For me as a former worker in the medical field, who is coming from the other part of the world, the predilection for medicament over usage in the U. S. was always surprising. Therefore, I was expecting to see in this video issues about psycho-neurological side effects of overmedicated in somatically ill child. There were several memorable moments which impacted my mind. One of them was Jacob’s story. It was sad to see how the persistent labeling with hyperactivity by preschool teachers took a 3 year old boy down to the pathway of a million American children, who were eventually diagnosed with bipolar disorder.
Most of these children were forced to take several strong antipsychotic drugs and mood stabilizers already in their teens. It is widely known that early childhood is one of the most physically active period of the life, in which the child undergoes an important anatomical, physiological and cognitive development. Therefore, the hyperactivity in early childhood is one of the traits of normal children’s development and it should not be over diagnosed. Unfortunately, Jacob’s teachers and doctors did not think in that way and the child was prescribed one drug and then a second one followed by many others.
These drugs do not always help the child completely. In Jacob’s case particularly, drugs caused harmful side effects, and consequently were leading to new prescriptions. The other memorable line from the video was that, despite the parents of the affected children were reluctant to the offered drug therapy, no one of the doctors suggested an alternative to the medications. In contrast, instead of trying some techniques of other non-pharmacological therapies, doctors tended to increase dozes or simply added a new medication.
It is understandable, that in some true bipolar cases doctors do not have the other choice then medication. However, it seemed that doctors tended to over diagnose, and consequently over use the medications. The number of affected children with bipolar disease is just frightening: a million of children are diagnosed with mood disorder in the U. S. According to the video’s statistic, the diagnosis of bipolar disorder increased to four thousand percent during the last decade. This labeling process seems to e almost a medical crime, where modern “Walter Freemans” easily manipulate and experiment the biochemical processes in the developing child’s brain by using strong mood stabilizers and antipsychotic drugs. Nevertheless, it puzzled me why so many doctors do not want to start with a mild therapeutical approach. For example, in many other countries treating childhood’s behavior problems with pharmaceutical substances is still almost a nonexistent practice. Instead of medications, other therapies are offered through special programs in school or kindergarten, where children learned to develop coping mechanisms.
This controversial video raised my following questions. First of all, why is the diagnostic rate of bipolar disorder among children so high in the U. S. ? Why diagnosed children start immediately with pharmaceutical treatment instead of trying other approaches? Whose fault is this tragic situation? When I started think about all this questions the other questions popped up in my mind: Are there any standards for normal child’s behavior? Who is in the charge of determination of them?
Then I recalled the discussion in the beginning of the course, where I learned, that often the society and the culture determine the line between normal and abnormal behavior. Therefore, certain members of society such as teachers, doctors, parents are the one who establish the criteria, which are applied on the one or the other disorder. In the sake of finding answer to my questions, I looked to recent publications which addressed the controversy regarding diagnosis and treatment of bipolar disorder among the children.
I found some explanations in the publication of Erik Parents and Josephine Johnston entitled “Controversies concerning the diagnosis and treatment of bipolar disorder in children” in Child and Adolescent Psychiatry Mental Health, 2010;4:9. According to the publication, children in the U. S. are brought to physicians’ offices more frequently for behavior problems leading to a more frequent diagnosis of bipolar disorder. In the U. S. there is also a higher rate accepted by the society and culture to use antipsychotic medication and mood stabilizers compared with other countries.
In these countries the emphasis is put more on psychotherapy. My other question about non-pharmacological alternatives was reflected in the statement: the teaching children problem-solving skills and teaching their parents to reward positive child behavior, are costly and difficult to disseminate. Physicians and families seems to focus primarily or solely on medication in order to reduce the cost for psychotherapy and also to cut back their time of active therapeutic involvement.
Finally, Parens and Johnston emphasized the evidence that the pharmaceutical industry plays a distressingly large role in shaping the interpretations and values of disorders. Even though the video almost fully covered the topic, I still have a feeling of missing part. The movie does not mention about the socio-psychological environment of children with psychological disorders. Many studies confirm that not only nature but also nurture has a profound effect on the development of children’s personalities. Therefore, parenting style plays a role on the attention and self-regulatory capacity of the child.
Moreover, according to the World Health Organization, the child with attention deficit hyperactivity disorder can represent family dysfunction or inadequacy in the educational system rather than an individual psychopathology. After watching the video I had a bitter feeling for these medicated children. It was painful to see how 3-year old DJ innocently was taking heavy medications from mother’s hands and artlessly consumed them. It is sad to say, but there is huge possibility that this children will end up in the same way as Jacob Solomon, with irreversible side effects and anticipation of a lifelong treatment.
The fact of over-diagnosing and consequently over-using antipsychotic drugs and mood stabilizers at such young age frustrated me. I hope that this growing medicated population will not be next terrifying tragedy of the nation. I was not familiar with the issue of medicated children before this movie. I did not expect that the rate of bipolar disease among the children in U. S. to be so high. Also, the facts of over-diagnosing and over-using anti-psychotic medications and mood stabilizers exceeded my expectation. The video changed my mind in the way that I have a better insight of the current, heart breaking problem.
Also, it was eye-opening that due to biochemical and anatomical changes of developing brain sometimes is too easy, and from the other had too dangerous to overmedicate the growing child. After watching this video I have a mind-changing perception that society often times supports the idea of medicating the children, which, unfortunately, starts from innocent in fact the sign of hyperactivity. I learned that the absence of clinical research data in children and lack centralized control of pharmacological therapy given to children can bring a tragedy in some families, and also can be catastrophic for growing population.