I have to say I'm disappointed with the cover story on bipolar children in Sunday's New York Times magazine. The author, Jennifer Egan, raises the interesting question about why there has been such a sharp increase in the diagnosis of childhood bipolar disorder, but she fails to note a few salient facts, for instance, that this controversial diagnosis has been championed by psychiatrists who have earned millions of dollars in personal consulting fees from the very companies who make the anti-psychotic drugs used to treat this disorder.
Egan does throw in this line, "And of course, there are pressures and blandishments from the pharmaceutical industry, which stands to profit mightily from the expensive drugs -- often used in combination -- that are prescribed for bipolar illness, despite the fact that very few of these drugs have been approved for use in children." But a few paragraphs later, when she mentions Joseph Biederman, a psychiatrist at Massachusetts General Hospital and one of the fiercest proponents of using powerful drugs to treat young children for bipolar disorder, she neglects to mention that Biederman is being investigated by the Senate Finance Committee for failing to fully disclose that he earned at least 1.6 million dollars in personal income from the companies that make these expensive drugs.(back story).
That's a glaring omission in my view.
In her lengthy, 9,500-word article, Egan also fails to note the link between mania and the SSRI antidepressants, which I write about in my book, Side Effects: A Prosecutor, a Whistleblower and a Bestselling Antidepressant on Trial. Research has shown that in some children and adults, taking antidepressants like Prozac, Paxil and Zoloft, actually induces manic behavior. So the question becomes: which came first, the predisposition to bipolar disorder, which is accentuated by the use of antidepressants, or the drug-induced manic behavior, which then leads doctors to label as bipolar patients who are taking the drugs for depression?
Throughout the piece, Egan seems to favor a completely biological explanation for bipolar disorder. She fails to consider that in some children, the mood swings, hostility and irritability that are characteristic of a bipolar diagnosis, may have been caused or exacerbated by family issues, parenting difficulties, sibling rivalries, divorce, etc. Near the end of her opus, she briefly mentions that some bipolar children appear to get well as they get older, but instead of following that intriguing observation into what could have been an interesting examination of the interplay between nature and nurture, she swerves off into a discussion of the search for "biological markers" for bipolar disorder, as if it's just a matter of time till we find some.
It's almost as if Egan is willfully ignoring the published research here. Doesn't she know that scientists have tried for years to find biological markers for schizophrenia and similar disorders and failed? When it comes to mental illness, the answers are simply not as clear-cut as Egan would have us believe.