U. S. Children Misdiagnosed with Bipolar Disorder. In the autumn of 1. At the annual conference of the American Academy of Child and Adolescent Psychiatry, I attended a workshop on bipolar disorder in children. About 1. 0 of us attended the meeting, held in a small, poorly lit room.
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Thank you for writing. I'm so glad that my advice to you in the past was helpful, and I'm glad you wrote to me now. You are in a difficult situation. "How can I handle tantrums with my child on the autism spectrum? How should I deal with 'meltdowns'? Should the two be treated differently? If so, how does one know. The one thing I’ve struggled with more than anything else in the last nine years of parenting has been temper. My own. Nothing and no one has caused in me the.
Only one or two doctors reported having actually seen a child with bipolar disorder, but we all agreed to keep our eyes open for other sightings. Three years later I attended another session about bipolar disorder in children at the academy’s annual meeting.
In a large ballroom beneath a gleaming chandelier, several hundred child psychiatrists buzzed with excitement. As a mainstream concept, the diagnosis had arrived. I have been a child psychiatrist for nearly five decades and have seen diagnostic fads come and go. But I have never witnessed anything like the tidal wave of unwarranted enthusiasm for the diagnosis of bipolar disorder in children that now engulfs the public and the profession. Before 1. 99. 5, bipolar disorder, once known as manic- depressive illness, was rarely diagnosed in children; today nearly one third of all children and adolescents discharged from child psychiatric hospitals are diagnosed with the disorder and medicated accordingly. The rise of outpatient office visits for children and adolescents with bipolar disorder increased 4. A Harvard child- psychiatry group led by Dr.
Joseph Biederman, a prominent supporter of the diagnosis, recently insisted, “Juvenile bipolar disorder is a serious illness that is estimated to affect approximately 1 percent to 4 percent of children.”Keep up with this story and more by subscribing now. I believe, to the contrary, that there is no scientific evidence to support the belief that bipolar disorder surfaces in childhood. In fact, the opposite seems to be the case: the evidence against the existence of pediatric bipolar disorder is so strong that it’s difficult to imagine how it has gained the endorsement of anyone in the scientific community. And the effect of this trendy thinking can have devastating consequences. Such children are regularly prescribed medications that are not effective in kids and have unwelcome side effects. The case of Rebecca Riley, a Boston toddler, vividly summarizes some of the inherent risks. Her psychiatrist first identified Rebecca as suffering from pediatric bipolar disorder at the age of 2.
The psychiatrist concluded that Rebecca’s two siblings were bipolar as well.) In addition to diverting the psychiatrist from the very real problem in Rebecca’s family—a well- chronicled history of child abuse—the diagnosis led to the prescription of a common cocktail of medications. Rebecca’s parents misused one of these medications—clonidine, prescribed to treat high blood pressure in adults but also given to children because of its sedative effects—to quiet their child. Forever. “There was no waking her up,” Rebecca’s mother stated on 6. Minutes. (The psychiatrist later settled a malpractice suit for $2. In adults, bipolar disorder is characterized by cycles in which a patient rotates between two extremes, or poles, of feeling: depression and mania. The cycles may vary in length and intensity, but the adult diagnosis depends on clear- cut episodes of behavior that is distinctively different from normal: severe overexcitement or highs that last for weeks, and crushing, painful periods of deep depression that also last for weeks or months.
The description of childhood bipolar disorder by its advocates is dramatically different. Where adult bipolar disorder expresses itself in episodic, out- of- character behavior, a child diagnosed with bipolar disorder will have symptoms that characterize the child’s typical behavior. In this telling, an elementary- school- age child with the disorder may be chronically enraged and have several tantrums per day. But this only points to another problem with the diagnosis: it’s nearly impossible to distinguish between children alleged to have bipolar disorder and those with straightforward anger- control issues. The symptoms may look like mania: irritability, distractibility, and talkativeness. But most of these symptoms can easily be matched to less- trendy conditions like attention- deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD).
My view is that a diagnosis of bipolar disorder in a child is almost always a case of severe ADHD combined with severe ODD, both fairly common in elementary- school children. Nowhere is the shaky science behind childhood bipolar disorder more evident than in the evaluation and treatment of preschoolers. The leading scholar of bipolar disorder in small children is Dr. Joan Luby of Washington University in St. Louis. In a series of studies, Luby reported that preschool children who exhibited grandiosity, elation, and interest in sexual behavior were likely to have bipolar disorder.
Most child psychiatrists, including me, would be challenged to weigh the meaning of such behaviors in preschoolers.
Toddler Tantrums.. Ways to Deal(photo of my youngest son who is now a toddler). My daughter is in the throes of tantrum times. She is around 1. 7 months and is quite dramatic. I don't remember my son starting this early, but I actually think he knew more words by this point and that's why he tantrumed less.
Anyways, I always thought I was a patient person before I became a parent. In fact, the staff that worked with me always remarked at how well I handled even the most insane behaviors from kids. Fast forward a few years and my patience isn't as incredible as it used to be. I've mentioned how I struggle with getting angry in a previous post called Eight Ways to Deal with Anger as a Parent.
So tantrums have been the bane of my existence this week. Some have been completely warranted on the part of my daughter.. So, why do tantrums happen and how do you deal with them? I am going to share some basic reasons for toddler tantrums and some ideas of how I deal with them. Pass along your advice too.
Some of you are wayyy more creative and experienced than me! Basic reasons for toddlers tantrums: 1. Can't express what they want/need. Trying to assert their independence. Want to be in control. Too many limits. 5.
Basic needs not being met- tired, hungry, thirsty, etc. Overstimulated. 7. Bored. Ways to deal: 1. Acknowedge. This strategy is probably my favorite and the most effective with my kids, which is why it is first. I even wrote an entire post about here ==> > My favorite tip for calming tantrums.
Make sure to check it out! Distract, distract, distract. Toddlers have notoriously short attention spans. This can occasionally be used to our advantage as parents. Today my daughter threw a tantrum at gymnastics because she wanted a turn on the trampoline and another kid was jumping right then.
She doesn't understand waiting and turn- taking yet, so she just gets mad. I explained in short phrases that he was going to take 1. I acknowledged that it was hard to wait her turn and she must be frustrated. I talk a lot with my kids about how it is ok to get upset or cry when you are angry/frustrated. That conversation wasn't cutting it though, so we moved over to another thick mat and I pretended that it was another trampoline and jumped on it. She got distracted having fun doing that and stopped screaming long enough for the other kid to get his 1.
Distracting doesn't mean that you don't acknowledge your child's feelings and recognize they need to express them. You can do that first and then help them find something else to do while they wait.
In my daughter's case, I showed her another option of what we could do while we waited instead of standing around screaming. If I were an even better mom, I would probably say something like, "When I am waiting my turn for the trampoline sometimes I like to practice jumping to get ready for my turn.." or share another tool my daughter could use while she waits her turn. Update: I have read this post on distracting toddlers by Janet Lansbury and I love many of the points shared in the article.
I still redirect my toddler from time to time, but also have tried some of her ideas! I definitely recommend reading her post. Farmers Dating Service. Give your child the words.
A lot of toddler tantrums stem from the fact that the child doesn't know how to tell you what they want. I think it is really important to be aware of this and slow life down so that you have time to model the words they should use when they are frustrated and need something. My daughter throws tantrums when she can't climb up on a chair or reach a particular toy. Just giving her words like, "Help me mama" or "up" really alleviates her frustration. As you do this over time, toddlers will need less and less modeling/prompting and will begin to use their words more and behavior less to communicate. This is so easy to forget in the busy pace of the day.. Fortunately your child's tantrum can easily help remind you if you forget : )4.
Ignore (the behavior, not the child) Sometimes there is really nothing you can do as a parent to snap a kid out of a tantrum, so I ignore my daughter's tantruming behaviors as best that I can and focus on teaching the appropriate behaviors/ways to express her feelings/needs. I acknowledge my child's feelings (mad, frustrated) and make sure my child knows I am trying to help her.
Then I focus on the positive behaviors that she can use to get help (use words, gestures, etc.), ignore the negatives ones, and give attention to the other kids/adults around me that are acting/behaving the way that I want my daughter to act/communicate. I stay close by as she tantrums and intervene if she is going to injure herself or others. I use words to tell her that I know she is upset but I won't let her hit/kick/throw, etc. I don't talk much because while she is raging she isn't really able to process what I am saying anyway. Take a break. When my daughter woke up from her nap today she was grumpy about everything.