20% of American children suffer from mental illness

The new SCHIP (State Children’s Health Insurance Program) law that President Obama signed significantly increases health coverage for children, which also includes mental health parity. According to Nancy Shute of U.S. News & World Report, health coverage is expanded to:

“4 million more children beyond the 6 million already covered but also brings mental-health parity to the state programs that provide insurance for children in low-income families, requiring that they get the same access to treatment for bipolar disorder, depression, anxiety, and other serious disorders as they do for physical ailments.”

Then I stumble across this:

“Mental-health needs are nowhere near being met,” says Jay E. Berkelhamer, past president of the American Academy of Pediatrics and chief academic officer at Children’s Healthcare of Atlanta. “At least 20 percent of all visits to pediatricians’ offices are related to mental-health problems.“

Normally, though, overworked pediatricians may not ask if a child has a mental-health problem—and may not know where to refer him or her if they do. About 20 percent of children and teenagers have a mental-health problem at any given time, or about 8 million to 13 million people. Two thirds of them are not getting the help they need.

That means out of roughly 40-65 million kids, we have 8-13 million who are “mentally ill.” And then about 5-8 million who aren’t getting proper mental help.

Color me cynical but I think 20 percent is a disproportionately high number to classify children as mentally ill. I think the percentage of adults being classified as mentally ill is exorbitant enough, let alone children who are going through stages in their lives where they’re simply developing, encountering mood swings, being disobedient, and perhaps, being — perish the thought! — normal children.

But let’s address something else here: I don’t think it’s impossible for children to suffer from mental illness but the incidence should be significantly lower.

According to Dr. Louis Kraus, the chief of child and adolescent psychiatry at Rush University Medical Center in Chicago, suicide ranks as the sixth-leading cause of death among ages 5-14 — “although rare.” From ages 15-24, it jumps to number three.

The key word in that last paragraph is suicide is “rare.” The rate of mental illness in children should reflect that somehow. While I’m very happy SCHIP includes widespread mental health parity for low-income families, I’m also concerned children will be overdiagnosed with a “mental illness” when they may simply be dealing with the normal challenges of a difficult life.

“I used to care, but now I take a pill for that.” — Author unknown

Philip Dawdy at Furious Seasons has some great posts on the bipolar child paradigm that further explore the murky world of psychiatry pushing psychiatric illnesses and psychotropic drugs on kids. I’d also recommend reading Soulful Sepulcher as Stephany recounts her and her daughter’s experiences in and out of the mental health system.

(pic from save.org)

Loose Screws Mental Health News (the ODD version)

I came across an article in my Google Alerts titled, “Harvard study: Under-treatment of mental illness contributes to crime.” Intrigued, I clicked on the link to read more of the article. Turns out the lede is:

Two thirds of prisoners nationwide with a mental illness were off treatment at the time of their arrest, according to a new study by Harvard researchers that suggests under-treatment of mental illness
contributes to crime and incarceration.

The article is poorly titled. The headline was designed to be alarming: “Watch out for those crazy people! They’re violent!” It’s not “under-treatment of mental illness” that “contributes to crime” so much as it is “two-thirds of inmates with mental illness are off medication.” There’s nothing in the article that asserts people with mental illness contribute to the crime rate in America. An interesting read but an inaccurate head.

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The New York Times had an article a few weeks ago on compulsive shopping eventually becoming a legitimate disorder. I’d been wanting to write about this for a while but Gianna at Beyond Meds beat me to it. She aptly titles her post, “It’s called poor impulse control, people .” She writes:

It’s a psychological problem. But let’s relegate out of control shopping to a brain disorder too, so people can have one less thing to take responsibility for. This is really getting ridiculous. Pretty soon we won’t be responsible for any of our bad behavior as it all becomes pathologized and out of our hands. And you can be sure they’ll be a drug for it, too. Since their calling it OCD related it’s a good bet they’ll try out SSRIs.

The DSM-V is currently being crafted in secret but everyone in the medical field fully expects new disorders (such as subthreshold bipolar disorder and Internet addiction) to pop up. Don’t be surprised if CSD (compulsive shopping disorder) pops up in it too. (pic via pro.corbis.com)

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In related let’s-give-everything-a-diagnosis news, some mental health experts are assigning a new label to women obsessed with having children: baby addiction.

…Sometimes the desire to keep having children can be rooted in complex psychological issues dating as far back as one’s childhood. In certain cases, experts say, it can become a compulsion, an obsession or even a “baby addiction.”

While the current book of psychiatric diagnoses, the “Diagnostic and Statistical Manual of Mental Disorders,” has no entry on baby addiction, mental-health professionals say they see patients, mostly women, who desperately want to keep having newborns, even when they already have several children and aren’t managing their family situation well. That, they say, is a big red flag, no matter what term is used to describe it.

“It can be an addiction,” says Gayle Peterson, a family therapist in the San Francisco area and author of “Making Healthy Families.”

Peterson has seen several women in her practice who’ve been overwhelmed with four or five children, including those with special needs. Some of the women were suffering with depression or panic attacks and yet when their youngest child became a toddler, they wanted another baby. These women can be driven to have more children in an effort to make up for some sort of void or loss, usually from their own unhappy childhood, explains Peterson.

“If you’re just having babies to complete something in yourself that never got completed, you really are talking about an addiction,” she says.

While it might be an addiction, it’s not DSM-V diagnosis-worthy and it definitely doesn’t need medicinal treatment. Get some psychotherapy and call it a day. An addiction like this is behavioral more than anything else. (pic via sodahead.com)

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And last but not least, we’ve also got a new case of “climate change delusion.” (Ha!)

Last year, an anxious, depressed 17-year-old boy was admitted to the psychiatric unit at the Royal Children’s Hospital in Melbourne. He was refusing to drink water. Worried about drought related to climate change, the young man was convinced that if he drank, millions of people would die. The Australian doctors wrote the case up as the first known instance of “climate change delusion.”Robert Salo, the psychiatrist who runs the inpatient unit where the boy was treated, has now seen several more patients with psychosis or anxiety disorders focused on climate change, as well as children who are having nightmares about global-warming-related natural disasters.

–snip–

Of course, no one can predict what effect warming will have on our psyches. The links between mental illness and the weather can be tenuous or even downright contradictory. Depending on which studies you read, suicide is more common, less common, or equally common in hot weather. Ditto dry weather.

It looks like my post just turned into an ODD (OverDiagnosis Disorder) case. I’ll get back to you once I’m free of my concern for the environment, my desire for multiple children, and my penchant for window shopping.

Bipolar Awareness Month

Apparently February is Bipolar Awareness Month. (Who decided this?) I’m well aware that I suffer from bipolar disorder, thankyouverymuch. Looking forward to Bipolar Overawareness Week in May.

Loose Screws Mental Health News

I decided to publish a “Loose Screws Mental Health News” post even though I said a few weeks back I wouldn’t do it anymore. Eh, can I change my mind? “Yes I can.”

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According to the Journal of Psychiatric Research and the British Journal of Psychiatry, women who had abortions suffered from more mental problems than women who did not. However, a report from the American Psychological Association asserts that there is no connection between abortion and mental health issues. (via CBN News; photo from solarnavigator.net)

I can’t imagine that there is no connection. Considering an abortion is stressful enough. I would think actually following through with it would induce a whole new set of problems.

I’m sure Liz Spikol has probably linked to this article already but the Philadelphia Weekly had a great cover story about a man’s struggle to take care of his mentally ill older brother who has bipolar disorder with psychosis. It’s a long read but well worth it and very touching. It reminded me a little bit of what my mother and I went through with my father which made me very empathetic.

An article in the Daily Mail reports that some scientists think depression can be good for people:

There are, they say, more benefits from the blues. Being sad can leave victims stronger, better able to cope with life’s challenges, and can lead to great achievements.

And their claims may stack up historically with Sir Winston Churchill, Abraham Lincoln, Sir Isaac Newton and Beethoven all suffering from some form of depression.

A growing number of psychiatrists are now questioning whether doctors and drug companies are too keen to treat the condition with pills that may have side effects and also harm the evolution of human emotion.

I think there’s some truth to that and I wholeheartedly agree with the third paragraph. However, I wonder if they’re simply addressing normal depression aka “the blues” rather than clinical or chronic depression.

Rare long, rambling, stream-of-consciousness post

Update: I decided to republish this for two reasons:
1) It’s a great point of reference for me to reread when these issues rear their ugly heads again (reading a draft is hellannoying) and 2) Ana reminded me that it’s good to know others feel the same and know they’re not alone.

If you’ve stumbled upon this post for the first time, I hope it can help you in some small way.

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It’s another one of those days. I’m at work, struggling with social anxiety yet again. I don’t normally ramble on my blog but I think everyone needs a vent post now and then. It’s not just about social anxiety but sort of a thought dump. It’ll likely be a long stream-of-consciousness vent post and may not make sense. I’m not editing it and it won’t have the best grammar. Expect run-on sentences. I don’t expect you to read it all; I have no attention span to reread it myself. It’ll just make me feel better. Deal.

WARNING: There is cussing in this post. If you are offended by that kind of language, I suggest you stop reading.

Do I have bipolar disorder because my father had schizophrenia?

According to researchers at Stockholm's Karolinska Institute, schizophrenia and bipolar disorder may have common genetic causes. Researchers studied 9 million Swedish people during a 30-year period and discovered that "relatives of people with schizophrenia or bipolar disorder had an increased risk of both disorders." The study may also suggest that "the two conditions may simply be different manifestations of the same disease."

The article from Reuters also points out that Seroquel and Zyprexa are used to treat both disorders, which may lead people in the psychiatric industry to further investigate the link between the two illnesses. Here are some interesting discoveries from the study:

 *  First-degree relatives (parents, siblings, or offspring) of people with either schizophrenia or bipolar disorder were at increased risk for both of these conditions.

 * If a sibling had schizophrenia, full siblings were nine times more likely than the general population to have schizophrenia and four times more likely to have bipolar disorder.

 * If a sibling had bipolar disorder, they were eight times more likely to have bipolar disorder and four times more likely to have schizophrenia.

 * Half siblings who shared the same mother were 3.6 times more likely to have schizophrenia if their half sibling had schizophrenia and 4.5 times more likely to have bipolar disorder if their half sibling had bipolar disorder. Half siblings who shared the same father had a 2.7-fold increase in schizophrenia risk and a 2.4-fold increase in bipolar disorder.

 * Adopted children with a biological parent with one of the disorders had a significant increase in risk for the other.

Creepy. My father's schizophrenia didn't begin to manifest itself until he was in his 40s. The same is true for my two other aunts as well. It may be silly but I live in fear that I may have the same problem. I'll eventually get a psychiatric advance directive in place just in case that day ever comes. After seeing three family members with debilitating schizophrenia/paranoia, sometimes it gets to the point where the benefits of being drugged up outweigh the risks.

Mood rating: 6

Christian counseling: Nouthetic vs. Biblical

Last night, I spent some time on the phone with my husband’s friend’s sister (aka my former pastor’s sister). We’ll call her Natalie.

Natalie was very sweet and kind, really encouraging and strengthening me by sharing her testimony of faith in God. She suffers from anxiety and panic attacks, which has led her to take Paxil (on and off) for the past 7 years. She says the drug has helped her tremendously and who am I to knock the drug (knowing what I know about Paxil/Seroxat) when she has seen the wonders that it has worked in her life?

I briefly explained my story of depression, history of suicide, and diagnosis of bipolar disorder. Although she couldn’t fully relate, she was very sympathetic and understanding. In fact, our conversation was so fruitful, I ended up taking notes!

We briefly touched on the issue of Nouthetic counseling (NC). She has undergone the course and simply needs to be certified. The counselor I currently see is associated with the Christian Counseling Education Foundation (CCEF), which has roots in NC and was founded by the man—Jay Adams—who developed the method. However, CCEF is now known for what is called biblical counseling. The organization has since moved away from pure Nouthetic methods and become more a bit more varied, taking bits and pieces of psychology (and perhaps psychiatry) that line up with the Bible. Adams, disagreeing with the organization’s approach, founded the Institute for Nouthetic Studies and uses the Bible as the sole counseling textbook. According to the wiki entry on Nouthetic counseling, Adams developed the word Nouthetic based on the “New Testament Greek word noutheteō (νουθετέω), which can be variously translated as ‘admonish,’ ‘warn,’ ‘correct,’ ‘exhort,’ or ‘instruct.'”

NC was developed back in the ’70s as a response to the popularity of psychology/psychiatry. Many Christians reject some of the teachings of such popular psychologists as Freud, Jung, Adler, Maslow, etc. Adams’ highly successful book, Competent to Counsel, criticizes the psychology industry and counters its teaching with a Nouthetic approach.

But NC has its Christian critics.

"Being bipolar"

Here’s a comment that stuck out to me recently that I wanted to highlight:

I think a lot of us feel like our disorder defines us and who we are. Often times, I feel this way. When I meet new people (which is a difficult thing in itself), I can always tell a difference in how they treat me once they learn that I’m bipolar. It only serves to solidify the notion that being bipolar defines me.

When I began this blog, my subtitle for my blog, depression introspection, was “a born-again Christian female ponders whether she is her diagnosis or whether her diagnosis is part of her.” I wrote back in February 2007 about how people are not their diagnoses. I no longer subscribe to the idea that I am bipolar but that I, rather, suffer from bipolar disorder. I beg to differ that we are not our diagnoses and I will do everything I can to remind myself that Marissa does not equal bipolar disorder. I am so much more than my diagnosis. As I said on my “Who I Am” page in the More About Me section:

This blog has helped me to recognize many of the things that I am.
That
I truly am more than my diagnosis and that my diagnosis does not define
me. I am not just a person with manic and depressive episodes. I am a
person with a personality….
This is my journey to learn more about myself, my diagnosis, my medical
treatment, and anything relating to my personal life and general mental
health.

Not only that, but as a Bible-believing Christian, I’m learning that my identity needs to be grounded more in God and what He thinks of me rather than what I think of myself.

Lamictal's generic equivalent, lamotrigine, has now hit the market

So much for Miss Up-on-Pharmaceuticals.

I’ve been paying so much attention to Pristiq that the very medication I take slipped out from right under my nose.

How did I find this out? It hit me where it hurt.

In the pockets, of course.

I went to CVS yesterday night for my Lamictal refill. Since I’ve been under my husband’s plan, we’ve been paying about $40 for the medication. So I nearly doubled over when the pharmacy cashier said $54.

WHAT?

I was in a bit of a foul mood about money anyway so the last thing I wanted to do was argue about the cost of my prescription that had jumped up by $14. (Which, in retrospect, I probably should have done because I could have saved $49 right there.)

I came home and made my husband’s day go from bad to worse. He flipped out and got on the phone with his insurance immediately. He said that the max he should pay on any medication is $50 so why was he paying $54 and why the cost rose so sharply.

“Well, sir, it’s because Lamictal has now gone generic and you’re paying the difference between the cost of the medication and the cost of the generic.”

Bob gets off the phone and goes straight to Google News to find out when Lamictal went generic.

According to MarketWatch.com, Teva Pharmaceuticals commenced shipment of lamotrigine tablets on July 22nd. So instead of either the pharmacist asking me if I wanted a generic version or the insurance company letting us know a generic version would be available (it would have saved them money), we ended up paying $49 more than necessary. It appears that Teva’s generic is AB-rated, which means that it has similar strength, bioequivalence, and efficacy. Overall, it likely shouldn’t be a problem if I go from Lamictal to lamotrigine. At least I hope not. We’ll see.

Mood rating: 5

Loose Screws Mental Health News

• Postpartum Progress reports that the Melanie Blocker Stokes MOTHERS Act bill did not pass. Spreading lies like this did not help.

• The FDA recently approved Stavzor, a valproic acid delayed release capsule, for the treatment of bipolar disorder, seizures, and migraine headaches. Wow. That’s covering the gamut. The drug looks like it’ll be competing directly with the Depakote brand.

The mastermind behind Stavzor is Noven Pharmaceuticals (in conjunction with Banner Pharmacaps Inc.). The new “small, easy-to-swallow soft gel capsule” is available in three strengths: 125, 250, and 500 mgs. The pills are are “up to 40% smaller than han Depakote® and Depakote ER® tablets at the 500 mg dosage strength.” From Noven’s PR:

Stavzor is approved for the treatment of manic episodes associated with bipolar disorder, as monotherapy and adjunctive therapy in the treatment of patients with complex partial seizures that occur either in isolation or in association with other types of seizures, and for prophylaxis of migraine headaches.

The drug will hit the market in mid to late August.

• A recent AP article notes that more than 22,000 veterans contacted the veterans portion of The National Suicide Prevention Lifeline hotline since its inception last July. The government reports that the hotline support has helped to prevent more than 1200 people from committing suicide. The Veterans Administration (VA) estimates that 6500 veterans commit suicide annually. In light of recent news regarding the increase in Marine suicides, the effectiveness of the suicide hotline is offers significant promise.

The hotline receives an average 250 calls each day from veterans that have fought in Iraq, Vietnam, and Afghanistan.

The issue of soldiers with mental illness has recently come to light with studies showing that 1 in 5 soldiers returning from Iraq and Afghanistan have shown symptoms of post-traumatic stress disorder. The issue of the high suicides rate has been a high priority of the VA since mental health director Ira Katz tried to hide the significant number of suicides committed by veterans.

The National Suicide Prevention Lifeline is available 24 hours a day by calling 800-273-TALK (8255); veterans should press “1” after being connected.

• Psychologists are now saying that hitting and yelling at children is causing an increase in mental illness, which has manifested in ages as young as 3 years old. News.com.au reports that 1 in 7 children are affected by a mental disorder.

“We have seen a 60 per cent increase in demand for our child anxiety classes in the past six months,” said [Dr. Kimberley O’Brien, of the Quirky Kids Clinic at Woollahra in Sydney].

It sounds more like the article is speaking of children who are exposed to constant physical and emotional abuse. If that’s the case, shouldn’t there rather be an increase in parenting properly classes?

• Finally, a bit of sad news: police in Connecticut report than 10-year-old killed herself apparently by hanging. Police do not believe that foul play was involved. I can’t imagine being 10 and feeling suicidal. It was tough enough at 14.