What Killed Rebecca Riley?

Katie Couric Reports On The Diagnosis Of Bipolar Disorder In Kids

(CBS)  60 Minutes went to talk to one of the leading proponents of the diagnosis of bipolar disorder in children and whose research Dr. Kifuji has said influenced her. He is Dr. Joseph Biederman, professor at Harvard and head of child psychopharmacology at Mass General Hospital.

"Previous studies that were conducted in the '70s and '80s determined it was very, very rare for a child to have bipolar disorder. And now you're saying up to a million children are running around with this," Couric remarks. "Why such a sea change?"

"The idea is rare if you define it in very strict ways," Dr. Biederman explains. "Our contribution has been to describe the many ways that this condition may emerge in children that may make it a little bit more diagnosable and less rare than people have thought about it."

The classic adult definition for manic depression or bipolar disorder is dramatic mood swings from severe highs to severe lows, which can last for weeks or months. Dr. Biederman's definition for children, though, is much broader. It emphasizes extreme irritability and at least four other symptoms such as recklessness, sleeplessness and hyperactivity. And while most doctors now believe that a child can be bipolar, there is no definitive medical test.

Now there's a cottage industry of bestselling books, magazine covers and Internet sites where you can test your child online. But even the top researchers can not agree on exactly what bipolar disorder looks like in children or at what age it can be diagnosed.

"The average age of onset is about four," Biederman says. "It's solidly in the preschool years."

"What about those who say, 'Oh, come on Dr. Biederman, a preschooler displaying these characteristics is often acting like a preschooler,'" Couric asks.

"Absolutely not," Biederman says. "The bar to consider a diagnosis in a very young child is very high."

Asked if he worries that his work is being used or applied too broadly and that too many children are being diagnosed as a result, Biederman tells Couric, "I am not so concerned if a practitioner recognizes that the symptoms have to be severe, debilitating, devastating, to consider the diagnosis."

Rhys Hampton was three years old when he began to have violent and explosive outbursts. After a year of treatment, his mother, Diana, says a psychiatrist told her he thought Rhys was bipolar.

"Would you describe his behavior as behavior that is extraordinary, severe, dangerous, and effects every, single aspect of his life?" Couric asks.

"Yeah. Every single aspect of his life," Hampton says.

"Bipolar disorder is also described as manic depression. Did he ever get depressed? Did he ever get sad?" Couric asks.

"He would tell us, you know, 'You don't love me.' 'You don't like me.' 'I don't like myself.' 'I hate myself.' 'I'm stupid.' 'Nobody likes me.' 'I wanna die.' Four-year-olds don't talk like that," Hampton says.

After Rhys' psychiatrist suggested a fourth medication, the Hamptons said "Enough."

They took their son to Seattle Children's Hospital, where they were told Rhys wasn't bipolar. He now takes medication for hyperactivity and a sleep disorder. And he's learning to deal with his explosive moods through a behavioral program.

"I mean, there's no comparison to the child that we're parenting today, as opposed to the one that we had last year," Hampton says.

Dr. John McClellan, who's familiar with Rhys' case, says the children's psychiatric hospital he runs in Washington state is filled with kids who have been misdiagnosed as bipolar. He says it has become a catchall for aggressive and troubled children.

"I think it's a problem to label kids with a major adult psychiatric disorder when they're five years old or when they're three years old," Dr. McClellan says. "Little kids are not adults. And little kids do things that if an adult did them, it would be evidence of a mental health problem."

"Having said that, if someone is bipolar and it presents later in life, doesn't it make sense that these issues exist really from birth?" Couric asks.

"No, that does make sense," McClellan says. "The problem is symptoms like irritability or recklessness or high energy when you're an eight-year-old don't necessarily predict in the long run developing bipolar disorder. Some might. Do you expose all those kids to medications to prevent the one kid that's going to get it?"

"Not that I don't use medicines, I do but the average kid comes into my hospital now on four different medicines. We had one kid that was recently admitted to our in-patient program that was on 12 psychotropic agents. At some level, there needs to be something else that's used besides just continuing to add medication after medication," McClellan says.

Dr. McClellan says we don’t really know how these drugs interact or effect developing brains because most are being used off-label, which means they haven't been approved by the FDA for use in children.

[ashleyaddams]

I have read the responses and I am a parent of an ADHD and Autistic Male Child. He was diagnosised when he was 3 but didn't start medication until he was 5. My mother is manic depresive with a bi-polor disorder. I have seen her go from a very gorgous aggressive independant woman to a shell of a person from over stimulated drug use. Oh I also worked in the Pharmacutical industry for 12 years as well (to this day she takes about 20 pills a day). I can't even leave her alone with her grandchildren even on good days for fear of a lapse, I love her but I can't always trust her. The other things they don't tell you is how many also use NON PERSCRIPTION drugs which in my case unfortunatly my mother also did.The problem is most people (including parents) don't have total disclosure with there doctors this prevents the doctor from being affective in your treatment.I do believe there are children with these disorders, I mean a child breaking a door off hinges absolutly has some mental problems, but medicating them into zombies is NOT the answer. Riddle me this how is ZOMBIE like behavior normal childhood behavior???It isn't and unfortunatly I have read all the articles on this case and I have to agree with the law, I believe she KNEW she was over medicating the child and DID nothing to correct it. My son weighs 65 pounds he takes 0.02mg of clonidine per night (Which little Becky at 4 was taking .35mg)that is enough to knock out a 150 pound person for at least 12 hours.My mother takes seriquel she weighs approx. 165 and she is like a ZOMBIE for hours after taking the stuff.My son takes Focalin 20mg time release capslues for his ADHD he takes Zomig (only when a migrain is on-set)1 or 3 times per month, chyproheptadine (annahystamine to trigger Zomig) 1/2 in morning whole at night(also helps him relax NOT CRASH)and clonidine 0.02mg per night. I have tests done on his liver and kidneys and regular physicals.You have to be responsible when administering drugs to your child, watch the child don't just pop them a pill and walk away use good judgment and just care about your children and LISTEN to them as well they also can identify when something isn't right.Also I don't know any 4 year olds that go to bed at 6pm at night my daughter is 4 and sleeps very little but she has no troble consintrating or focusing she gets into soooo much but to be honest it won't hinder her abilities in school she at age 4 can count to 10 and know almost all her ABC's, her brother barly spoke at her age and I just knew something wasen't right.

[Liz_Kelly]

There are also a number of helpful public radio stories at The Infinite Mind

http://www.lcmedia.stores.yahoo.net/infinitemind.html
http://www.lcmedia.stores.yahoo.net

[lmshaker]

I just found out about Rebecca. I am ABSOLUTELY Disgusted.
How could any doctor in their RIGHT MIND diagnose a TWO year old with bpd?? How? This doctor should be....ashamed...have hislicense revoked/be educated in the least. Her mother should have read some books on raising children. Two years old. Unreal...

What kind of symptoms could Rebecca have exibited to be diagnosed?

Sexual Promiscuity?
Impulsivity? Did she take a credit card buy 20k worth of goods while manic??
Drug use?
Weeks of depression, weeks of mania? Or could it be that she is two years old and needed mothering and become acclimated and better adjusted?

WIth what experiences did this child have for anyone to measure an ADULT illness?

I'm sickened over this.

[sharinginc]

Look at Rebecca''''s forensic evidence, look at the lack of attempt at Bi-Polar education of the parents. Also, look at the horrific facts on over medicating by physicians today.

I will ask everyone on this blog to do a poll and ask other parents at their child''''s school if their children are on any meds. My husband coaches 11-12yr old rec football. Half the team is on something and so are the parents. His father teaches middle school and has for 30+ years. The statistics would blow you away, just at his school.

We all know the real issue here and we need to get a handle on it NOW. It is not bi-polar that is the epidemic problem. It is the mis-diagnosis in children and others, over-medication in all areas and the root causes/triggers of these supposed RAMPANT illnesses.

The doctors are not just doing this to children ask any senior citizen you pass on the street the same questions. It is the power of the drug companies, medical field and the lack of public education and misguided trust in those systems. See our earlier posts.

We are now asking that you help us petition to STOP this abuse of our children and families. We need your support to be able to act on this epidemic NOW.

www.sharinginc.com

[jonjojo777]

My Daughter is in a similar situation living with her BI Polar mother. She is 5 years old and is currently taking
Seroquel.I believe she has been misdiagnosed and am very concerned and worried.She,s the most well behaved child in the world when she,s with me. I think [ the system] has wrapped her up in their little game.The mother goes to a mental health service for parenting skills, and then all the sudden she has Bi Polar disorder. What does a duck say ? If anyone can help me and my daughter, or have any info, please contact me at my [e-mail] thankyou

[jonjojo777]

My Daughter is in a similar situation living with her BI Polar mother. She is 5 years old and is currently taking
Seroquel.I believe she has been misdiagnosed and am very concerned and worried.She,s the most well behaved child in the world when she,s with me. I think [ the system] has wrapped her up in their little game.The mother goes to a mental health service for parenting skills, and then all the sudden she has Bi Polar disorder. What does a duck say ? If anyone can help me and my daughter, or have any info, please contact me at my [e-mail] thankyou

[jonjojo777]

My Daughter is in a similar situation living with her BI Polar mother. She is 5 years old and is currently taking
Seroquel.I believe she has been misdiagnosed and am very concerned and worried.She,s the most well behaved child in the world when she,s with me. I think [ the system] has wrapped her up in their little game.The mother goes to a mental health service for parenting skills, and then all the sudden she has Bi Polar disorder. What does a duck say ? If anyone can help me and my daughter, or have any info, please contact me at my [e-mail] thankyou

[sharinginc]

We are focusing on the issue at hand. There are organizations who cover the issue of a cure. This is how an issue never gets resolved. It get diluted and then it dies. Please lets deal with the subject of those who are abusing the systems and the patients lack of education. Not the ones who are doing it right. The only ones who need to be delt with are those who are abusing the systems and families. Also, families who are abusing their children through this system they can "work". It is out there. If you are not doing it, or do not want to help others fix it, then please do not condem a honest mission.

www.sharinginc.com

[j_m_ryan-2009]

Katy Couric (and her producer) did a respectable job on the feature regarding the tragic death of 4-year-old Rebecca Riley and the prescribing of so-called antipsychotic drugs to toddlers. They did bring out as "expert" Dr. Joseph Biederman, who never heard of a drug he didn''t like to prescribe to anybody. Dr Biederman has been accused by another Doctor, Lawrence Diller, M. D., of being "morally culpable in providing the ''science'' that allowed Rebecca to die." (Boston Globe, June 19, 2007). Dr. Diller further wrote "... The ultimate absurdity of this {Biederman''s} scientific model is diagnosing bipolar disorder in 2-year-olds and linking it to the adult disorder of the same name -- in the process saddling young children as chronic mental patients condemned to a lifetime of psychiatric drugs."

For "balance" they interviewed a Dr. John McLellan, who runs a clinic in Seattle. Dr. McLellan stated that he thought that antipsychotic drugs were over-prescribed, not that the drugs are dangerous. They had no one like Drs. Peter Breggin, Fred Baughman, Lawrence Diller, or Grace Jackson as balance, to explain how dangerous these powerful, brain-altering drugs are, particularly to young, developing brains.

Overall though, it was about as good as those of us who worry about the dangers of these powerful drugs can expect from network TV, given that the networks make millions of dollars yearly for advertising prescription drugs.


J. M. Ryan
Las Cruces, NM

[sharinginc]

You can read our reason''s at:
www.sharinginc.com

Or go straight to our PETITION at:

http://www.thepetitionsite.com/1/be-our-voice

[sharinginc]

Please see our previous posts and sign our petition. We need your responses to continue on with this issue. If we let it die, then they will continue to profit from the lack of pubic education. We can begin a great mission here for our children if you just continue to speak out on your intollerance of abuse through the medical field for profit. That is the story. Doctors should have guidelines and we all know they do not. Rebecca''s story has rang the alarm. Do not let it fade into the background with the rest of the "big money" issues that big business hopes will get swept under the rug. Speak up!

www.sharinginc.com

[brightchild]

I also say, that maybe if I had medication as a child I would not have attempted suicide at age 11 and 18. Therapy alone did not work for me.

[brightchild]

Bipolar is only a stigma because of ignorant society. There are many people who are adults with bipolar and function society. And Sally%u2026.. I myself have a professional career, have been to college, have a mortgage, have health insurance, and I never had the desire to serve in the military. Oh! I have custody of my children as well.

My son goes to ministry school on Tues. Bible study on Thurs. and Church on Sunday. He also volunteers in the community. He has more manners that many of the children I have encountered in his school. I am very proud of him. And yes, he is bipolar. Many people would not have known unless we told them, or when he was hospitalized four times for rapid cycling.

Sharinginc, if you really want to start a petition that makes a difference. Petition for more funding for the cure of this illness.

[tink517]

Sally, Did I use an exteme example to put emphasis on my point? Yes! You trivialize the condition when you use the term label vs diagnoses.
Sally wrote:
As for the person who posted that there are plenty of people labeled as bipolar who function in society, of course that''''s true, however, once someone discloses that they are bipolar, they are not allowed to function in society. When you label your child bipolar and disclose such on your heatlh insurance claims and/or to school systems, that child is forever labeled and stigmatized unfairly.

With people like you out there, the stigma will continue. Your oversimplication of the causes of this condition don''t just border on, but are ludicris (sp). At least when I suffer from dillusional thinking, my family knows to get me help. Also, I thank God that I don''t run into many people who think the way you do. I do not keep it a secret that I am bi-polar. I am open and upfront. I am one of the lucky ones who is on the right medication.

[mdw19581]

First off, let''s not forget that Katie Couric''s story was completely one-sided. All she did was interview a severely depressed, heavily medicated grieving mother who could barely defend herself. What she didn''t do, what she should have done to present a truly balanced picture, was to go into the home of some of these children, and FILM THE CHILDREN! Show the public how these children really think and act.

None of you can pass judgment until you have lived with such a child. CBS did a horrible disservice by failing to show the public what the home life of such a child and their family is like. If Katie Couric had spent half her time in such a home filming the actual children, instead of interviewing a medicated, grieving mother, maybe some of you would have a glimpse of what it is like to live with child whose ever hour of life is filled with fear, paranoia, pain, grandiosity, aggression, and suicidal thoughts.

Tink wrote: "Sally, Stigma, mortgage insurance, getting into college? There are people on this board with children who don''''t want to live to see the light of tomorrow."

Tink, you cannot really be telling me that you think its okay to label these kids because they wouldn''t be able to accomplish anything anyway. Perhaps people with children they choose to label bipolar should look to the parents of children with down''s syndrome for role models. That''s an honorable group of people who don''t blame their children or limit their opportunities.

As for the person who posted that there are plenty of people labeled as bipolar who function in society, of course that''s true, however, once someone discloses that they are bipolar, they are not allowed to function in society. When you label your child bipolar and disclose such on your heatlh insurance claims and/or to school systems, that child is forever labeled and stigmatized unfairly.

[tink517]

As I said in my first post, there needs to be more doctors like the one from Washington state. Are there children out there that are misgidagnosed? Yes, but I don''t believe that can be said for all of them. Are some of these misdiagnosis do to poor parenting? Yes, but that also can not be said for all. There is no child on this earth that asked to be here so our obligation is to give them the best possible upbringing that we can. We being not just the parents, but society as a whole. To get somewhat off subject, there are parallels in how we deal with our children to how we care for our elderly. As a volunteer with two different hospitals, and member of a pet therapy group, visitation of the sick and elderly does not seem to be high on anyone''s list. During the course of a month, I''m in and out of 6-7 nursing and rehab centers and two mental health facilities. Regular family visitation of residents of thses facilities does not seem to be a high priority on anyone''s list. As a manic depressive, I would not be able to do any of this except for the proper medications and the excellent care that I receive from my doctor.

[alikirsten]

Read the comment of the mother who placed her son on so many different meds. Skykysmom...even she herself said that after her son was diagonsed and was doped up and hospitalized he was taken off the meds and now is a COMPLETELY DIFFERENT CHILD...............................

[alikirsten]

I am the mother of a three year old little girl. And I am only 21 years old. In watching this clip tonight and reading some of the responses I honestly have to say you people make me sick.There is no such thing as a toddler being too hyper or even bipolar. It is called POOR,LAZY parenting. If you can''t off your behinds to raise your children and you actually have to go to a liberal money hungry "doctor" to dope your children up so that they don''t drive you "crazy" then you had absoultely NO RIGHT becoming parents to begin with. YOu people honestly make me sick to stomach. And to say that the medication is helping your children wait till five years from now when their brains are so DOPED up from all the pills you have given them cause you dont have a clue as to how to raise them. Think about all the side affects...I mean come on people. WHAT IS WRONG WITH YOU?!?!?!?!?! THis poor little girl died because her ghetto mother couldnt get off her fat *** to interact with her child and thought the best thing for this FOUR year old would be to put her soo many DIFFERENT kind of pills...the kind of pills that havent even been tested much like the pills you lazy mothers are putting your kids on NOW and claiming it''s "helping" them. I just hope and pray that there will not be another child that ends up like this little girl and shame on you for not using proper parenting.

[tink517]

Sally, Stigma, mortgage insurance, getting into college? There are people on this board with children who don''t want to live to see the light of tomorrow.