http://www.newsweek.com/id/137517
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COVER:
GROWING UP BIPOLAR
NEWSWEEK
EXAMINES BIPOLAR DISORDER IN CHILDREN
THROUGH EXPERIENCE OF ONE FAMILY
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DISEASE
HARD TO PIN DOWN; AT LEAST 800,000 CHILDREN IN U.S. DIAGNOSED
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UNCLEAR
HOW DRUGS WORK; NO STUDIES ON LONG-TERM EFFECTS IN CHILDREN
New York-As Newsweek General Editor Mary
Carmichael reports in the May 26 cover, "Growing Up Bipolar" (on
newsstands Monday, May 19), childhood bipolar disorder is hard to pin down. At
least 800,000 children in the U.S. have been diagnosed as bipolar, no doubt
some of them wrongly. There are many drugs, but it's unclear how they work.
Often they don't work at all, and they may interfere with normal brain growth.
There are no studies on their long-term effects in children. Yet untreated
bipolar disorder can be disastrous; 10 percent of sufferers commit suicide.
Parents
must choose between two wrenching options: treat their children and risk a bad
outcome, or don't treat and risk a worse one. No matter what they do, they are
in for uncertainty and pain. Carmichael reports on the dilemma by telling the
wrenching story of one family, Amy and Richie Blake and their 10-year-old son
Max, who was diagnosed with bipolar disorder when he was two years old.
She
reports that Max was seven the first time he tried to kill himself. He wrote a
four-page will bequeathing his toys to his friends and jumped out his
ground-floor bedroom window, falling six feet into his backyard, bruised but in
one piece. Children don't really know what death is, as the last page of
Max's will made clear: "If I'm
still alive when I have grandchildren," it began. But they know what
unhappiness is and what it means to suffer.
On a
recent Monday afternoon, Max, now 10, was supposed to come home on the
schoolbus, but a counselor summoned his mother at 2:15. When Amy Blake arrived
at school, her son gave her the note that had prompted the call. "Dear
Mommy & Daddy," it read, "I am really feeling sad and depressed
and lousy about myself. I love you but I still feel like I want to kill myself.
I am really sad but I just want help to feel happy again. The reason I feel so
bad is because I can't sleep at night.
And dad
yells at me to just sleep at night. But, I can't control it. It is not me that
does control it. I don't know what controls it, but it is not me. I really
really need some help, love Max!!!!! I Love you Mommy I Love you Daddy."
At 10,
Max Blake has been on 38 different psychoactive drugs, Carmichael reports. The
meds have serious side effects. They have made Max gain weight, and because
he's still growing, they frequently need to be changed. The Blakes are aware
that many people think their child-any child-should not be on so many drugs.
They aren't always happy about it either. But to some degree, they have made
their peace with medication.
"He's
oppositional-defiant, he's dyslexic, he's ADHD, he's OCD," says Amy.
"Give me an initial and he has it."
Bipolar children, especially those diagnosed early, often have such a
litany of disorders. The bipolar brain tries to compensate for its weak
prefrontal cortex by roping in other areas to help; these areas may now become
dysfunctional, too. Child psychiatrists thus face an enormous practical
challenge: they often can't treat one disorder without affecting another one.
"It's like a balloon where you push on one side and the other side pops
out," says Janet Wozniak, the Massachusetts General Hospital psychiatrist
who helped define childhood bipolar disorder. With kids like Max, she adds,
parents often have to settle for "just having one part of the symptoms
reduced."
Max's
life has improved in some ways since his early childhood. The Manville School,
part of the Judge Baker Children's Center in Boston, has given him a social
life. Last year he won a "Welcome
Wagon" award after teachers noticed he was always the first to show new
students around. When his classmates have outbursts of their own, he talks them
down. "He'll say that maybe they need to take some space, take a deep breath,
leave the classroom," says his teacher, Julie Higgins.
He has
not, however, figured out how to talk himself down, and for all he has
progressed as a classmate, he struggles as a student. Technically, Max is in
fourth grade-Manville does not separate grade levels-but he is behind in some
subjects. He loves science and art, but he has a hard time reading, and
although he is creative, he can't put his ideas in a coherent order. Even
holding a pencil for more than a few minutes can be a challenge. "Sometimes
you can look at him and you know his disorder has captured him," says the
school's director, Jim Prince. "But we can't abandon him. We have to be
able to hold on to him, sometimes literally, but also emotionally, to help him
come out on the other side."
# # #
(Read cover story at www.Newsweek.com.)