The Bipolar Child, Part I: Reactions

Newsweek If you haven’t been reading the news recently, Newsweek magazine published a feature article on Max, a 10-year-old who struggles mainly with bipolar and attention-deficit/hyperactivity disorders among other mental illnesses. I read the article and was astounded at what Amy and Richie Blake, Max’s parents, have to contend with. I’m astounded at what Max suffers with.

The article was educational but for all the 8 computer pages that I printed, I didn’t read about Max; I read about his diagnoses:

Max Blake was 7 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.

He cried for hours at a time. He banged his head against his crib and screamed until his face burned red. Nursing, cuddling, pacifiers—none of them helped.

Richie carried his son to the backyard and tried to put him down, but Max shrank back in his father’s arms; he hated the feel of the grass beneath his small bare feet. Amy gave Max a bath and turned on the exhaust fan; he put his hands over his ears and screamed. At 13 months, he lined up dozens of Hot Wheels in the same direction, and when Amy nudged one out of order, he shrieked “like you’d just cut his arm off.” At day care, he terrorized his teachers and playmates. He wasn’t the biggest kid in the class, but he attacked without provocation or warning, biting hard enough to leave teeth marks. Every day, he hit and kicked and spat.

By 7½, Max was on so many different drugs that Frazier and his parents could no longer tell if they were helping or hurting him. He was suffering from tics, blinking his eyes, clearing his throat and “pulling his clothes like he wanted to get out of his skin,” says Richie. In February 2005, under Frazier’s supervision, the Blakes took Max off all his meds. With the chemicals out of his system, Max was not the same child he had been at 2. He was worse. … Off his meds, Max became delusional and paranoid. He imagined Amy was poisoning him and refused to eat anything she cooked. He talked about death constantly and slept little more than two hours a night.

During a recent appointment at Frazier’s office, he went into full-fledged mania. Laughing wildly, he rolled on the floor, then crawled over to his parents and grabbed an empty medication bottle, yelling, “Drugs! I’ve got drugs! It’s child safety!” Richie grabbed it back, Max screamed, Richie threw the bottle across the room, as if playing fetch. Max squealed and dove for it, then began to sing into the neck of the bottle: “Booorn to be wiiiiild …” Amy rolled her eyes: “Two kids.” And then: “It’s hard not to laugh.” (I’m not the only one who doesn’t think this is mania.)

All throughout the article, I couldn’t help but think to myself: Who is Max? Max without meds — does he have a personality? What does like to do for fun, even for short periods of time? Karate is mentioned — does he read? He has trouble writing for long stretches. He’s got a friend. What makes Max so charming other than the fact that he’s 10 years old?

(Image from Newsweek)

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TAC's Irrelevant Statistics

A couple of things:

  • I’m going to go the way of Gianna at Bipolar Blast and admit that my stats weren’t as accurate as I would have liked them to be. (Hey, I did say, "I could be wrong.") My math is about average and stats were never my thing so please, feel free to take a page out of John Grohol’s book at PsychCentral.com and do a kick-ass analysis of studies or stats that interest you. I must say, however, I am quite flattered at helping raise awareness about the TAC’s stupidity. All credit goes to Furious Seasons for picking at them piece by piece first. Cairn, a commenter over at CLPsych, did a better job of analyzing the stats I used. It seems pretty spot on to me.
  • My husband – the better mathematician and also my better half – pointed out something I’m not sure anyone picked up on. (My apologies to anyone who did.) Let’s recap:

USPRA: “Violence is no more prevalent among individuals with mental illness than the general public”
Fact: The CATIE violence study found that patients with schizophrenia were 10 times more likely to engage in violent behavior than the general public (19.1% vs. 2% in the general population).

Have you figured out what it is yet? Well, the TAC took the USPRA’s broad statement about violence among people with mental illness and applied data about violence among schizophrenics only. The data the TAC used is irrelevant because it doesn’t even apply. The percentages that the TAC used to combat the USPRA’s statement isn’t even an accurate because, well, the USPRA wasn’t talking about schizophrenics; they were talking about the mentally ill in general. So all my stats in my last post are pretty much moot at this revelation because of TAC’s skewed application of the CATIE violence study statistics.

"There are three kinds of lies: lies, damned lies,
and statistics."
~ Mark Twain

A classic case of twisting the words of someone who supposedly shot the messenger

The subject title is long, but – I think – apropos.

The Treatment Advocacy Center’s post, “A classic case of shooting the messenger,” has been bothering me all day. I’ve been wanting to do further research on their claim that “patients with schizophrenia were 10 times more likely to engage in violent behavior than the general public.” Funny thing is, I didn’t have to look far.

The TAC links to a summary of the CATIE violence study and surprisingly, it contradicts the TAC’s post. I couldn’t help but chuckle once I realized I could easily debunk their claims from what they considered supporting evidence.

USPRA: “Violence is no more prevalent among individuals with mental illness than the general public”
Fact: The CATIE violence study found that patients with schizophrenia were 10 times more likely to engage in violent behavior than the general public (19.1% vs. 2% in the general population).

MY TAKE:Overall, the amount of violence committed by people with schizophrenia is small, and only 1 percent of the U.S. population has schizophrenia. Of the 1,140 participants in this analysis, 80.9 percent reported no violence, while 3.6 percent reported engaging in serious violence in the past six months. Serious violence was defined as assault resulting in injury, use of a lethal weapon, or sexual assault. During the same period, 15.5 percent of participants reported engaging in minor violence, such as simple assault without injury or weapon. By comparison, about 2 percent of the general population without psychiatric disorder engages in any violent behavior in a one-year period, according to the NIMH-funded Epidemiologic Catchment Area Study.”

This data is a little skewed here. (CLPsych or Philip Dawdy could do a better job at clarifying this for me.) First of all, “about 2 percent of the general population without psychiatric disorder engages in any violent behavior in a one-year period.” How many people does this constitute? The sentence doesn’t specify ‘without schizophrenia’; it says “without psychiatric disorder.” That means Americans who do not suffer at any given time from depression, bipolar disorder, psychosis, anxiety, schizophrenia, obsessive-compulsive disorder, postpartum depression, and the list goes on and on. Can anyone compile complete data of Americans who suffer from a psychiatric disorder? (Why do I have the funny feeling that Americans without psychiatric disorders are becoming the minority?)

In the January 1994 issue of the Archives of General Psychiatry, results of the National Comorbidity Study were released. Diagnoses from the DSM-III were applied to the participants ranging from ages 15-54. The study found that 50 percent of participants reported “one lifetime disorder” and 30 percent said they had “at least one 12-month disorder.”

That was January 1994. The American population has grown significantly since then, so I have a hunch that there's an increase in diagnosing people with psychiatric illnesses. But like I said, that’s, uh, just a hunch. (Keep in mind that the study does not include children ranging from ages 4-14 who are likely to receive ADHD and/or bipolar diagnoses.)

Humor me: Let’s take the NC study’s findings and apply it to the current estimated U.S. population (assuming that the percentage of those with a lifetime disorder has remained the same). Out of nearly 300 million Americans (July ’06 estimate), that means about 150 million Americans have at least some form of a psychiatric disorder. If 1 percent of the general population suffers from schizophrenia, that comes out to 3 million people. If we apply CATIE’s violence percentages, TAC’s right; 19.1 percent of schizophrenic patients engage in violent behavior of any kind. However, the CATIE study also says that two percent of the general population without psychiatric disorder engages in violent behavior. That means out of the remaining 150 million, 2 percent of that would be —*drumroll please* — 3 million Americans! Maybe it’s just me, but doesn’t seem 10 times likely. I could always be wrong.

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Loose Screws Mental Health News

I haven’t done this for a while so hopefully I can pick this up again a little more regularly. (crosses fingers)


Read a heart-wrenching story in the UK Daily Mail about a mother whose postpartum depression led her to begin slitting her wrists.

Tom ChaplinTom Chaplin, singer for the band Keane, has admitted to contemplating suicide.

Tom – who was taking up to two grams of cocaine a day – revealed to Britain’s Q Magazine: “I was at the end of my tether in Japan. I was tired of my life and feeling pretty suicidal. I got off the plane and called my dad. I’d told him that I’d left the band and that I was falling apart. I checked myself into The Priory.”

Chaplin’s interesting view:

Despite his own drugs hell, Tom says it’s a personal decision to experiment with substances. He claims troubled rock star Pete Doherty should be left to take all the drugs he wants.

Tom said: “No-one’s got any right to stop him killing himself.”

An article in the Chicago Tribune on how VNS is beginning to show benefits for some patients. Which reminds me, browse on over to VNSdepression.com to learn more.

Nicholas Vakkur must have read the Treatment Advocacy Center’s post on how the CATIE study shows an increase in violent offenses by mentally ill patients (namely those with psychosis and schizophrenia). He refutes this idea on dissidentvoice.org:

Individuals with a mental illness are far more likely to be the victims, rather than the perpetrators of violence, while the vast majority of people who commit acts of violence against others are not in fact mentally ill.

This rush to stereotype individuals suffering from psychiatric illness as likely murderers is reckless and lacks credulity. Mental illness has no role in the majority of violent crimes committed in our society. Alcohol and substance abuse far outweigh mental illness as factors contributing to violence, while the strongest predictor of violent and/or criminal behavior is a past history of violence and criminality, not a major mental illness.

Treatment Advocacy Center?

Please correct me if I’m wrong, but the Treatment Advocacy Center sounds prejudiced against those with mental illness. I’ve come to this conclusion after skimming a few posts. Can anyone refute this for me?