A very odd parlor game that some of my family members like to play (this is extended, not immediate family) is diagnosis the disorder. This alternately humorous and horrifying pastime consists of select family members (some with medical and psychological backgrounds and some just with their very assured opinions) talk about members of the family (in present company or not) and try to arrive at a consensus about what sort of psychological disorder they are suffering from. Luckily, the genetic pool that I was born from is not despoiled with any momentous or debilitating disorders. For our family the diagnosis consists of mainly things like OCD, minor bi-polar disorder, and plain old neurosis. For the most part, this is a collective and familial way to bring a sense of levity to the emotional (and psychological) challenges that confound us.
However, the diagnosis and treatment of mental illness is hardly something to be flippant about. Countless numbers of young people are diagnosed, as well as misdiagnosed with serious mental illness annually in the United States, and thousands of other children in need are never given the attention they so desperately need.
This past week, a panel of medical experts for the Food and Drug Administration (FDA) was asked to approve three powerful and tremendously expensive antipsychotic drugs for the use of children. The drugs in question, Seroquel, Zyprexa and Geodon, are already widely used by adults who suffer from schizophrenia and bipolar disorder, and have also been frequently prescribed to children by doctors without FDA approval. In general, the use of these drugs have greatly helped children and adults, but there remain significant questions about side effects–including sedation, heavy weight gain, and other problems that could lead to heart disease and/or diabetes. Some concern arises around the idea that many of these children who are prescribed these drugs will no doubt be taking them (and dependent) for the rest of their life, and the long-term effects are yet unknown.
So this leaves parents (and children) is a predictably difficult crisis. Do you run the risk of the side effects, to provide an emotionally and mentally stable life for your child? Is this essentially trading up for a smaller set of problems and risks (sedation and weight gain) instead of a larger more immediate disorder (psychosis for example)? And what about the large incidence of misdiagnosis that needlessly puts thousands of children on antipsychotics and SSRIs?
No doubt this is a huge pragmatic, as well as ethical issue.
Opinions anyone? Feel free to share your experiences as a parent, child, medical professional or just someone contending with a disorder.
Eric Steinman is a freelance writer based in Rhinebeck, N.Y. He regularly writes about food, music, art, architecture and culture and is a regular contributor to Bon Appétit among other publications.