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:

Depressed child“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)

The Zoloft-rage/violence connection

[This post is quite lengthy so I suggest you grab a cup of coffee or tea and sit down and read it. The following is not for the faint of heart (or those with a lack of time).]

It’s been amazing to me that I’ve received numerous comments on Zoloft inducing rage. I’m humbled by having a Pittman supporter visit my site and post some comments from the ChristopherPittman.org forums. Read the following:

In my senior year in high school I was diagnosed as being severely depressed and put on medication. The first medication that I was on I took for 5 months and it made me really aggressive. My friends and family noticed the change and I told my doctor about it and she changed my meds. After that I was fine. I am normally a very passive person and will let just about anything fly. But the medication made me really aggravated and aggressive toward my friends and family and it seemed that I wasn’t overcoming my depression. I just got done watching the 48 hours investigation on the Discovery Times Channel and felt a connection with Chris. I felt that I had to write this to let you know that Chris is not the only one out there that had these side effects. I think there should be a study done to see how many people that take antidepressants have increased aggression. The problem is that the pharmaceutical industry has deep pockets and many lobbyists. I hope this helps in some way.

And another:

I remember the case when it happened.

At the time I thought, “Zoloft right”.

Let me tell you my physician put me on Zoloft and it took about three weeks for my to become psychotic and I’m a 50 year old woman.

I have three children and I don’t make a lot of money but please let me know if I can do anything for the Pittman boy.

The jury should have been placed on Zoloft before they made they decision. Unless you’ve experience it you simply cannot believe its’ effect.

Brynn and Phil HartmanI did a bit of quick reading/research into Zoloft triggering violence in people who otherwise would have never been violent and it seems that are a few stories out there to support the assertion. I found a few comments on depressionblog.com that mentioned a link between Zoloft and rage fits. A Salon.com article published a story antidepressants inducing rage in 1999. Apparently, Brynn Hartman, the wife of famous comedian Phil Hartman, killed herself and her husband while taking Zoloft. While close friends attribute the sudden behavior on the antidepressant, others attribute it to a combination of the medication with cocaine and alcohol in her system. (Zoloft does have a warning against alcohol use in conjunction with the drug.)

One interesting thing I learned from the article is that this kind of behavior is often labeled under the name akathisia on patient safety guides. Most – if not all – of the major antidepressants list akathisia as a side effect. Here’s the initial description of this condition from Wikipedia:

Akathisia, or acathisia, is an unpleasant subjective sensation of “inner” restlessness that manifests itself with an inability to sit still or remain motionless… Its most common cause is as a side effect of medications, mainly neuroleptic antipsychotics especially the phenothiazines (such as perphenazine and chlorpromazine), thioxanthenes (such as flupenthixol and zuclopenthixol) and butyrophenones (such as haloperidol (Haldol)), and rarely, antidepressants.

Akathisia may range in intensity from a mild sense of disquiet or anxiety (which may be easily overlooked) to a total inability to sit still, accompanied by overwhelming anxiety, malaise, and severe dysphoria (manifesting as an almost indescribable sense of terror and doom).

No real mention of extreme anger or irritability mentioned there. But if you read on…

The 2006 U.K. study by Healy, Herxheimer, and Menkes observed that akathisia is often miscoded in antidepressant clinical trials as “agitation, emotional lability, and hyperkinesis (overactivity)”. The study further points out that misdiagnosis of akathisia as simple motor restlessness occurs, but that this is more properly classed as dyskinesia. Healy, et. al., further show links between antidepressant-induced akathisia and violence, including suicide, as akathisia can “exacerbate psychopathology.” The study goes on to state that there is extensive clinical evidence correlating akathisia with SSRI use, showing that approximately ten times as many patients on SSRIs as those on placebos showed symptoms severe enough to drop out of a trial (5.0% compared to 0.5%).

Read the rest of this entry »