A Rush to Medicate Young Minds

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Of possible interest to those with children or grandchildren diagnosed

with behavioral disorders.

A Rush to Medicate Young Minds

http://www.washingtonpost.com/wp-dyn/content/article/2006/10/06/AR2006100601391.\

html

By J.

Sunday, October 8, 2006; B07

I have been treating, educating and caring for children for more than 30

years, half of that time as a child psychiatrist, and the changes I have

seen in the practice of child psychiatry are shocking. Psychiatrists are

now misdiagnosing and overmedicating children for ordinary defiance and

misbehavior. The temper tantrums of belligerent children are

increasingly being characterized as psychiatric illnesses.

Using such diagnoses as bipolar disorder, attention-deficit

hyperactivity disorder (ADHD) and Asperger's, doctors are justifying the

sedation of difficult kids with powerful psychiatric drugs that may have

serious, permanent or even lethal side effects.

There has been a staggering jump in the percentage of children diagnosed

with a mental illness and treated with psychiatric medications. The

Centers for Disease Control and Prevention reported that in 2002 almost

20 percent of office visits to pediatricians were for psychosocial

problems -- eclipsing both asthma and heart disease. That same year the

Food and Drug Administration reported that some 10.8 million

prescriptions were dispensed for children -- they are beginning to

outpace the elderly in the consumption of pharmaceuticals. And this year

the FDA reported that between 1999 and 2003, 19 children died after

taking prescription amphetamines -- the medications used to treat ADHD.

These are the same drugs for which the number of prescriptions written

rose 500 percent from 1991 to 2000.

Some psychiatrists speculate that this stunning increase in childhood

psychiatric disease is entirely due to improved diagnostic techniques.

But setting aside the children with legitimate mental illnesses who must

have psychiatric medications to function normally, much of the increase

in prescribing such medications to kids is due to the widespread use of

psychiatric diagnoses to explain away the results of poor parenting

practices. According to psychiatrist , quoted in the

January/February issue of Psychotherapy Networker, " Many clinicians find

it easier to tell parents their child has a brain-based disorder than to

suggest parenting changes. "

Parents and teachers today seem to believe that any boy who wriggles in

his seat and willfully defies his teacher's rules has ADHD. Likewise,

any child who has a temper tantrum is diagnosed with bipolar disorder.

After all, an anger outburst is how most parents define a " mood swing. "

Contributing to this widespread problem of misdiagnosis is the doctor's

willingness to accept, without question, the assessment offered by a

parent or teacher.

What was once a somber, heart-wrenching decision for a parent and

something children often resisted -- medicating a child's mind -- has

now become a widely used technique in parenting a belligerent child. As

if they were debating parental locks on the home computer or whether to

allow a co-ed sleepover, parents now share notes with each other about

whose child is taking what pill for which diagnosis.

These days parents cruise the Internet, take self-administered surveys,

diagnose their children and choose a medication before they ever set

foot in the psychiatrist's office. If the first doctor doesn't prescribe

what you want, the next one will.

There was a time in the profession of child psychiatry when doctors

insisted on hours of evaluation of a child before making a diagnosis or

prescribing a medication. Today some of my colleagues in psychiatry brag

that they can make an initial assessment of a child and write a

prescription in less than 20 minutes. Some parents tell me it took their

pediatrician only five minutes. Who's the winner in this race?

Unfortunately, when a child is diagnosed with a mental illness, almost

everyone benefits. The schools get more state funding for the education

of a mentally handicapped student. Teachers have more subdued students

in their already overcrowded classrooms. Finally, parents are not forced

to examine their poor parenting practices, because they have the perfect

excuse: Their child has a chemical imbalance.

The only loser in this equation is the child. It is the child who must

endure the side effects of these powerful drugs and be burdened

unnecessarily with the label of a mental illness. Medicating a child,

based on a misdiagnosis, is a tragic injustice for the child: His or her

only advocate is the parent who lacked the courage to apply appropriate

discipline.

Well-intentioned but misinformed teachers, parents using the Internet to

diagnose their children, and hurried doctors are all a part of the

complex system that drives the current practice of misdiagnosing and

overmedicating children. The solution lies in the practice of good,

conscientious medicine that is careful, thorough and patient-centered.

Parents need to be more careful with whom they entrust their child's

mental health care. Doctors need to take the time to understand their

pediatric patients better and have the courage to deliver the bad news

that sometimes a child's disruptive, aggressive and defiant behavior is

due to poor parenting, not to a chemical imbalance such as bipolar

disorder or ADHD.

The writer is a child and adolescent psychiatrist in California and the

author of " Should You Medicate Your Child's Mind? "

--

ne Holden, MS, RD < fivestar@... >

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