Welcome to Max’s world, Bipolar disorder is a mystery and a subject of medical debate. But for the Blakes, it’s just reality.

In a Newsweek cover story, Mary Carmichael tells the story of the estimated 800,000 American children with bipolar disorder through the eyes of 10-year-old Max Blake and his family. Max was diagnosed at the age of two and first tried to kill himself at seven. He has been on 38 different psychoactive drugs, all with serious side effects. His parents worry about that, but to some degree have made their peace with medication.

It is an elusive disease that no parent fully understands, that some doctors do not believe exists in children, that almost everyone stigmatizes. But this is also a love story. Good things happen. A couple sticks together, a child tries to do better, teachers and doctors and friends help out. Max Blake and his parents may not have much in common with other families. They are a family nonetheless.

… The disease is hard to pin down. The bipolar brain is miswired, but no one knows why it develops that way. There are many drugs, but it’s unclear how they work. Often, they don’t work at all, and they may interfere with normal brain growth. There are no studies on their long-term effects in children. Yet untreated bipolar disorder can be disastrous; 10 percent of sufferers commit suicide. Parents must choose between two wrenching options: treat their children and risk a bad outcome, or don’t treat and risk a worse one. No matter what they do, they are in for uncertainty and pain.

Advice for parents of children with bipolar disorder.

From the New York Times:

Activists like writer/blogger Liz Spikol (left) and USC law professor Elyn Saks are speaking candidly and publicly about living lives with mental illness, promoting awareness and acceptance of people with such diagnoses as bipolar disorder and schizophrenia.

“Until now, the acceptance of mental illness has pretty much stopped at depression,” said Charles Barber, a lecturer in psychiatry at the Yale School of Medicine. “But a newer generation, fueled by the Internet and other sophisticated delivery systems, is saying, ‘We deserve to be heard, too.’ ”

About 5.7 million Americans over 18 have bipolar disorder, which is classified as a mood disorder, according to the National Institute of Mental Health. Another 2.4 million have schizophrenia, which is considered a thought disorder. The small slice of this disparate population who have chosen to share their experiences with the public liken their efforts to those of the gay-rights and similar movements of a generation ago.

Just as gay-rights activists reclaimed the word queer as a badge of honor rather than a slur, these advocates proudly call themselves mad; they say their conditions do not preclude them from productive lives.

From the Houston Chronicle:

Nearly half of the youths locked up in the Harris County Juvenile Detention Center [have] mental health problems – far more than the estimated 20 percent with mental disorders in the general youth population – figures released Thursday show. [Harris County includes Houston.]

These youngsters, mostly teenagers, have been diagnosed with maladies including bipolar and attention deficit disorders, according to data compiled by a group of organizations studying the issue. Nearly 20 percent have severe emotional problems, the data show, and a quarter had never been diagnosed previously.

“For the first time ever we’ve collected amazing data that really give us the hard facts about what issues are there and what diagnosis we need to treat,” said Betsy Schwartz, president of Mental Health America of Greater Houston. The nonprofit agency and the county juvenile probation department are coordinating Operation Redirect, a collaboration of local groups trying to prevent mentally ill kids from ending up behind bars.

See related posts:

• Mentally ill strain Georgia prisons
• Editorial: Help — not jail — needed for people with mental illness

An analysis by the Dallas Morning News of state personnel records finds that 72 employees from Texas’ 10 state mental hospitals have been fired in the last three years over allegations of physical abuse, including brutal beatings and sexual abuse. Hundreds more were terminated for other violations, from sleeping on the job to over-medicating mentally ill patients.

State officials say there will always be some reports of abuse and neglect in an institutional setting. And they say they take any allegations of mistreatment seriously. But the records show that as in other state-run facilities, abuse and neglect are systemic.

The state’s juvenile prisons, group homes for the disabled, and state schools for people with mental disabilities all came under fire last year for reports of widespread physical and sexual abuse. The state psychiatric hospitals, like other systems for vulnerable Texans, are chronically starved for cash, advocates of more state funding say, and services at the local level can’t keep up.

“You get what you pay for,” said Rep. Garnet Coleman, D-Houston, who has bipolar disorder. “When you financially dumb something down, you make services cheap, something’s got to give. Unfortunately, it usually ends up being a mentally ill or disabled Texan.”

See earlier posts here and here.

From the New York Times, Minneapolis Star Tribune, CBS News, Wall Street Journal and elsewhere:

After more than a decade of struggle, the House on Wednesday passed a bill requiring most group health plans to provide more generous coverage for treatment of mental illnesses, comparable to what they provide for physical illnesses.

… The Senate has passed a similar bill requiring equivalence, or parity, in coverage of mental and physical ailments. Federal law now allows insurers to discriminate, and most do so, by setting higher co-payments or stricter limits on mental health benefits.

… Supporters of the House bill, including consumer groups and the American Psychiatric Association, said it would be a boon to many of the 35 million Americans who experience disabling symptoms of mental disorders each year.

The bill is a deeply personal one for sponsors Rep. Patrick J. Kennedy (D-R.I.), who has said he has bipolar disorder and Rep. Jim Ramstad (R-Minn.), a recovering alcoholic who says he has not taken a drink in 25 years. Patrick Kennedy and his father, Sen. Edward M. Kennedy (D-Mass.) hold competing versions of the bill. (above)

The White House opposes the bill.

From the [Toronto] Globe and Mail:

A growing number of children in Canada, as in the United States, are being diagnosed with bipolar disorder. Kids as young as 7 are taking powerful cocktails of mood-altering drugs never tested in children, with side effects that include significant weight gain, blood clots and tremors.

Some see the spike as the natural consequence of recognizing a real childhood condition that was previously missed or misdiagnosed. Others say that childhood bipolar disorder is psychiatry’s latest fad – an overdiagnosis driven by fuzzy definitions, new drugs, eager doctors and anxious parents.

(more…)

Writing in USA Today, Janet Kornblum uses Britney Spears’ recent hospitalization to examine the problems families routinely face when a loved one needs some kind of help for behavioral problems or mental incapacity.

Spears was reportedly placed on an involuntary 72-hour hold under California penal code 5150, which allows law enforcement or medical personnel to confine someone “when any person, as a result of mental disorder” is deemed a danger to oneself, and/or others or is “gravely disabled.”

Public ignorance about mental illness is compounded by stigma, leaving patients and families to feel they are to blame for their own problems. Making matters worse are state laws that do not allow families to act until there is a crisis.

When someone has a heart attack, “you say, honey, you lie down right here. I’m calling 911,” (more…)