Nearly 1 in 5 children in the U.S. suffers from a mental disorder, and this number has been rising for more than a decade.
According to a study conducted by the Centers for Disease Control and Prevention, up to 20 percent of American children are suffering from mental disorders such as attention-deficit hyperactivity disorder (ADHD), anxiety, depression and autism.
The CDC’s first study of mental disorders among children aged 3 to 17 also found that the cost of medical bills for treatment of such disorders is up to $247 billion each year.
Depression is one version of hell on earth, and Americans have a lot of it. A recent international study of 18 countries found America near the top, with 19.2 percent of the population having experienced depression — only France, at 21 percent, ranked higher. With our tottering health care system and vigorous arguments that antidepressants are useless, what are people to do?
Lots. Recognize that a stalled body and a stalled economy have much in common. They can degenerate or reinvent and regenerate themselves to survive and thrive. Depression is a systemic, whole body illness — its causes are multiple, its manifestions endless and its treatment multi-faceted. As Jonathan Himmelhoch and others have argued, depression represents an overall failure of the human body to adapt.
It’s time to adapt a new way of looking at the human body — one that aids us to heal ourselves.
When you’re depressed you can’t think, and you can’t sleep. Your IQ drops, you’re tired in your bones and you become convinced this horror will never leave — and nothing will make it better. No wonder depressives were burned as witches in 17th century England and New England; the transformation of the person is so total only devils could have done the work.
And the causes? More than you can name.
In the fight against childhood cancer, everyone is on the same side — the side of doing more research, finding better cures and saving lives. In the fight against childhood psychiatric disorders, there is no such unity — as the comment sections of even the most uncontroversial articles demonstrate. Some commentators feel that autism doesn’t exist, or if it does exist, it shouldn’t be considered a psychiatric disorder (implying that being in that category is demeaning). Others feel psychiatric medications are over-prescribed, that diet causes ADHD, or that pharmaceutical companies are engaged in a conspiracy whereby they “create disorders” in order to profit on the pain of children and families who don’t know where else to turn. All of these myths — expressed so frequently in abusive and judgmental language — preclude both civilized debate and progress in the field of child and adolescent psychiatry. We generally ignore the fact that over 10 years ago Surgeon General David Satcher conducted a historic first mental health report and informed us that most kids with psychiatric disorders are never given any treatment.
And what happens as a result? As a physician-in-training on the forefront, I see it stopping families from seeking treatment for childhood psychiatric problems, and those who finally do seek help are often demoralized and afraid. I’ve heard countless mothers say:
“I don’t want anyone to know my son has ADHD. Teachers will brand him. Parents won’t want their kids to play with him.”
And the question parents constantly ask me is this:
“How can my child get treatment without being humiliated in the process?”
Kids and their families deserve so much better.
There are of course many important and complicated issues in child mental health. We’re only beginning to understand healthy brain development and what happens in the brain when psychiatric disorders emerge — yet in the last five years we’ve made extraordinary leaps forward. We’ve begun identifying children’s symptoms earlier and treating their conditions more effectively.
One pill makes you larger
And one pill makes you small
And the one that mother gives you
Don’t do anything at all
Go ask Alice
When she’s ten feet tall
— From “The White Rabbit” by Jefferson Airplane
And I thought that tune was dated. But not after I saw “Limitless,” the film starring Bradley Cooper (Eddie Morra) and the legendary Robert DiNiro (Carl Van Loon), and directed by Neil Burger.
A writer, Eddie, who cannot put two words in a row on a page finds himself unable to deliver on the book he somehow has had an advance on, his beautiful and talented girlfriend (Abbie Cornish) hands him back his apartment keys and says goodbye, and dishes and debris pile up around him in the shambles of his apartment in New York’s Chinatown. He has been drinking too much and now has cause to drink more. But chance happens upon him as his ex-wife’s brother spots him on the streets of New York, asking if indeed that is his address. Vernon (Johnny Whitworth), a former drug dealer we learn, looking quite dapper and well to do, takes the sad sack Eddie out for a drink, not hard to do, and offers him a pill that will change everything. One pill makes you larger. What the hell, what does Eddie have to lose?
And so begins his adventure, as Vernon supplies him with NZT (why does my mind go to AZT, an antiretroviral medication for HIV/AIDS?), a drug that takes his limited brain functioning — we use a fraction of our brain’s capacity — and delivers it to its totally unharnessed power. He becomes limitless — soon making a fortune and is featured in the NYC tabloids as its latest phenom.
At the end of the recent film The Social Network, Mark Zuckerberg’s character, by now a wealthy and successful entrepreneur in Silicon Valley, types in the name of the young woman from Boston University who had dumped him at the beginning of the film. He sits all alone before the computer and stares at the screen, suggesting to filmgoers that the billionaire with millions of “friends” still yearns for a truly human connection.
But would it be fair to say that Zuckerberg, played in the film by Jesse Eisenberg, is depressed?
A study in the April issue of Pediatrics, published by the American Academy of Pediatrics, posits that there is a “new phenomenon” known as “Facebook Depression,” in which kids can become depressed when they compare such metrics as their number of “friends” and “status updates” to those of their peers.
Let’s explore the myth that psychiatric conditions aren’t as well defined as other medical diseases and psychiatric treatments aren’t supported by as much scientific evidence, and don’t work as well, as other medical treatments. Even my fellow psychiatrists believe this. I’ll take broken limbs and that sort of thing out of the equation and go on from there.
Are psychiatric conditions nothing more than labels for normal behaviors? Is a person with social anxiety disorder just a shy person? Is depression just an experience we all have to live with during hard times? What makes a super-punctilious person a case of obsessive-compulsive disorder? It’s true that some psychiatric conditions exist on a continuum with normal reactions, normal states of being. Differentiating them from normal is no different than deciding what level of blood pressure is ‘hypertension,’ how many pounds add up to ‘obesity,’ or how many hours of labor it should take before a baby is born. A condition rises to the level of disease when it handicaps a person, is associated with bad outcomes, and/or can be treated — in psychiatry just as in the rest of medicine.
Call them brain pacemakers, tiny implants that hold promise for fighting tough psychiatric diseases – if scientists can figure out just where in all that gray matter to put them.
Deep brain stimulation, or DBS, has proved a powerful way to block the tremors of Parkinson’s disease. Blocking mental illness isn’t nearly as easy a task.
But a push is on to expand research into how well these brain stimulators tackle the most severe cases of depression, obsessive-compulsive disorder and Tourette’s syndrome – to know best how to use them before too many doctors and patients clamor to try.
A day in the life of a paranoid schizophrenic — keep in mind most hallucinations are auditory, visual hallucinations are relatively rare.
The food police may find this hard to take, but chocolate has gotten a bad rap. People say it causes acne, that you should eat carob instead, that it’s junk food. But these accusations are not only undeserved and inaccurate, they falsely incriminate a delicious food that turns out to have profoundly important healing powers.
There is in fact a growing body of credible scientific evidence that chocolate contains a host of heart-healthy and mood-enhancing phytochemicals, with benefits to both body and mind.
For one, chocolate is a plentiful source of antioxidants. These are substances that reduce the ongoing cellular and arterial damage caused by oxidative reactions.
You may have heard of a type of antioxidants called polyphenols. These are protective chemicals found in plant foods such as red wine and green tea. Chocolate, it turns out, is particularly rich in polyphenols. According to researchers at the University of Texas Southwestern Medical Center in Dallas, the same antioxidant properties found in red wine that protect against heart disease are also found in comparable quantities in chocolate.
Are you taking antidepressants for something like sleep problems or a sour mood?
Well according to a recent study in The Journal of Clinical Psychiatry, you may not be alone.
Researchers found that more than a quarter of Americans currently taking antidepressants haven’t actually been diagnosed with the conditions that traditionally qualified one for a prescription, like depression or anxiety disorders.
Antidepressant medication may be prescribed by both psychiatrists and general practitioners.
The potential issue with all of this, Reuters Health reports, is that it means thousands of patients are being exposed to possible side effects, sans any proven health benefits. And where antidepressants are concerned, side effects do exist.
According to the Mayo Clinic, antidepressants can cause anything from nervousness, headache and dry mouth to insomnia, dizziness and erectile disfunction.
The prescription of antidepressants has long been a hot-button issue, with some arguing that while popular, the drugs are not always helpful. Others believe that they are absolutely essential to treating depression and have called for the continued development of new, more effective drugs.
While the new study raises concerns about the antidepressant treatment in the U.S., experts speaking to Reuters Health cautioned against rushing to judgement.
“As far as overprescribing, I don’t think you can say that it is occurring as a blanket statement,” Jeffrey S. Harman, an expert in health services at the University of Florida in Gainesville, told Reuters.
“There are undoubtedly many people being prescribed antidepressants that may not be effective for them, but there are also millions of Americans suffering from depression who are not being prescribed antidepressants or are being prescribed them at a suboptimal dose.”