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

(March 19, 2006) -- It's 3 o'clock and following her afternoon ritual, Kim Smith carefully places a little blue pill on the table in front of son Tyler, "the magic pill," she calls it, a talisman of the peace, healing and normalcy they both long for and seek every day.

Tyler, a thin, serious-looking boy with dark, short-cropped hair, just finished a weekly session with his therapist, and he has been spinning in a swivel chair and pacing the room at the Southwest Mental Health Center, in constant motion. He quickly downs the pill with a drink, and everyone waits the 30 minutes or so it takes to kick in.

This is only one talisman, one of 16 pills, half a dozen medications the 10-year-old takes every day. His condition was diagnosed as bipolar disorder, manic-depression, at 6 — his mother thinks he was sick long before that. He also has oppositional defiant disorder, ODD, and like about 90 percent of youth with bipolar disorder, he suffers from attention-deficit/hyperactivity disorder. He is on two mood stabilizers, along with the stimulant Adderall for the ADHD (the blue pill) and several sleep medications, the last because without them, he can go for days without sleeping. In addition to the psychiatric medications, he takes medicine for asthma and for severe migraine headaches that send him to his dark, quiet bedroom until the pain and nausea subside.

It's a mountain of trouble for a little boy to deal with, and even with medications and therapy, Tyler has terrible days, so bad that already in his young life, he has been hospitalized at Southwest 17 times, with several stays lasting 90 days.

Tyler's story is a disturbing glimpse into the far- from-carefree lives experienced by millions of American youngsters and their families dealing with serious illnesses such as major depression, bipolar disorder, a raft of anxiety disorders and, in very rare instances, even early onset of the devastating mental illness, schizophrenia.

A Harvard Medical School researcher last year found that half of all cases of mental illness start by age 14, often with mild symptoms that go untreated and turn into serious disorders. According to the Surgeon General's Report on Mental Illness, one in 10 American children has a mental disorder severe enough to cause impairment.

The report lays out a public crisis in mental health care, including an acute shortage of child and adolescent psychiatrists and fragmented, limited treatment services, in which only one in five of these children gets the specialized care he or she needs. In some tragic cases, parents without the money or health insurance to cover needed psychiatric residential treatment are relinquishing custody of their children to state child protective services or the juvenile justice system to get them treated. About 250 families a year in Texas do this, according to the Mental Health Association in Texas.

Some specialists fear psychiatric disorders, which are linked to both genetic and environmental factors, are increasing in children. Perhaps most astonishing and controversial for many, researchers studying the early onset of depressive disorders and bipolar disorder are finding them in preschoolers — 3- to 6-year-olds. Clinicians tell of 5-year-olds with depression who talk about killing themselves.

Beyond the rage

When Tyler was just a toddler, he had raging temper tantrums with kicking and screaming that lasted for hours, episodes that went way beyond normal childhood tantrums. By kindergarten, his condition was diagnosed as attention-deficit/hyperactivity disorder. But as his mother Kim Smith recounts, treating the ADHD with Ritalin only made his manic symptoms worse. He bloodied one child's nose and stabbed another kindergartener in the side with a pencil. After he was suspended for the third time for aggressive outbursts in first grade, she was desperate and camped out in the doctor's busy waiting room until he could see the boy. While they waited, Tyler kicked a patient. He was hospitalized at Southwest Mental Health Center, where his bipolar disorder was diagnosed. It was the beginning of help and understanding but not the end of Tyler's manic episodes.

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He once wrecked a classroom, and he can be violent at home as well. "He has punched me. He has hit me. He has kicked me. He has bit me. You name it, he's done it," Smith says. "But I don't get mad. You just have to know that at that point in time, he's not in control of his body."

There are times she has to physically restrain the 10-year-old, sitting on him and holding his crossed arms down on his chest. And there are the calls at work from home or school when he's out of control.

Last updated: 3/06

Reprinted from the San Antonio Express News

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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