My name is Angela Terrio and I am in school studying youth care. For a class assignment we have to create a treatment plan for a child who has bipolar disorder. Any information anyone has on the subject would be a great help.
That's easy. No child has bi-polar disorder. Hand in an empty page.
I would like to respond to Gerry's glib 'hand in an empty page' comment in response to Angela's inquiry.
While it is true that labels are often too easily assigned, and I don't necessarily accept a diagnosis at face value, he was mistaken when he implied that bi-polar disorder is not seen in children. It is true that it was once thought that children could not experience mood disorders, or that they were extremely rare. Studies and researchers are now finding that it may be more common than once thought, but it was misdiagnosed or overlooked. There is a psychiatric condition called Childhood-Onset Bipolar Disorder (COBPD) . Although this diagnosis rarely occurs in children by itself. It is often accompanied by a cluster of symptoms that when observed at certain points in a child's life suggest other comorbid disorders. (such as ADHD, OCD, conduct disorder, or oppositional defiant disorder) . Studies indicate that there is a higher incidence in children where there is a familial history of depression or other mood disorders. COBPD does not manifest itself in children in the same manner Bi-polar disorder does in adults. If Angela (or Gerry for that matter!) would like more information, there are several websites, articles and books. Try: www.bipolarchild.com; www.nami.org/helpline/bipolar-child.html; Also, there was an article in Time magazine in August 2002 focusing on the bipolar child.
Of course Lynn is correct, psychiatrists have devised a "condition" and named it "Childhood-Onset Bipolar Disorder" Now they are devising new relational and family conditions to be included in their latest list of maladies and malfunctions – I can't wait for the new line of medications to come onto the market..
I don't believe my position to be "mistaken". Stated simply, I do not accept the existence of something called "Childhood-Onset Bipolar Disorder" any more than I would accept something called "post-orgasmic bliss disorder." From my humble little place in the cosmos, the DSM IV expresses a reality that is far more psychotic than the "disorders" it attempts to define. So, for me, the problem is not one of possible "misdiagnosis" – something that doesn't exist can't be missed.
The real problem is our willingness to accept having our thoughts, feelings and behaviors medicalized in the form of simplistic "symptom" clusters before running off the the pharmaceutical companies for help. When it comes to subjecting children to this nonsense, my humor quickly turns sour. I would suggest, for example, that the ADHD label has inflicted more damage on children over the past two decades than any "real" disease or illness. Now the US Food and Drug Administration has approved the use of Prozac for children aged seven and over, we can confidently expect that "Childhood Depression" will become an epidemic in the hands of the Eli Lily Corporation (They've been lobbying for ten years on this one).
So, I don't consider my position to be "glib". Taking the life of a child and reducing it to half a dozen treatable symptoms – now that's glib.
T H A N K Y O U G E R R Y ! ! ! On behalf of my 12 year old (ADHD?) son who refuses to take prozac just because he sometimes misses his family during the day and becomes a little melancholy. :-(
Well put Gerry! I couldn't agree more.
So true. Far too often we reduce children and adults to the labels that they somehow cannot shake. I believe that if we are reduced to four words it would be nice if they could describe what we contribute to the world. In my opinion the label itself does not encourage health it does however provide financial assistance because of the way we funnel or silo our resources. One wonders if the damage that is perpetuated by labelling outweighs the treatment that is offered when one is diagnosed?
Gerry says 'hand in an empty page' – I am reminded of a story I read somewhere. Someone was interviewing Jay Haley, I think, and asked him how he treated girls with adolescent borderline personality disorder, back when that was the new and popular label of the day. He said, I don't – I just wait seven years and it will be replaced with another label.
Thanks for your support. Let's hear it for your son. He seems to have more sense than most of the professionals who seek to "cure" him. Let's hope he doesn't get involved in peddling his medication at school. It's quite the business these days.
Gerry, I can understand your objection to labels. Many times, it is too easy for the average person to dismiss someone because of a label. Just as years ago, people were being ignored during interviewing due to race or religion. Gerry you are fully entitled to your opinion. I wish to give you another perspective. I have some serious objections to your statement that psychiatrists have devised conditions. Unfortunately, I feel that the "conditions" were already there, which is why the family / person went to the psychiatrist in the first place. They want help, and they want to understand what is going on. You also said "the DSM IV expresses a reality that is far more psychotic than the "disorders" it attempts to define". Have you seen / met someone with a "Tourette Syndrome" diagnosis / label? Many appear to be defiant, or acting out... especially those who have a "mild condition". Yet, the label or diagnosis is based on the presentation of symptoms. And trust me... there is a wide range of those! This disorder has been known for over 600 years, even thou it was not named until 200 years ago. It is only now, in this age of "instant" information, that it is gaining recognition. Pharamaceutical companies had no influence 600 years ago, when people were presenting these symptoms. What the label does, is give you an idea of what to expect. A person who sees a doctor for pain in the knee, will have different reactions to the diagnosis of Arthritis vs. Cancer. Arthritus can be crippling and painful, but it is not life-threatening, although it is life-style threatening. Cancer is thought of as being life-threatening, although with modern day treatments, it does not necessarily have to be. The person still walked in with pain, wanting answers. The symptoms were the same, but the label allows how to proceed next, and what expectations are possible. That is all that the "DSM" is for. No matter what volume it is. A guidebook on symptoms and possible following proceedures. You also say: "The real problem is our willingness to accept having our thoughts, feelings and behaviors medicalized in the form of simplistic "symptom" clusters before running off the pharmaceutical companies for help".
I agree. Just because someone has a label / diagnosis does not mean that they need medications. Dr. Duncan McKinlay, a pscyhologist in Toronto Canada, does not agree that everyone who is given a diagnosis of Tourette Syndrome, needs medications. He should know... he has Tourette Syndrome. His website is www.lifesatwitch.com . However, there is no doubting that he presents the symptoms of this disorder... just watch him walking down a hall, as he whistles, barks, laughs, and so on. And you are correct that too often people go running off to the pharmacy to get "fixed". Just like doctors have given out anti-biotics for viral infections, for so many years, needlesly. It is up to the caregivers of children, to ask questions, and to decide whether or not medications are the answer for each child, individually. These labels do have a purpose. And as CYC's, we can use the knowledge that they provide, to enhance our approaches to our clients. When you know a child has Obsessive Compulsive Disorder, you understand that going for a walk to the store, may mean that your client has to stop every third step to readjust their socks. And an average 15 minute walk, may take you 45 minutes. You adjust accordingly. You don't wait to leave, until 20 minutes before the store closes.
You also said: "we can confidently expect that "Childhood Depression" will become an epidemic". How do we know it isn't already? At least, not anymore so than adult depression is. It's how we proceed that matters. Not all depression can be treated with medications, either.
I remember growing up, and the doctors saying that children did not get headaches. My own daughter, has had Migraines.. not just headaches, since she was 6 years old. She's 17 now. Age, does not disqualify symptoms. A label does not mean medications are all that is available, or that there is a "fix", for it. A label provides us with potential behaviours to expect. A child with a bi-polar diagnosis, means that we have to expect he/she will have days of withdrawal, and other days of off the wall behaviour. A child with Tourette Syndrome, may wake up one morning, coughing, clearing their throat, and sniffling... it doesn't mean they have a cold, but could simply be the presentations of their Tourette Symptoms.
A child who has been labeled with Obsessive Compulsive Disorder, may not be able to hold their pen at school, in order to do their math exam... because they have to twirl it. So, as a CYC.. we know that how we can assist this child, is to take them aside, and give them the exam, orally, while scribing for them.
Assisting the child, to live the best they can, is in my honest opinion, the main purpose of all CYC's... Anyone interested in more information on Tourette Syndrome and on how to therapeutically present this syndrome to children and others, may check out my website at: www.freewebs.com/tic_and_twitch