• ADHD books published by NorthEast Books & Publishing, by Association for Youth, Children and Natural Psychology
  • ADHD books published by NorthEast Books & Publishing, by Association for Youth, Children and Natural Psychology




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Drugging Our Children: How Profiteers Are Pushing Antipsychotics on Our Youngest, and What We Can Do to Stop It (Childhood in America), by Sharna Olfman (Editor), Brent Dean Robbins

Since 2001, there has been a dramatic increase in the use of antipsychotics to treat children for an ever-expanding list of symptoms. The prescription rate for toddlers, preschoolers, and middle-class children has doubled, while the prescribing rate for low-income children covered by Medicaid has quadrupled. In a majority of cases, these drugs are neither FDA-approved nor justified by research for the children's conditions.

This book examines the reasons behind the explosion of antipsychotic drug prescriptions for children, spotlighting the historical and cultural factors as well as the role of the pharmaceutical industry in this trend; and discusses the ethical and legal responsibilities and ramifications for non-MDs—psychologists in particular—who work with children treated with antipsychotics.

Contributors explain how the pharmaceutical industry has inserted itself into every step of medical education, rendering objectivity in the scientific understanding, use, and approvals of such drugs impossible. The text describes the relentless marketing behind the drug sales, even going as far as to provide coloring and picture books for children related to the drug at issue. Valuable information about legal recourse that families and therapists can take when their children or patients have been harmed by antipsychotic drugs and alternative approaches to working with children with emotional and behavioral challenges is also provided. (from the publisher)


Bipolar Children, edited by Sharna Olfman, Ph.D.


No Child Left Different, edited by Sharna Olfman

No Child Left Different skillfully considers psychiatry issues and children from a panel of professionals. Focus is on psychiatric drugs, causes of mental health disorders in children, media, ADHD, bipolar disorder.


Overcoming ADHD Without Medication, by the AYCNP

This discusses causes for ADHD in children, as well as natural solutions, focusing on lifestyle changes and developing coping skills. Additionally, childhood depression, bipolar disorder and prevention are considered.


Please Don't Label My Child, by Scott Shannon

A child psychiatrist discusses why treating children without labeling them (eg. ADHD, bipolar, OCD) gets better results. This is a balanced book that comes very close to the truth in discussing children's mental health. The book is solution-oriented and breaks from the medical model in mainstream treatment approach.


Sharing Nature With Children by Joseph Bharat Cornell

Children benefit from time spent enjoying nature. This book is recommended by American Camping Association and the National Audubon Society, as well as other organizations. Sharing Nature With Children is "..an effective tool for creating a greater awareness and enthusiasm for the beauty of nature." -- Today's Librarian


Freeing Your Child from Negative Thinking: Powerful, Practical Strategies to Build a Lifetime of Resilience, Flexibility, and Happiness Tamar E. Chansky

This is written by a leading clinical expert in child cognitive behavior therapy and anxiety disorders. Dr. Tamar Chansky provides guidance for parents and caregivers in changing negative thinking into positive, especially as it relates to raising children.


Building Resilience in Children and Teens: Giving Kids Roots and Wings by Kenneth R. Ginsburg MD MSEd FAAP

There are sometimes overwhelming stresses on children today. A child who develops resilience is more likely to bounce back from highly stressful situations or life's problems, present and future. This book helps children and teens to build resilience and learn coping strategies for life.


Meeting the Challenge of Bipolar Disorder: Self Help Strategies that Work!, Association for Natural Psychology, Gabrielle Woods PhD (Editor), Laura Pipoly PC EdD (Foreword)

Self help for bipolar disorder can result in positive gains. Your moods involving mania and depression can be positively affected through Positive Lifestyle Changes. By developing an array of coping skills, and making gradual, incremental changes in your lifestyle, you will find that mood swings are less dramatic, and mood stability can be attained.


So Sexy So Soon: The New Sexualized Childhood and What Parents Can Do to Protect Their Kids Diane E. Levin Ph.D., Jean Kilbourne Ed.D.

The media accentuates and hastens the sexuality of young girls. Dianne Levin, Ph.D., notes how everything from the Disney Channel, Barbie, Britney Spears, Miley Cyrus, and Bratz, is affecting children.


Page updated April 19, 2013

INTRODUCTION: BIPOLAR CHILDREN
by Sharna Olfman, PhD


Reproduced with written permission from Sharna Olfman
Also see The Sexualization of Childhood book review


Introduction to Bipolar Children, by Sharna Olfman

Bipolar Children (2007). Why the rise in diagnosis of bipolar children in the past 10 years? What are the roots?

On December 13, 2006, 4-year-old Rebecca Riley died of a prescription drug overdose. At 2 and one half years of age, she was diagnosed with bipolar disorder (BD) and attention-deficit/hyperactivity disorder (ADHD) by a respected psychiatrist in a clinic affiliated with Tufts University, who prescribed three medications: Depakote an anti-seizure drug, Clonidine, an anti-hypertensive, and Seroquel, an antipsychotic. These three drugs were in her system at the time of her death. [1]

Up until recently, giving toddlers multiple psychiatric diagnoses and drug cocktails was unheard of. Bipolar disorder was considered to be a rare, devastating disease that began in adolescence or early adulthood. But in the last two decades, the field of children's mental health has undergone a disturbing change. Multiple psychiatric diagnoses and polypharmacy regimens for children have become norm. And over the last decade there has been up to a 40-fold increase in the diagnosis of Bipolar Disorder in children which is now diagnosed more commonly than depression. Many of these "bipolar" children have already received a diagnosis of ADHD and/or depression, and their prescriptions are often added to the ones that they already have. Bipolar preschoolers are now being recruited for drug trials of antipsychotics.


All green links on this page are off-site links from sponsors and funds are used to support the non-profit activities of the AYCNP

Why has our understanding and treatment of children's psychological disturbances, and pediatric bipolar disorder in particular, changed so dramatically?

One widely held view is that advances in medical technologies such as genetic mapping and fMRI scans, have led to a more finely honed understanding of the genetic and neurological origins of mental illnesses, promoting the development of new drugs that target the source of these illnesses with laser like precision.

It is also widely believed that we have recently learned to recognized the early signs and symptoms of BD as they manifest in children, which we failed to notice in the past. But research does not support these claims. To date, there are no genetic markers or brain imaging tests that can definitely diagnosed BD. and the so called new class of drugs that are being used to treat BD are, if anything less, rather than more specific. In fact, these new drugs are antipsychotics developed to treat schizophrenia and anitconvulsants, originally designed to treat epilepsy, which have been re-branded by pharmaceutical companies as “mood stabilizers“.

Both classes of drugs are major tranquilizers, and have a calming effect on agitated or manic patients. But it is important to note that they are not addressing an underlying disease process in the way that an antibiotic does. They treat the symptoms, not the underlying cause. Moreover, their effects are generic, so that anyone who takes them will be tranquilized. And none of these drugs have been approved by the FDA for prevention or cure of bipolar illness.[2]

In January of 2007, the American Academy of Child and Adolescent Psychiatry, the governing body of child and adolescent psychiatrist in the U.S. issued new practice guidelines for the assessment and treatment of children and teens with bipolar disorder in order to address some of these misconceptions. Here are some direct quotes form the guidelines:

  • The evidence is not yet sufficient to conclude that most presentations of Juvenile manic depression is continuous with the classic adult disorder. [3]
  • [t]he validity of diagnosing bipolar disorder in preschool children has not been established. [4]

  • [T]he U.S. Food and Drug Administration (FDA) [has been advised] to only extend medication treatment studies down to age 10 years, given concerns about the challenge of accurate diagnosis in younger children. [5]

  • The short and long-term safety of mood stabilizers and atypical antipsychotic agents in young children has not been established. [6]

  • There are no biological tests, including imaging or genetic studies that are helpful in making the diagnosis of a bipolar disorder.[7]


    Bipolar Disorder in Historical Perspective


    In order to fully appreciate the conditions that set the pediatric bipolar epidemic in motion, it is useful to being with a brief history of bipolar illness. Originally named manic depressive psychosis, bipolar disorder was the first psychiatric illness to be identified by Emile Kraepelin “ the father of modern psychiatry “ in 1896.

    After a century of research on bipolar illness, Kraepelins original description of its symptoms and course have proved to be remarkably robust. [8] The international medical community still believes, as did Kraeplin, that BD is a devastating albeit rare, brain disorder that begins in late adolescence or early adulthood, and is characterized by intense cycles of mania and depression. Outside of the U.S., bipolar disorder is diagnosed less frequently than schizophrenia, which is itself and uncommon disorder.[9]

    Symptoms typical of mania include marked euphoria, grandiosity, irritability, racing thoughts, agitation, rapidly shifting mood and sleep disturbance. Paranoia, confusion and psychosis are also typical. Depressive episodes are characterized by fatigue, oversleeping, suicidal thoughts and suicide attempts, and often, psychosis. [T]he crashing lows and manic highs that are the hallmarks of BD can ruin the lives of individuals and families.[10]

    [I]n the mid-twentieth century John Cade, an Australian psychiatrist discovered that lithium carbonate not only had a calming effect on manic episodes, but also seemed to prevent future cycles of depression and mania.

    Approaches to diagnosis and treatment of BD in the U.S. began to diverge from the rest of the world with the publication of the 1987 edition of the Diagnostic and Statistical Manual of Mental Disorders whose acronym is the DSM and is the preeminent American system of psychiatric diagnosis. This version of the DSM introduced BD subtypes, which both broadened and diluted the criteria for diagnosing it.

    After bipolar subtypes were introduced into the DSM classification system, the number of adults in the U.S. meeting these much broader criteria began to soar. It is important to note that the World Health Organization, which published the International System of Classification, now in its 10th edition has much more stringent diagnostic criteria for BD.[11]

    In the mid-nineties, two child psychiatry research groups, one at Harvard, another at Washington University - began to train their attention on pediatric bipolar disorder. Both groups contend that until recently, bipolar disorder was under-diagnosed in children because the early symptoms of the illness are typically different from those in the adult phase.

    Both groups stress that a majority of bipolar children also suffer from [ADHD], and that many were erroneously diagnosed as depressed. The Washington group, headed by Barbara Geller, claims that children with bipolar illness often cycle through manic episodes that may last anywhere from a few minutes to a few days, as compared to mania in adults that lasts for several weeks or months if left untreated. The Harvard group, led by Joseph Biederman believes that bipolar children may not exhibit cyclical mood disturbances at all, but instead, they may be chronically irritable and explosive, or chronically depressed and angry. His group has run several antipsychotic drug trials with bipolar preschoolers.

    As a result of Biederman and Gellers research, the diagnostic criteria for pediatric BD now extend to children who have brief stormy episodes of mania ” lasting only minutes, and extremely moody, irritable, aggressive or emotionally explosive children whose symptoms have almost no continuity with the DSM criteria. [12]


    From Theory to Practice


    Geller and Biederman claim that bipolar disorder often begins in childhood, but with a different symptom picture, set the stage for the dramatic rise in the diagnosis of pediatric BD. Btu what really accelerated this trend were books on childhood BD, as well as websites, and drug ads targeted to children and parents. In these venues, symptoms are stretched even further to include mildly irritable kids, preschoolers prone to temper tantrums, and creative jubilant, high energy children many of whom have ended up on antipsychotics after a quick visit to the pediatrician.

    End Part 1


    Bipolar Disorder Overdiagnosed reafirms a recent study by Zimmerman, associate professor of psychiatry at Rhode Island University.


    Introduction to Bipolar Disorder and Children by Sharna Olfman - Part 2


    The 2007 American Academy of Child and Adolescent psychiatry practice guidelines represent an effort to stem these reckless diagnostic and prescribing practices, by elucidating the differences between tentative research findings and sound clinical practice. However, while the authors' intentions are honorable, their recommendations hardly address the many troubling questions that they themselves raise.

    In the preamble to the guidelines, they clearly state that there is no evidence to date that children exhibiting anything other than the classic symptoms of bipolar illness will fact become bipolar adults. Yet they recommend that children with symptoms such as those identified by Biederman, which bare only a remote resemblance to the DSM criteria, should be labeled "bipolar disorder NOT OTHERWISE SPECIFIED." However, adding the term "not otherwise specified" to a diagnosis of BD will have almost no impact in terms of how an ostensibly bipolar child is regarded and treated by her parents, her teachers, and her physician, who is likely to prescribe accordingly.

    Also, the authors of the guidelines state that the safety of atypical antipsychotic and anticonvulsant drugs has not been established with children, and yet these very drugs are listed as first line treatments for children diagnosed with bipolar disorder. Finally, although they assert that there is no reliable method for diagnosing BD in preschool children, they do not recommend a moratorium on this practice.

    Of even greater concern is the way in which these guidelines are filtering down from clinicians working in university affiliated clinics to psychiatrists in private practice, to pediatricians with no training in psychiatry or psychology, and to harried, sleep deprived residents and interns who treat the majority of disadvantaged children.

    As a consequence, there has been up to a forty-fold increase in the number of children being diagnosed with BD in the span of a decade, a trend that is exclusive to the U.S., the majority of whom are being prescribed antipsychotic drugs often in combination with anticonvulsant drugs. These classes of drugs have dangerous side effects, such as a doubling of mortality rate, shortened lifespan, extreme weight gain and type II diabetes. [13]

    At the end of the American Academy of Child and Adolescent Psychiatry's write-up of the guidelines, it was disclosed that two of the three authors had ties to the pharmaceutical industry. The lead author, Robert McClellan, received a research grant from Pfizer..........has received research support, acted as a consultant, or served on the speakers' bureaus of no fewer than 16 different pharmaceutical companies. I believe that the disconnect between their research and their recommendations reflects the conflict of interest that invariably ensues when profit driven drug companies fund medical research. In light of the dire consequences for millions of children affected by reckless polypharmacy, these conflicts of interest are not just misguided. They are immoral, and should be illegal.


    The Pediatric Bipolar Epidemic in Cultural Context


    Questionable diagnostic and prescribing practices, fueled in large part by unethical partnerships between the medical profession and the pharmaceutical industry, are the direct cause of the American pediatric bipolar epidemic, but broad cultural trends have acted as enablers. These include the glaring absence of support for families in this nation, and our faith in the technological fix.


    Bipolar Disorder and Children - Families Under Siege


    A cultural condition that has set the stage for the steep rise in child psychiatric diagnoses in general, and bipolar disorder in particular, is the dearth of public policies that support the welfare of children and families in the U.S. As Urie Bronfenbrenner, on of the finest developmental psychologists of the 20th century expressed:

    "The heart of our social system is the family. If we are to maintain the health of our society, we must discover the best means of nurturing that heart." [14] Tragically though, as Bronfenbrenner noted towards the end of his career. "the comparative lack of family support systems in the United States is so extreme as to make it unique among modern nations." [15]

    How can a mother who must return to work only days after giving brith, while placing her newborn in substandard care, establish a secure attachment with her infant? If a single mother must work two or three low wage jobs to make ends meet, while her children return to an empty home, how can she scaffold their arduous journey towards adulthood?

    And how can she protect them from the tidal wave of violence, hatred, racism, sexism and pornography that pervade the media? And if this mother is the second or third generation to have raised children under these compromised circumstances, how will she herself have acquired the psychological maturity and wisdom to related lovingly and responsibly towards her children? But these are precisely the conditions under which millions of American parents are obligated to raised their children. And when parents are overwhelmed, their children are more likely to be overwhelmed and overwhelming. Parents in turn become more reliant on and more vulnerable to the current climate in child psychiatry which views virtually all forms of psychological distress as a medical illness to be treated with drugs.


    The Medical Model - Mind as Machine Medicine


    The medical model of mental illness conceptualizes psychological distress as symptomatic of an underlying medical condition. So for example, just as fever may signify the presence of a virus, depression and mania are assumed to point to the presence of a genetically influenced brain disorder. This model makes an important contribution to the mental health field, because it recognizes that genetic predisposition, and brain anomalies can play a role in psychological disturbance.

    However, other models are equally essential to our understanding of the cause and cure of mental illness because they explain the role of social and cultural forces, and the human condition in all of its rich complexity. The field of developmental psychology also offers vital insights, because it provides a yardstick of healthy development against which to measure disturbance.

    But the medical model of mental disorders has monopolized the mental health field in recent decades, effectively 'muscling out' other approaches, and this has led to a biased and distorted understanding of the cause and cure of psychological disturbance. The medical model lends itself to a conceptualization of the human mind as a machine, whose software is a set of genes that we are learning to decode and recode, and whose hardware can be corrected or enhanced pharmacologically.

    We have bought into the 'mind as a machine' metaphor to such an extent, that even children's expressions of emotion are being translated into the language of symptoms in need of a pharmacological overhaul as opposed to meaningful communications. So for example, a child's jubilant elation is reframed as 'hypomania' and her sadness is termed 'depression'.


    Child Psychology: Emotions and Children - Learning to Feel


    Emotions are not simple reflexes or instincts that are present in their mature form at birth, that are either in working order or in need of an 'adjustment'. Like other lines of development such as intellectual, language, personality and social development, they follow a trajectory that is powerfully shaped by experience. In the early months and years, healthy emotional development is dependant on loving and consistent 'attachments' to parents and other caregivers.

    When a child is deprived of loving care in the first months and years of life, her emotional development will be stunted. For such a child, everything from mild disappointment to profound loss may engender rage, and everything from a simple courtesy to passionate love may elicit elation. Conversely an emotionally deprived child might defensively blunt all emotionally loaded experiences. We can imagine how in the current climate, derailed emotional development might be recast as early onset bipolar disorder.


    Child Psychology: Emotions and the Human Condition


    When children's emotions, their highs and lows, anger and frustration, humiliation, irritation, giddiness, joy, enthusiasm are stripped of meaning and read exclusively as symptoms, the consequences are profound. When a form of experience and expression that is integral to our humanity, and essential to our fulll engagement with life is reduced to a symptom, then we risk dehumanizing our children; treating them like machines to be programmed rather than children to be loved, taught, mentored and disciplined.


    Stemming the Tide of the Pediatric Bipolar Tsunami


    Many of the children and adolescents who have been labeled with BD, now numbering into the millions, are in great emotional pain, and in some cases they are an overwhelming challenge to their families. but in the vast majority of cases, they are not suffering with BD.

    A child who is misdiagnosed with a bipolar illness is effectively denied treatment for the real source of her suffering. And when we expand and distort the diagnostic criteria for BD beyond recognition, we risk making a mockery of a grave illness, and denying those who do suffer from it, access to effective research and treatment. When a child is unnecessarily prescribed antipsychotic and anticonvulsant drugs, her mental and physical health may be irrevocably compromised. With as many as two and a half million children from across the socioeconomic spectrum not taking antipsychotics we have set the stage for [a form of] wide scale child abuse.

    In June of 2007, a nationally known group of mental health specialists convened at Point Park University in Pittsburgh to identify the factors that have set the stage for pediatric bipolar epidemic in the absence of any compelling evidence for either the validity of the diagnostic criteria currently used, or the safety and efficacy of the drugs being prescribed to treat it, and to insist that rigorous scientific standards which do not imperil children's safety be reinstated in the research and treatment arenas.


    ENDNOTES for Bipolar Children


    1. Roberts E. (2007). The Childhood Bipolar Epidemic: Brat or Bipolar? In Sharna Olfman, Ed., Bipolar Children: Cutting Edge Controversy, Insight, and Research. Praeger Press, Westport CT.

    2. Healy, D. (2007). Bipolar Syndrome by Proxy? The Case of Pediatric Bipolar Disorder In Sharna Olfman, ED., Bipolar Children Cutting Edge Controversy, Insight, and Research. Praeger Press, Westport CT.

    3. J of AACAP, 46:1, January 2007, p.107

    4. J of AACAP, 46:1, January 2007, p.114

    5. J of AACAP, 46:1, January 2007, p.114

    6. J of AACAP, 46:1, January 2007, p.116

    7. J of AACAP, 46:1, January 2007, p.115

    8. Burston, D. (2007). An Invisible Plague: Pediatric Bipolar Disorder and the Chemical Colonization of Childhood. In In Sharna Olfman, Ed., bipolar Children: Cutting Edge Controversy, Insight, and Research, Praeger Press, Westport CT.

    9. Healy, D. (2007). Bipolar Syndrome by Proxy? The Case of Pediatric Bipolar Disorder In Sharna Olfman, ED., Bipolar Children Cutting Edge Controversy, Insight, and Research. Praeger Press, Westport CT.

    10. Healy, D. (2007). Bipolar Syndrome by Proxy? The Case of Pediatric Bipolar Disorder In Sharna Olfman, ED., Bipolar Children Cutting Edge Controversy, Insight, and Research. Praeger Press, Westport CT.

    11. Healy, D. (2007). Bipolar Syndrome by Proxy? The Case of Pediatric Bipolar Disorder In Sharna Olfman, ED., Bipolar Children Cutting Edge Controversy, Insight, and Research. Praeger Press, Westport CT.

    12. See chapters by Diller, Healy and Roberts.


    Related Articles - Off-site links

    Bipolar Disorder Overdiagnosed reaffirms a recent study by Zimmerman, associate professor of psychiatry at Rhode Island University.

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