Saturday, November 13, 2010

None Dare Call it Acting Out

Recent headline (November 11, 2010) in the Memphis Commercial Appeal newpaper:  "Survey: 1 in 10 U.S. children has ADHD."  One in ten.  Imagine that!  "Biological" psychiatrists believe that ADHD is a genetic and/or neurodevelopmental disorder.  I can't think of any other such disorder that effects 10% of the entire population.

The survey was performed by the U.S. Goverment.  According to the newspaper article, this represents a "sizable increase from a few years earlier that might be explained by growing awareness and better screening."  Specifically, the number represents an increase of 22% from 2003 to 2007.  The actual numbers of affected kids would be 5.4 million children - an increase of about one million in that period of time. Two thirds of the children were on medication.

Of course, the study seemed to just assume that the diagnoses were all valid.  Surely there are more parents aware of ADHD than ever before, so the "increased awareness" part of the story is undoubtedly true. 

The statistics for the "incidence" of childhood bipolar disorder (also called pediatric bipolar) are even more striking.  Prescriptions for powerful psychiatric drugs to young children for this disorder quintupled in less than four years.  The graph below shows the amazing increase in private office visits for bipolar disorder in children under twenty. 

Source: Pharmed Out

Of course, real bipolar disorder often first manifests in sufferer's late teens, and rarely occurs in children - as reflected in the number of office visits shown in '94-95, before pediatric bipolar diagnosis became a fad.  For decades, the incidence of bipolar disorder was pegged at about 1%, but now suddenly it is almost 5%.  This figure includes many who are diagnosed as "bipolar II" or "bipolar NOS" (see my post of July 24, 2010, Counting Symptoms that Don't Count for a discussion of how the designation NOS has been misused in defining bipolar disorder).

The dramatic increase in diagnosis of both ADHD and pediatric bipolar (without any change in the gene pool) is more strong evidence for the main thesis of my book, How Dysfunctional Families Spur Mental Disorders.  An upspoken and unholy alliance between pharmaceutical companies, biological psychiatrists, and overwhelmed and guilty parents has led to the disappearance in many mental health circles of the use of the term acting out in children in favor of a brain disease model for out-of-control children. 

As defined by, acting out is performing an extreme behavior in order to express thoughts or feelings the person feels incapable of otherwise expressing. Instead of saying, “I’m angry with you,” a person who acts out may instead throw a book at the person, or punch a hole through a wall. When a person acts out, it can act as a pressure release, and often helps the individual feel calmer and peaceful once again. For instance, a child’s temper tantrum is a form of acting out when he or she doesn’t get his or her way with a parent. Self-injury may also be a form of acting-out, expressing in physical pain what one cannot stand to feel emotionally.

Heaven forbid we should look at the problematic parenting trends described in detail by parenting columnist John Rosemond or the staggering incidence of child abuse and neglect in creating acting out.  How much more comforting for parents to think they bear no responsibility for how their children turn out.


  1. The attention deficit is primarily on the part of the parents who do not seem to understand the nature of parental responsibility: attend to their children's needs for attention consistently, to provide an environment that prepares them for school while they are preschoolers. To have home life revolve around the needs of the children, who depend on this to develop a sense of self worth. Children need structure, it provides security. They need to be attended to to enable them to know they are valued, not so they don't make us look bad or to meet any of the parent's needs--It seems to me, some people are parenting their children as parental duties fit around the rest of life--no wonder the lack of esteem and alienation many kids experience as a result. I know that my own parenting improved the more I dealt with my emotional and spiritual needs--and declined when I did not...When I did not attend to my emotional and spiritual needs, I was not the parent I am when these needs are met. A parents responsibility, unmet, results in acting out; often, acting out is simply a desperate attempt to get needs met! These kids get blamed and labeled dysfunctional--and told their brains don't work right, etc. No wonder so many grow up to disrespect authority, have negative self-esteem, negative behaviors, and often, little hope for a positive future. These attitudes and behaviors appear to me to be natural consequences, when viewed from this perspective.

    I wonder if some psychiatrists rely on medications and fail to offer other types of treatment because of the effort required of themselves; or worse, do not even tell parents that psycho-social, cognitive-behavior and other evidenced-based treatments work. In reality, being evidenced-based, unlike many medications they should be presented as options in any discussion where medication is a proposed treatment. This would require mutual trust and respect, (i.e. personal investment)without which there is no therapeutic relationship. A very real commitment and hard work on both/all sides is required to achieve results, even more to achieve recovery. It requires connection of a very real sort that writing a prescription does not.

    Blaming the kid works out well for the grownups, in the short term, and for no one in the long term.

  2. I'm sure that 10% number will eventually be adjusted to a more realistic 15-20%. Now there is apparently evidence that many adults or teens with ADD did not show signs of the disorder in childhood. I suspect the diagnosis is frequently made by response to the treatment, or "If you like (or behave better) taking stimulants, you must have ADD." or "The solution is in the bottle."

    Structure and Diagnosis of Adult Attention-Deficit / Hyperactivity Disorder, by Ronald C. Kessler, et. al. {12 co-authors} in Archives of General Psychiatry, vol. 67 (NO. 11), November, 2010, pp. 1168-1178.

    BTW: I think the "psychcentral" definition of acting out is too narrow. The behavior should not necessarily be extreme to qualify.

    BTW2: Have we counted all the people who would test positive with one of Dr. Amen's brain scans?

  3. They're ECTing children now...chldren who "failed treatment" for things such as "bipolar"...did you know? I'm horrified. I can't believe this. This is what happens when psychiatry has gone mad. There's no end to the madness.

  4. The reason I posted that link (you need to copy it into the adress bar to follow it) is that I am 100% sure that ECT will nto be reserved for that oen in a million child with psychosis who really needs a biological treatment and hasn;t responded to medications. It will be used to 'treat' all the children you talk about. I've seen ECT being used in adults to treat misery that the so-called treaters were too obtuse to recognise.

    I am shocked by this and doubly stunned that no one else seems to be. This is a crime perpetrated against children, and not in some wacko scientologist sense. As physicians we have a moral obligation to speak up for those who can't speak for themselves. This therapeutic furor of using physical means to treat psychological and social problems is harming the defenseless. I'm stunned that this is permitted. But then, I'm stunned that drugging little kids is permitted , except in extremis and with a few relatively safe medications.

  5. Pacificpsych,

    I must say I was stunned when I looked at the link you sent. Never heard of that before. Thankfully, I have not heard about the use of ECT on kids here in Memphis. Let's hope this whole idea dies on the vine - at least it shouldn't have Big Pharma pushing it.