Bipolar Children: Problem practitioners or poor parenting?

I remember being in high school and thinking what a waste all those boring classes were. I suspected then that I'd never have a practical application for the abbreviations on the Periodic Table, the procedure for dissecting a frog, or anything I learned in calculus or trigonometry. But one skill that has been invaluable is the critical thinking skills I learned during my time on my high school debate team.

I normally have an opinion on any issue that I care about (and many that I don't - just for the sake of conversation). Yet despite my usual ability to choose a position, I also pride myself on being able to make thoughtful and persuasive arguments on either side of an issue. Whether resulting from logical analysis or a deeply ingrained sense of empathy, I can usually walk a proverbial mile in the other person's shoes, even if I chose not to wear them for long.

But at the urging of Danielle at The Biopolar Diaries, I'm faced with a question that I'm really not sure how I'd answer. Danielle recently linked to an op-ed piece about the alarming rise in diagnoses of bipolar disorder among young children in recent years. I've seen the headlines on this story, but to be honest, I didn't pay much attention until reading this essay written by child and adolescent psychiatrist and author, Dr. Elizabeth J. Roberts, who postulates that at the urging of parents, doctors are medicating too many children who, according to Dr. Roberts, simply suffer from the results of poor parenting.

This is an incredibly controversial issue, and I honestly don't know where I come out on this one.

The argument for problem practitioners. It took nearly 20 years for me to get a diagnosis of bipolar disorder (atypical bipolar II, and I don't fit neatly into that label either). I've read many times that this is about the average amount of time it takes for an adult to get an accurate diagnosis. Despite the fact that I'm well-educated, articulate about describing my symptoms and very proactive about my health care, obtaining a diagnoses was an incredibly difficult, frustrating and time-consuming process.

It's no secret that women, in particular, deal with a unique set of diagnostic issues. Many "invisible" diseases like fibromyalgia, irritable bowel syndrome, leaky gut, severe premenstrual syndrome, migraines and others are misdiagnosed because doctors have been so ready to dismiss any systems that couldn't be confirmed with blood tests or X-rays as being "all in her mind." I'm convinced that there are way too many women who have been routinely prescribed antidepressants when their symptoms were in fact caused by something else entirely.

So, given the difficulty that adults have with obtaining diagnoses, it should come as no surprise that children, who are likely to be much less articulate about their feelings, moods and symptoms could frequently be misdiagnosed as well.

Having also been misdiagnosed with systemic lupus, a potentially life-threatening disease, cancer, arthritis, and countless other things throughout my life, I also know that doctors can be very quick to come up with an explanation for what ails us, even if it's the wrong one, because for some doctors, any answer is preferable to admitting the unthinkable, that they simply don't know. Don't get me wrong, there are some wonderful, thoughtful, caring and concerned doctors out there, but sadly, I find them to be more of the exception than the rule these days.

Then of course there are the pressures of managed health care, limitations and restrictions from health insurance companies concerning the tests and treatments that can be provided to patients, and the pressure from parents to figure out what's wrong with their child and "fix it". Given all these factors, and many others I'm sure, it's no wonder that doctors are increasingly turning to catch-all diagnoses to cover a multitude of behaviors. I believe that bipolar disorder is the new ADD/ADHD for "problem" children.

The argument for poor parenting. Here's where I expect to step on quite a few toes. It only takes a visit to the local Wal-Mart or heaven forbid, the toy store at this time of year, to see the difference in parenting styles today. I've complained for years that I think parents of today (generally) are much too permissive, distracted and/or politically correct. In some cases, thanks to fertility advances and women wanting to establish their careers before having children, parents are older and are so thankful to finally have children that they let them get away with more. Or, on the other end of the spectrum, babies are having babies - another prescription for disaster.

When I was a young child in the 60's, parents only needed to give their children "the look" to instill the fear of a spanking when they got home if they didn't stop whatever they were doing right then and there. And except for the most tough-skinned, the look almost always worked. Today, parents threaten Johnny or Emily with a time-out, an empty threat that they usually don't follow through with anyway because it might hurt the child's self-esteem. When I was a child, if I did anything wrong while playing in the neighborhood, one of the "nosey neighbors" would have already called my parents before I made it home, and that's after they gave me a tongue-lashing to set the stage for what was sure to come from my parents. Today, a neighbor, teacher or another parent who attempts to offer such reprimands is often threatened with a lawsuit or worse.

Add to that the violence, promiscuity and profanity that children are exposed to at younger and younger ages through television, the internet, and simply listening to their parents and friends, and again, you have the perfect storm for bad behavior. Is it any wonder that our society is spiraling so out of control?

So what's the answer? I doubt that anyone knows for sure, but I'm guessing that the truth lies somewhere in the middle, meaning that both doctors and parents looking for easy answers are at least partially at fault. How's that for an answer worthy of one of the 2008 Presidential candidates.