Wednesday, November 17, 2010

A Parent’s BSD Challenge

Raising children is a rewarding journey with a most steep learning curve. Any new parent’s notion that since they are older than their child means they are wiser soon learns that it is the child who teaches the parent many things.

Think of the journey of a parent of a child who for no apparent reason engages in aggressive anti social behavior, angry unending tantrums, or a child who is ultra sensitive to all stimuli and overreacts to ordinary things in life, or a child who acts out in school seeking to always be the center of attention.

This is the life of a parent whose child has possible BSD disorder. The word possible is included in the sentence because BSD in children and teens is very difficult to diagnose, and before the 1980s was rarely described in children. Symptoms include rage, hyperactivity, sleep disturbances/night terrors, risk taking and giftedness.

BSD is manifested differently in children and teens than adults. Diagnosis is based on behavioral observation over a period of time and family history. Very often children suffer several depressive episodes before a manic episode. Depressive symptoms are not typical and include increased appetite and carbohydrate cravings, and extreme fatigue despite excessive sleeping. BSD in children and teens is often accompanied by other behavioral issues, such as behaviors that are like ADHD. The manic phase is often overlooked and attributed to normal development stages. Cycling of episodes in children and teens is more rapid and less clearly defined as manic and depressive. 20-30% of adult patients report that they had their first episode before 20 years of age.

Yet correcting behavioral issues is crucial to the child’s social, academic, and emotional development. There are no FDA approved drugs for children and antidepressants are not recommended for them. Yet despite this they are in widespread use.

Lithium has been proven to be less effective in children. Even a widely prescribed drug such as Ritalin for ADHD slows production of the human growth hormone because of how it affects the pituitary gland. This has detrimental irreversible consequences for children.

Studies have shown that drugs do not work for 50% of patients who have a mental illness, and the remaining 50% discontinue use because of side effects.(2).For children this statistic is alarming because they have less choice as to whether they will or won’t take the medication and they are less able to articulate the impact of side effects.

Questions have been asked about the effects of decades of drug use on brain damage. This gives even more credible urgency to such alternative therapies such as psychoeducation, cognitive behavior therapy, family focused therapy, and diet. Psychosocial factors such as life events, cognitive style, family dynamics, and social support influence the extent of BSD. It is these factors that psychotherapy addresses in the hope that a patient will have a brighter future.

(2) Healing Depression and Bipolar Disorder Without Drugs. G. Guyol Walker Press 2006 p14

Bipolar 101 A Practical Guide to Identifying Triggers, Managing Medications, Coping with Symptoms and More. R. White J. Preston New Harbinger Publications Inc. 2009

New Hope for People with Bipolar Disorder. J. Fawcett, B. Golden, N. Rosenfeld. Three Rivers Press 2007

Consumer’s Guide to Psychiatric Drugs. J Preston J. O’Neal, M. Talaga Pocket Books 2009

Break the Bipolar Cycle E. Brondolo, X. Amador McGraw Hill 2008

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