, eventually something or some combination of things works and actually makes a difference.

I can only imagine how much more difficult it is to deal with that as a child, with less of a perspective on what might might be normal feeling and thinking and behavior. You only know that you don't feel right, and you can't stand it. And then as the parent, you ache for your child. You might feel like you only want to help them and you don't know what to do. And then the frustration of not being able to keep things together and under control...

As a caretaker, you're limited in the time you can spend with patients. And these days, it seems like there's an overload of information to sift through in trying to reach a diagnosis. You want to do the best for your patients, and it's probably very easy to slip into a state where you try and make each patient fit into the charts of symptoms and treatments.

I'm not sure if they do this, but it seems to me that childhood mental and emotional disorders need to be treated as a separate entity from adult disorders. My favorite analogy is diabetes because it's a manageable condition that you can live with, but which may also kill you. And look at how we classify that - childhood diabetes, gestational (?)diabetes, diabetes associated with certain triggers like obesity or age or other diseases... And they are not diagnosed in the same way and they are not managed in the same way.

Treatments for mood disorders in children can't be treated in the same way as they are for adults. Because there are so many other factors than biological issues or a predisposition to such things, there's the whole thought side of things. That's the hard part to deal with. The thoughts triggered by the mood and the thoughts that trigger the mood. And with children who may not be able to fully express those thoughts, there needs to be specialization in helping them articulate their feeling, thoughts, and needs - to provide individual care that they need.

I still think that while the meds keep me sort of stable, the most beneficial thing that I've done to manage being bipolar is hypnotherapy. It's been the most effective and targeted treatment for my trigger and symptomatic thoughts. It doesn't make me feel worse about myself, as talk therapy often does. It's proactive. It's empowering. I really think that it could give us some means to really explore with suffering children, what they're thinking and feeling so that we can help them stabilize. Regardless of the medications or diagnoses.

And I will stop talking now!

mr lady said...

Ugh. I want your take before I spout mine.

Diane said...

I saw it and thought of you. Will read it tonight when I have more time.

caty said...

Agreed that children's mental health should be treated differently than adults. While i know there might not be a better alternative, i cringe when i think about children being on risperdal and depakote and other antipsychotics. Those meds are hardcore and i know so many educated parents know this but that is all that is working with their child. But i also know there are uneducated parents who don't understand how hardcore these drugs are and don't ask the right questions of their physicians and don't see these drugs as a last resort.
Also, am surprised that only 4 of 10 do some kind psychotherapy. For nearly all mental disorders, a combination of meds and therapy (whatever you choose--hypno, talk, behavioral, cognitive, etc) is what seems to be most effective. Interesting.
Since i have counseled kids, i understand that not all children benefit from therapy. Some kids just deal better with their families and are the type of people who like to work things out on their own. At the same time, even with my most challenging client, i think most kids want to belong and be accepted. That can't always happen in a school setting due to time and staffing constraints but in counseling, a skilled therapist can help the child feel more "normal" and process what they are feeling (i hate that word "normal" when talking about this stuff but i think you catch my drift). Anyway, that's my case for therapy. Don't know why i went off in that direction except that i was startled by the low # of kids doing any kind of therapy.
But, as you know, they probably do therapy type stuff with those kids all day at school but may not identify it as that.

Hmmmmmm, i have such mixed feelings on this issue of diagnosing kids....as i am sure so many people do.

caty said...

molly, where r u? Have been anticipating your thoughts on this topic......you ok?