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stateofgrace -> RE: Mental Health Issues - One Stop Thread (11/24/2005 2:31:37 AM)
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I wouldn't personally consider psychiatry a soft-science, just that we are at a point where research has finally begun to uncover a lot of specifics about how the brain works...but we still have a lot to learn. Brain scanning technology, studies of genetics, etc....it's all adding pieces of the puzzle, we're just still missing some significant pieces.
A person with Bipolar Disorder, or a parent of a child with Asperger's, as two examples, often can't "afford" to wait till we have all the answers.
As far as the ADD/Bipolar thing, I personally think the explination that makes the most sense is that Early Onset Bipolar has been misdiagnosed as ADD for a good number of kids. This situation happened with our daughter.
Then the typical kid who has this misdiagnosis goes ballistic on ADD medication, and often gets put on an anti-depressant for the down/irritiable side of the mood swings, which shoots them over into the mania side more frequently (with Early-Onset, extremely rapid cycling is common). Not a pleasant experience, believe me. From the time I spent on the Child and Adolescent Bipolar Association site, I know that many other parents had this experience as well. And from their research, Dennis and Janice Paplos, the doctor and nurse that have done much to bring childhood Bipolar into focus in the last decade, discovered that this was a frequently occuring situation. This is why they recommend getting the mood disorder stabilized before considering ADD medication, if there is evidence that a mood disorder exists.
Up till recently, doctors "understood" ADD more then they understood Early-Onset Bipolar, because they were more familiar with ADD, although that is slowly changing. And, hypomania in a 4 to 6 year old looks a lot like hyperactivity. Looking back at some home videos when my daughter was that age, it really seems obvious in hindsight. But it wasn't obvious at the time.
There's some different stuff going on in the brain of someone who has "typical" ADD vs. someone who has "typical" Bipoar, either first being diagnosed in adolescence or later, or the Early-Onset type. I know Daniel Amen has identified a frequently occurring brain pattern he calls "Ring of Fire" which he first put as a subcategory of ADD, but he's appeared to move positionally that it might be more along the lines of a mood disorder.
Like with later-onset Bipolar, many Bipolar kids are able to stabilize very well on medication, once the right combination of medication for them is found. I tend to say that my daughter is 90-95% of what would be considered in a normal range as far as mood swings right now. That's a big improvement from where she was at 10 or 11. She's living a "normal" life now because a treatment was available that would stabilize her mood swings.
Teens wtih Bipolar Disorder are at high risk for suicide, and for extreme risk-taking destructive behavior. My daughter, praise God, is not struggling with either issue. OTOH, and this is JUST anedotal, but I have a friend whose son was not treated till late in his teen years (another misdiagnosis) and he's attempted suicide twice, the second time after going off meds in college. So one thing I have treally tried to hammer in with my daughter is that this is a chronic condition, and any changes in medication need to be closely supervised by a doctor, and done with personal accountability to someone. She understands chronic medical conditions because she had asthma as a young child, and at 12 her sister still has it.
I have a theory as to why we're seeing more kids with serious brain-related problems, too...beyond just using research to identify patterns occuring in many kids. Not wanting to get into something that might be considered social Darwinism, but I think that in the last few decades, cultural changes and advances in medicine have enabled more people with their own mental health problems to bear and raise children. Since there is a genetic link with many of these disorders, I think we've got more people bearing more children who are vulnerable to these disorders. As one rather simplistic example, in the day where a woman depended on a man to support her, she was less likely to look at a man that might have potential problems in taking on those responsibilities as a prospective mate.
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