800,000 "Bipolar Children"

The front cover of the May 26, 2008, Newsweek has a banner headline, "Growing Up Bipolar," with a split-face photograph of a 10-year-old boy named Max. In day care, 18-month-old Max kicked, bit, and spat on his larger peers. Before he was 2 years old, his overwhelmed parents took him to a well-known Boston psychiatrist who quickly diagnosed the toddler as bipolar and placed him on the "mood stabilizer" valproate (Depakote). This is an antiseizure drug that is sufficiently sedating to subdue the mind and behavior of children, at least until the brain compensates, causing the effect to wear off. According to the parents, the doctor told them that the bipolar diagnosis was a "life sentence." It was a life sentence, not to suffer from a mental disorder, but to suffer from lifelong exposure to psychiatric drugs. At the age of 10, Max is already 8 years into his potentially interminable sentence. The first psychiatrist probably put Max on several medications at once because a second psychiatrist wanted to "streamline" the boy's meds. Reducing anyone's medications is a rarity in psychiatry; Max's first psychiatrist must have been overprescribing even by the standards of those of his colleagues who shared his zeal for diagnosing a young child with bipolar disorder. A mere 10 years old, Max has already been on 38 different psychoactive drugs. Newsweek observes, "His parents aren't happy about it, but they have made their peace with it." The magazine concludes, "Max will never truly be OK" because of his "disease." In reality, toxic chemicals will inevitably cause developmental neurotoxicity, suppressing and distorting the growth of Max's brain. Max now leaves suicide notes for his family to find. For several years, the Food and Drug Administration (FDA) has required antidepressant drugs to carry a black box warning concerning the risk of antidepressant-induced suicidality, overstimulation, mania, and a general decline in mental condition (Breggin, 2006). Yet these drugs are frequently used to treat children labeled bipolar. More recently, the FDA issued an "Information for Healthcare Professions" warning about suicidality caused by antiepileptic drugs, many of which are used as mood stabilizers in children, including valproate (Depakote), carbamazapine (Tegretol and Carbatrol), and gabapentin (Neurontin) (FDA, 2008). Tragically, he has become so afraid of psychiatric treatment that after writing his more recent suicide note he sobbed, "Please don't send me to the hospital." From now on, Max, his family, and his doctors will face an increasingly impossible dilemma. If they try to withdraw Max from his multiple psychiatric medications, like most children in similar circumstances he will probably go through severe withdrawal problems with extreme emotional instability and the risk of worsening violence and suicidality. In? fact, we are told that an attempt to take Max off his medications resulted in his displaying hallucinations and delusions, which Newsweek attributes to his worsening condition and his need for drugs. The odds are overwhelming, instead, that he went through a severe withdrawal reaction. But if the doctors keep Max on drugs indefinitely, his brain, mind, and overall condition will further deteriorate (Breggin, 2008). Max is not an illustration of bipolar disorder in children; he is an example of the hazards of exposing small children to multiple psychiatric drugs. It can sometimes be relatively easy and safe to withdraw a child from one or even two psychiatric drugs, especially if the parents are willing to learn improved methods of disciplining their offspring. But when multiple drugs are involved, when the drugs have been taken for a long time, and when the parents are deeply distressed or cannot agree on how to raise their child, withdrawing the child from psychiatric medication can be difficult and hazardous. The Newsweek article makes clear that Max's parents have serious conflicts over how to raise their son, but they have not pursued therapy, marriage counseling, or, apparently, not even parenting classes. …