Thursday, February 26, 2009

A Note From A Child Psychiatrist

By Elizabeth J. Roberts
Sunday, October 8, 2006

I have been treating, educating and caring for children for more than 30 years, half of that time as a child psychiatrist, and the changes I have seen in the practice of child psychiatry are shocking. Psychiatrists are now misdiagnosing and overmedicating children for ordinary defiance and misbehavior. The temper tantrums of belligerent children are increasingly being characterized as psychiatric illnesses.

Using such diagnoses as bipolar disorder, attention-deficit hyperactivity disorder (ADHD) and Asperger's, doctors are justifying the sedation of difficult kids with powerful psychiatric drugs that may have serious, permanent or even lethal side effects.

There has been a staggering jump in the percentage of children diagnosed with a mental illness and treated with psychiatric medications. The Centers for Disease Control and Prevention reported that in 2002 almost 20 percent of office visits to pediatricians were for psychosocial problems -- eclipsing both asthma and heart disease. That same year the Food and drug Administration reported that some 10.8 million prescriptions were dispensed for children -- they are beginning to outpace the elderly in the consumption of pharmaceuticals. And this year the FDA reported that between 1999 and 2003, 19 children died after taking prescription amphetamines -- the medications used to treat ADHD. These are the same drugs for which the number of prescriptions written rose 500 percent from 1991 to 2000.

Some psychiatrists speculate that this stunning increase in childhood psychiatric disease is entirely due to improved diagnostic techniques. But setting aside the children with legitimate mental illnesses who must have psychiatric medications to function normally, much of the increase in prescribing such medications to kids is due to the widespread use of psychiatric diagnoses to explain away the results of poor parenting practices. According to psychiatrist Jennifer Harris, quoted in the January/February issue of Psychotherapy Networker, "Many clinicians find it easier to tell parents their child has a brain-based disorder than to suggest parenting changes."

Parents and teachers today seem to believe that any boy who wriggles in his seat and willfully defies his teacher's rules has ADHD. Likewise, any child who has a temper tantrum is diagnosed with bipolar disorder. After all, an anger outburst is how most parents define a "mood swing." Contributing to this widespread problem of misdiagnosis is the doctor's willingness to accept, without question, the assessment offered by a parent or teacher.

What was once a somber, heart-wrenching decision for a parent and something children often resisted -- medicating a child's mind -- has now become a widely used technique in parenting a belligerent child. As if they were debating parental locks on the home computer or whether to allow a co-ed sleepover, parents now share notes with each other about whose child is taking what pill for which diagnosis.

These days parents cruise the Internet, take self-administered surveys, diagnose their children and choose a medication before they ever set foot in the psychiatrist's office. If the first doctor doesn't prescribe what you want, the next one will.

There was a time in the profession of child psychiatry when doctors insisted on hours of evaluation of a child before making a diagnosis or prescribing a medication. Today some of my colleagues in psychiatry brag that they can make an initial assessment of a child and write a prescription in less than 20 minutes. Some parents tell me it took their pediatrician only five minutes. Who's the winner in this race?

Unfortunately, when a child is diagnosed with a mental illness, almost everyone benefits. The schools get more state funding for the education of a mentally handicapped student. Teachers have more subdued students in their already overcrowded classrooms. Finally, parents are not forced to examine their poor parenting practices, because they have the perfect excuse: Their child has a chemical imbalance.

The only loser in this equation is the child. It is the child who must endure the side effects of these powerful drugs and be burdened unnecessarily with the label of a mental illness. Medicating a child, based on a misdiagnosis, is a tragic injustice for the child: His or her only advocate is the parent who lacked the courage to apply appropriate discipline.

Well-intentioned but misinformed teachers, parents using the Internet to diagnose their children, and hurried doctors are all a part of the complex system that drives the current practice of misdiagnosing and overmedicating children. The solution lies in the practice of good, conscientious medicine that is careful, thorough and patient-centered.

Parents need to be more careful with whom they entrust their child's mental health care. Doctors need to take the time to understand their pediatric patients better and have the courage to deliver the bad news that sometimes a child's disruptive, aggressive and defiant behavior is due to poor parenting, not to a chemical imbalance such as bipolar disorder or ADHD.

The writer is a child and adolescent psychiatrist in California and the author of "Should You Medicate Your Child's Mind?"


  1. A subject I feel strongly about.
    medicating kids is a lot of bullshit.
    but big pharma loves it.

    when I was a kid, no kids were adhd, or bipolar, or any other labels.

    my own kid was busy, I mean super busy, I think I ran miles behind her daily when she was younger.

    And I am not kidding!
    I recall one gal at the time saying, you don't have a play pen for her
    god, if anyone needs one, you do for that kid.

    she meant well, but. No thanks.

    My MiL, told me my daughter was hyperactive, repeatedly. I was beside myself. She had raised three kids, me, that was my only.
    Thankfully the old school doctor, said, bollocks to that, she is not hyperactive she is active and interested.
    Man did I tell my MiL, she is not hyper, she is active and interested and that is dam good, now could you stop saying that to me, repeatedly.
    god, sometimes these people really undermine a new mom's confidence.
    Cause I didn't think she was, I knew she was a "go go girl"
    that's what I called her, but dam I liked that better then some lethargic kid.
    she always loved everything and was enthusiastic about it all
    ya know what I mean?
    I am always so glad, this doc was old school!

  2. Good article. It is funny that when society said we can't spank our children any more, the temper tantrums started and the medical community says our children are all ADD riddled Bi-Polar idiots. It is so sad when I think of a child living while under a drug induced daze.

  3. I know Penny, I didn't know a single kid with add, adhd, bipolar disorder or any other's of those made up crap-shoot big pharma created problems. It seems 3 out of 5 kids are now diagnosed with it simply because parents aren't allowed to spank their kids anymore. Some kids are just naturally calm and don't need the dicipline that other's do, but then there are kids like Munchkin (my youngest), she was a holy terror. As I've already posted the whole situation, I won't go back into it, but thank god Silv got to me when he did!

    Good for you for not putting your kid on meds, and hurray for your doc being old school!

  4. It is sad Etta, my daughter was one of them as I posted here in my blog earlier. You can find them under the same label of Kids On Meds. It's horrible what I had done to my daughter under the advise of doctors.

    Thankfully, she is a perfectly normal child now all due to the man in my life, Silverfish. I don't know where I'd be today if he hadn't taught me how to be a parent!

  5. Hi Skye,

    My own experience was with the schools - when I told our doctor he laughed out loud (I had a good doc). The school insisted and long story short he was out of that place the next year - where he happily went about his learning...

    I think too it's an easy fix for parents that don't want to discipline properly and set guidelines for behaviour.

    Wake up people - parenthood is no walk in the park, sometimes we can't be 'friends' to our children - sometimes it's better to be the PARENT - with all the hardness that entails.

    Too many kids are whacked out on all these drugs - no wonder they have issues.


  6. "Too many kids are whacked out on all these drugs - no wonder they have issues."

    Not only that, but the pharmaceutical drugs are addictive and soon don't do any good. Hense the "upgrade" to pot, cocaine, heroin, etc. It's a vicious cycle, one that needs to be stopped!

  7. I am absolutely without a doubt ADD. I have read about it, taken evaluations, and spoken with medical professionals.

    ADD was just emerging in the 1980's when I was school bound, and my parents didn't feel much pressure from my school or society at large to get me tested.

    And I struggled. I surely did. And even though I barely made it out of high school with a 2.3 GPA, I got into a good state college, I was a talented artist, reader and writer... and I landed a 29 on my ACT's...

    And I did it all connected to myself... rather than Aderoll. Kudos to Mr. and Mrs. Brazen- to them I indebted for their loving support in the midst of teacher conferences, forged report cards, and quite possibly the messiest room in northeast ohio.

  8. Yes Brazen, I do believe that there truly are some people who are ADD etc., just not as many as are diagnosed in today's world.

    Definitely Kudos to your parents for helping you out the way they did, that's what good parents do! I wish my parents had been as supportive of my interest in the arts, but thats a whole other story altogether!

    I however wasn't such a good parent. If you scroll back through my blog, you'll find the other posts a few pages back. That will help to explain why I believe parents need to take back the job of parenting and pay more attention to exactly what it is that their children are doing.


I've started to moderate comments so that if someone wishes to post something private they don't want shared, they can. So feel free to speak your mind, and share your thoughts with me.