Children of Rage and Sorrow — More Children are Battling Mental Illness

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Mornings are worst. Having gone all night without medication, Tyler is bouncing off the walls, and Smith needs to give him his pills immediately, so he is stable by the time he gets to school. As bad as the mania is, his depressive cycles are heartbreaking. "It's awful to see him so sad," his mom says.

He struggles with his emotions. "Sometimes I get mad over nothing, and sometimes I get mad at somebody who does something to me. A lot of times, I get real bored, or I just get really sad because I think about my past."

Like many with his disorder and severe mood swings, he finds it difficult to make and keep friends, so he spends a lot of time playing computer games, and he and mom enjoy going to movies.

A single parent working full time on the night shift at a hospital and going to school as well, Smith was living with her parents but now has her own apartment. Tyler has been making progress recently, moving from a special-education classroom to a regular fifth-grade class at Oak Grove Elementary School. He's getting good grades and loves math. It helps that his father, Paul Koberstein, is doing more with him lately. The boy's face brightens as they meet one afternoon at a fast-food restaurant.

The severity of it all

The National Institute of Mental Health reports that, overall, disorders such as bipolar appear to be more severe in children and adolescents than adults. The recognition of childhood disorders took some time.

"Twenty or 30 years ago, psychiatrists and other physicians believed that childhood was a happy time," says Thomas Anders, president of the American Academy of Child & Adolescent Psychiatry and a professor at the University of California at Davis. "We had a belief that psychiatric disorders didn't begin until a child reached puberty or after. That wasn't based on science. It was based on the philosophical sense that children are always happy."

When troubled children acted out or were unmanageable, they were simply labeled "bad kids." Or the blame fell on bad parenting. That misperception was changed by science, controlled clinical trials and epidemiological studies with children. "We began to see that these disorders — anxiety disorders, depression, bipolar disorder, obsessive compulsive disorder — were present in younger and younger children. Research changed practice," Anders says.

Tristan's story

Wendy Glover-Strom received the kind of call parents of children with mental disorders dread— it was from the school psychologist telling her to "come quickly, your son is threatening to stab himself with a knife." By late afternoon that day in early March, Tristan is in Southwest Mental Health Center. By 8:30, after intake processing, psychiatric evaluation and a wrenching, emotional parting with his mother, he is admitted into a locked unit, where he is watched and checked every 15 minutes, for 24 hours.

"You have to take these suicide threats seriously," explains Juan Zavala, the psychiatry fellow on call. "That's because he's not in control of his impulses. The impulsivity with bipolar disorder can be overwhelming."

Tristan, who turns 9 this week, was acting out aggressively at 4 and 5. By the time his bipolar disorder was diagnosed at age 7, he was suicidal with a plan to get a gun from a relative's home and put a bullet in his stomach. He hears voices telling him whom he should kill and, at various times, has threatened to kill his mother, his little sister and stepfather. In the throes of mania, he kicks, punches, bites and tears things apart.

Still, "I'm not afraid of him," Glover-Strom says. "When he's rapid cycling, he's like a demon. I hate to say that word because they don't understand why they're doing what they're doing. When he's not rapid cycling, he's a very loving child."

When the boy is totally out of control, mom restrains him with hug holds for periods lasting from minutes to hours. "Ten or 12 restraints a month, that's mild," she says. After violent outbursts, Tristan goes into a depressive state and says he's sorry.

Along with bipolar, he has ODD and ADHD. He suffers from paranoia and says people hate him. When he's stable, he's bright and chatty, but like Tyler and many other children with mental disorders, he has trouble making friends.

The family lives in Castroville, and Tristan is in third grade in a behavioral class at LaCoste Elementary School in the Medina Valley district. He's reading considerably above the grade level.

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After hospitalization for a difficult two weeks in which Tristan's medication had to be readjusted several times because of side effects, the boy finally went home. But for Glover-Strom, who works at the Center for Health Care Services, the public mental-health provider in Bexar County, the stress of caring for her son is unrelenting. So is the anguish of seeing Tristan struggle with the illness.

"I asked him once what was going on inside him," she says. "He said, 'Mommy, there's a war raging in my brain, and there's a good general and a bad general, and the bad general is trying to wipe out all the good. I hate my life. I want to die.'"

Last updated: 3/06

Related Information:

• Course of Bipolar Disorder in Youths Described for the First Time
• Bipolar Disorder in Children: How Common Is it?
• About Early-Onset Bipolar Disorder
• How to Help Your Child
• Treatment and Parent’s Role in Treating Your Bipolar Child
• Addressing Educational Needs of Children with Bipolar Disorder
• Living with Bipolar as a Teen: Dealing with School (for teens)
• Mood Swings and Substance Abuse
• Girls with Bipolar Disorder
• Bipolar Patients Show Differences in MRI
• Brain Damage From Bipolar Disorder
• What Causes Bipolar Disorder?
• Bipolar is a Serious Psychiatric Condition
• APA 2004 Mtg. Report: New Research on Biological Psychiatry and Psychopharmacology
• How To Survive Bipolar Disorder
• Family-Focused Therapy Helps Bipolar Patients Cope

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