Implications, NeuroPsyche, Toxicology

The Patriot Ledger How many more Rebecca Rileys? To diagnose a 2-year-old as bipolar by adult standards is crazy

Letters to the editor:

By Jacob Azerrad

Jan 10, 2009

— In a 2007 “60 Minutes” episode, Katie Couric focused on the short
life of 4-year-old Rebecca Riley of Hull. Diagnosed with bipolar
disorder at age 3, she was dead one year later from an overdose of a
psychotropic drug cocktail. At one point, Couric asks Rebecca’s mother,
who has been charged with her daughter’s murder, if she thinks her
child’s behavior might have been normal. That in fact, maybe little
Rebecca was just exhibiting Terrible Two’s behavior.

Couric might well ask mental health professionals: Whatever happened to the Terrible Two’s?

use a medical model developed by Freud, not a behavioral model, to
measure behavior. Freud believed that if a behavior works, it’s
healthy, and if it doesn’t, it’s sick. So if a 3-year-old is drawing
inside the lines of the coloring book, parents don’t have a thing to
worry about, but if he or she is drawing on the wallpaper, the stage is
set for a clinical diagnosis.

there’s a pill to fix it. There are pills for yelling, biting,
throwing, kicking, cursing, punching, name-calling and lying. There are
pills for whispering in class, for when grandma dies and for bad
habits. There are pills for daydreaming.

There’s a big
difference between using medicines to treat genuine mental illness and
designing new drugs to medicate perfectly healthy children. Today, as
the mental health industry systematically pathologizes more and more
childhood behavior, we see a raft of drugs aimed at “curing” them.

the medical model of behavior overshot its target. Now it’s treating
learned responses as though they were diseases, and almost all human
behavior is based on learned responses.

Studies in the 1970s and
’80s concluded bipolar disorder was rare in children, but between 1994
to 2003, there was an astounding 40-fold increase diagnosing bipolar
disorder in children. Children as young as Rebecca are now given
powerful drugs not approved for children.

In Massachusetts
alone, from 1988 to 2003, the prescription of stimulants,
antidepressants and anti-psychotics given to children rose more than
300 percent, and the number of teenage users is even greater.

1993 through the first three months of last year, 1,207 children who
were given Risperdal suffered serious problems, including 31 who died.
Among the deaths was a 9-year-old who suffered a fatal stroke 12 days
after starting therapy with Risperdal.

A key issue is the misuse
of psychiatric diagnostic labels to explain bad behavior in children.
This has resulted in the drugging of young children to a degree
unprecedented in our history. To diagnose a 2-year-old as bipolar by
adult standards is crazy.

The behavior of a 2-year-old is filled
with curiosity about everything and anything. The young child has
extraordinary ability in terms of emotions and cognitions. They can be
very upset very quickly, very angry, very depressed, because their
emotions are so fluid, so available. When a guy in the Terrible 50s
tries to diagnose the Terrible Two’s on an adult level, that is
craziness and dangerous.

By prescribing strong medicines instead
of teaching children new choices using proven behavioral methods, we
short-circuit a child’s learning process and, even worse, lay the
tracks for a lifetime habit of responding to challenge and
disappointment with avoidance, denial and chemical dependency.

up is not a condition. Childhood is not a disease. Children act up and
defy authority and they need adults to teach them how to manage
difficult feelings and handle disappointment appropriately.

are ways for parents to do this that are quite effective and don’t
involve drugs, but they do involve parents being teachers. Our
preschool children are far too young to defend themselves.

up to parents to “say no to drugs” and teach their children that life
is meant to be learned and experienced – it’s not just a pill to be

Jacob Azerrad, a
clinical psychologist in Lexington, is the author of “From Difficult to
Delightful in Just 30 Days,” published by McGraw-Hill.


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