A 40-fold increase in bipolar?

This is a little outside my usual areas of focus, but Michelle Cottle from The New Republic does a great job summarizing a very troubling story from the New York Times:

There’s a disturbing front-pager in today’s New York Times about the sharp increase in the diagnosis of bipolar disorder among U.S. children.

According to a study in this month’s Archives of General Psychiatry, between 1994 and 2003, the number of bipolar diagnoses for Americans under the age of 20 rose from 20,000 to 800,000. As the Times calculates it, the disorder now affects about 1 percent of the under-20 population, making it more common than garden-variety depression.

These findings strike me as deeply troubling, not because I think today’s kids are dramatically more disordered than they were a decade ago, but because–this being America–the rise in diagnoses is naturally being accompanied by a rise in the prescription of powerful drugs.

Whatever your views on America’s psychopharmaceutical habit, you have to admit we have an unfortunate (and accelerating) tendency to respond to any unpleasant behavior with medication. So be it. But ostensibly well-informed, responsible adults dosing themselves willy-nilly is one thing. Dosing their kids is another matter entirely.

For starters, as psychiatric experts told the Times, diagnosing biploar disorder in kids is an iffy business, in part because it tends to manifest itself differently in children than in adults. Worse still, the meds used to treat the disorder apparently have few proven benefits in children and can prompt some pretty nasty side effects (including tremors and rapid weight gain). As we saw with certain antidepressants’ tendency to raise the risk of suicide in kids, assuming that what’s good for Mom and Dad is also good for Junior can be flat-out dangerous.

One might argue that no parent would dose their beloved offspring with a brain-altering drug unless the kid’s behavior was so terrible that there was no doubt but that he was seriously ill. (And yes, more often than not, the child in question is a he: two-thirds of bipolar patients are boys.) But I think exactly the opposite is true: Parents understandably cannot bear to sit helplessly by and watch their children suffer–Why is he so angry? Why is he so sad? Why does he get into so much trouble at school? We want answers. We want a plan of action. We want desperately to be told by some nice doctor that the nightmare will end with the proper combination of pills. (Besides, who has the time, energy, and comprehensive insurance coverage for longer-term treatment options?)