Dear FRONTLINE,

As a psychotherapist who treats young children with severe behavioral and emotional issues, I was surprised as I watched your program at how little attention was given to the availability and efficacy of therapeutic interventions. I hope that there will continue to be a growing awareness of how many options there are for helping children with Bipolar and ADHD symptoms as either an alternative to medication or as an enhancement.

Celia Sugg
Grapevine, Texas

FRONTLINE's editors respond:

Please see the Frequently Asked Questions section of this Web site for more information about the therapeutic approach.

Dear FRONTLINE,

I am a clinician working 16 years in a 45-day diagnostic program for children and youth. During my tenure I have seen a huge growth of children coming to us with multiple diagnoses and medications. The diagnoses are heaped on as the distressed family goes from one service provider to the next. Doctors see the children for very brief times and base their diagnosis on a sample of behavior that may not typify how the child functions in other settings. Prior diagnoses are often accepted without question. Medications are always an experiment and certainly that experiment is without any controls.

We need to establish objective criteria - what is "irritability" and baselines - how much, how often, how long. When there are multiple medications, there is no clear way to know how the medications are interacting and what symptoms are actually being caused by the medications.

The program was extremely helpful but there is so much more to discuss. Behavioral treatments are very effective with children but require time and skilled providers. It's easy to see why medications are so popular. The effect of pharmecutical companies has been ennormous in terms of influencing both the medical profession and the public. We need much more research before we subject children to long term use of these drugs. I agree that some children cannot function without a certain medication. But most can. Until very recently most of the human race successfully made it through childhood without being diagnosed bipolar and being medicated. There is not an epidemic of bipolar disorder in children. There is only an impression of one and we need to address what has created that impression.

Karen Crisp
Mansfield, PA

Dear FRONTLINE,

Thank you for you report. It was one of the least biased I have seen. As the mother of a 10 year-old diagnosed with bi-polar and ADHD, I can honestly say that this is the first time I did not feel attacked by one of these stories. One thing I did not see mentioned in the story, but I have seen on this board is the number of people who seem to think these problems can be controlled by non medical means (such as nutrition). While I know this has worked for some, it is not the solution for everyone. We tried nutrition and vitamins and yoga and therapy and anything else you want to think of. While we continue the therapy, my daughter could not exist without the medication she takes. So I for one, would like to thank the pharmecutical companies instead of bashing them. There is no one answer to this disease and I appreciate your positive report.

Houston, Texas

Dear FRONTLINE,

The program was riveting. We wonder if any of the doctors interviewed have read Tony Attwood's book, Asperger's Syndrome a Guide for Parents and Professionals...which is about Asperger's Syndrome a neurological/biological/developmental disorder...which is along the autistic spectrum. The 'behaviors' the psychiatrists listed as being bi-polar, are very similar to the behaviors of undiagnosed or mis-diagnosed children who have Asperger's Syndrome. Autism is NOT a mental illness. There are millions of people in the USA who have Asperger's Syndrome...they and their families are waiting for professionals to become informed, so they can be supported, assisted, diagnosed and treated appropriately.

Karen Rodman
Centerville, Ma.

Dear FRONTLINE,

Ms. Gaviria, your piece on FRONTLINE last night did an excellent job of exposing the current and disturbing practice of overmedicating children with psychiatric drugs in the US. In the 30-plus years that I have been treating, educating and caring for children, half of that time as a child psychiatrist, I have found that the approach to diagnostics and treatment in child psychiatry has severely deteriorated over time.

There was a time when psychiatrists insisted on hours of evaluation with a child and his parents before venturing a diagnosis or prescribing a medication. Today many of my psychiatric colleagues brag that they can complete an initial assessment of a child and write a prescription in less than 20 minutes. Parents have told me it took their pediatrician less than five minutes to diagnose and medicate their child. There is no excuse for this shabby practice. I still spend hours of time with each of my patients in evaluation. All child psychiatrists should take the time needed to evaluate each patient's circumstances thoroughly and each parent's discipline approach carefully. Anything less is malpractice.

I have been trying to shed light on how children have come to be overmedicated and what parents can do to get the best care for their kids in my books "Should You Medicate Your Child's Mind?" and "Bipolar Children" www.DrElizabethRoberts.com

Your viewers made many excellent points in this online discussion. Though there are many cases of legitimate mental illness which are benefitted by psychiatric medication, the vast majority of children diagnosed with Bipolar Disorder are the victims of poor parenting. Their bratty behaviors having been pathologized by schools, media and psychiatry into a "chemical imbalance."

Unfortunately, permissive parents who are seeking solutions for their child's temper tantrums, are being steered to the mental illness explanation by doctors, teachers and media. Your program demonstrated nicely how each of these resources promote the conclusion to families that children misbehave because they have a psychiatric condition that needs to be treated with medications. In spite of the dangers, doctors are justifying the sedation of these belligerent children with powerful psychiatric drugs by using the Bipolar Disorder explanation. Though some children may be temporarily sedated when treated with anti-psychotics and mood stabilizers, they continue to be oppositional and defiant. Of the many children I treat every year, whose previous doctor had attempted to treat the child's defiance with medication, not one stopped throwing tantrums after being medicated, though they were more sedated briefly.

DJ's behavior is a perfect example of how poorly the medication solution works for defiant children. No matter what medication DJ was given, ultimately he became accustom to the sedating effects and was again belligerent and tantruming, as was demonstrated so well in your program. His mother's attempts to "calm" him were tragically ineffective. The poor woman is desperately in need of parenting guidance, not more meds. I hold her doctor wholly responsible for overmedicating DJ and mismanaging his care.

Thank you for your enlightening story. I hope families in America heed your warnings.

Elizabeth Roberts, M.D.
Murrieta, CA

Dear FRONTLINE,

I was physically ill in the days leading up to the this broadcast. I was afraid of the response of the public. I was relived and affirmed as the program ended asking more questions than answers.

My husband and I are bipolar and our two children were diagnosed this year with the same illness. Our childrens' diagnosis didn't just happen to us. We wrestled for years to bring their lives into balance. We had excellent care; therapists, psychiatrist, and pediatricians. After several years of investment our childrens lives were not coming around. They were missing key developmental milestones. In addition to the frightful extremes of mood they had to deal with, my children were falling backward socially.

So many express disgust at the thought of using these psychiatric meds on children. I am disgusted as well. My children take such medication. I despise the pill containers and the ritual of dishing out the meds. I wonder is this safe? Will there be some horrible black box on the bottles five years from now banning their use in children? But I give it to them. It is critical to their developement as normal kids. We are crippled all of us and for now this medicine is a great equalizer. I give it to my wonderful children like a prayer, maybe treatment will change. Or maybe this illness will be better defined when they are teens. The wish I share with so many parents is that maybe the label is all wrong and maybe the meds wont be needed for long. But for today this is our equalizer. In the interim my husband and I haunt ourselves with "what ifs". What if it is our parenting? What if there is something else we can do? I can assure anyone who reads this that we have and will continue to try anything to help our children. Supernatural parenting classes would be so welcome over putting chemicals in small children. So far we have not found any parenting style or form of discipline that can curb the dangerous highs and despairing lows.

Thank you to our physician Dr. Axelson and to his prudent psychopharmacological treatment of our children. They will be getting off the school bus running home after a normal day in school, like there is nothing wrong with them and that is the way we want it.

Carol Amidi
Pittsburgh, PA

Dear FRONTLINE,

This program was facinating. However, like another viewer I turned it off early because it made me angry. As a nutritionist, I was appalled to see one child being fed cookies, Goldfish crackers and Gatorade because he was "so hungry". Why is there such a disconnect with these parents and physicians regarding the effects of diet on these children? It doesn't make sense that diet wouldn't be a factor! People are raising their children as little garbage cans. All children need whole, healthy foods. I have worked with enough children and parents to know that diet is related to mood and behavior "disorders". Another point I need to make is that the parents are essentially the ones buying the junk foods and as long as they bring it into the home (and eat it themselves!) the child has no hope of learning to eat and enjoy a healthy diet. Most of the mothers of the children shown were obese. The whole family would benefit from a diet and activity overhaul! Thank you for your wonderful reporting on the most important topics of the day. I continue to be a dedicated viewer of Frontline.

Patricia Davis
Little Egg Harbor, New Jersey

Dear FRONTLINE,

As a child therapist who has worked with children just like the ones profiled in your show, I was disappointed that professionals other than psychiatrists were not interviewed extensively. After further investigation into the causes of behavior such as rage outbursts, self-injury, etc. I found repeatedly that many of these children were being exposed to domestic violence on a regular basis, had significant attachment issues due to having been abandoned by one or both of their parents at one point or another, had been exposed in utero to drugs and/or alcohol, etc. In not wishing to blame parents, many professionals are not asking the right questions and medicating children in unproven, potentially dangerous ways. With all due respect to the psychiatrists you interviewed, these well-meaning professionals have rarely, if ever, spent time in people's homes, seeing the things to which many of these children are exposed. It is not the parents' fault, but it is their responsibility to provide a safe, nurturing home to their child. No medication in the world is going to have as much effect as that.

Amanda Lucas, LCSW
NASHVILLE, TN

Dear FRONTLINE,

I was appalled at the ease with which doctors dispense medication to young children. We have not yet done away with the old familiar saying that children are to be seen and not heard. Isn't that what is happening to these children? Now normal childhood behavior is seen as an illness. The United States certainly does not support family and family values. Our young parents are exhausted from too much work, not enough money and all the stresses imposed on them in this society. Children are the ones who suffer from the lack of good family interaction They are carted off to daycare at very young age and in the care of their exhausted parents for a few hours each day. Maybe we need to look at the real cause and not mask the kids but the parents with meds.

Lise Wood
Portland, ME

Dear FRONTLINE,

I am disappointed to see Brain Matters, a private brain imaging company run by businessmen with no understanding of the complexity of the brain, featured so prominently in your show. This company is using an untested version of a SPECT camera to make psychiatric diagnoses. They have done no research themselves on the accuracy of their claims. There is research on SPECT imaging, but not with their camera. Moreover, research tells us about correlations in groups of people, not a diagnosis in an individual. Even the most simple test, like a rapid strep test, has a false positive and false negative rate. The complexity of variables involved in this type of imaging are immense. Brain Matters has no idea how accurate or inaccurate their scans are. Moreover, if you read 20 or so of their reports, you wil find they all pretty much say the same thing. Brain Matters is a scam designed to rip off desparate people who are scrambling for hope. The American Psychiatric Association has already condemned such psychiatric diagnosis by neuroimaging has boogus.

Denver, CO

Dear FRONTLINE,

Wow, people are judgmental. My 7-year-old son has been on meds for Autism spectrum disorder/Bipolar disorder for a year and a half. It was most certainly our last resort. We got several second opinions and asked a lot of questions. We also tried other "therapies".

My son's problems are not due to the family not sitting down together for dinner every night. We do have a very traditional home life. My husband and I are both very educated people, married for 10 years, I work as a teacher so I am always home for my kids, we eat well and do a lot of things together as a family. We believe in disciplining our children and giving them lots of love!

Before I had my son and watched him develop, I probably would have had the same thoughts as many others who have posted on this site; "it must be the parents or the environment". To those of you that think this way, please understand that we struggle every day with our decisions of what to do with our special children. It was more than "temper tantrums" that prompted us to have our child evaluated.

Since putting our son on meds it is obvious that his ife has become easier and he can communicate better. We think we are doing the best for HIM.

I never imagined that I would have a child like my son. I never imagined that people I didn't even know would be so judgmental of me, my child, and the decisions I made for him.

Waterford, MI

Dear FRONTLINE,

I am the grandmother of a 5 year old boy diagnosed with bipolar/ADHD a year ago. He and his mother lives with me. I knew shortly after he was born there was something different about him. He never slowed down, extreme mood swings, very physical. Even at a very young age, kids his own age responded different to him. It was like they could "feel" he was different. He is on 3 types of mood stablizer medications-which has helped some. The doctor is introducing another medication for his ADHD next week. Our life has been turned upside down. The yelling, running, and never stopping is more than I can handle sometimes. But he is an angel who loves me and tells me this for no reason at all. I will fight for him to live "happily ever after".

Tricia Allen
Blue Springs, Mo

Dear FRONTLINE,

Dear Frontline,

Your show pointed out a major problem with the health of children today without even mentioning it-bad diet and the lack of attention to the diet of children affected by disorders.

As the parents of the young boy described his behavioral symptoms they fed him corndogs and Gatorade-processed foods. The Yellow #5 alone in the Gatorade has been shown to induce hyperactivity in children, according to studies done in Europe.

Then the second problem was the attitude of the child Psychiatrist treating him- there is no other alternative therapy avaliable other than pharmacotherapy. This doctor clearly is detrimental to the health and well-being of the child and a second opinion, or even third should be addressed.

It's the children who will suffer from such maligned actions, and they day will come in the future when medical science will say "how could they do something so barbaric to fragile children", Similar to our thoughts on bloodletting and lobotomies now.

These doctors should be ashamed of themselves, the subject of litigation, and the parents charged with neglect for poisoning their child, both from food and from the drugs prescribed.

Mark Nelson
Norfolk, MA

Dear FRONTLINE,

I'll make this brief because my comment will no doubt be immediately slammmed, but in my day (60 yo in June) bad behavior was always rewarded with a slap on the butt. Its quick, easy and don't cost anything and the results can be amazing.

If the bad behavior escalates, then take the kid to a pediatrician or other clincial specialist but first give the tried and true method that's worked for thousands of years a shot.

Toledo, Ohio

Dear FRONTLINE,

I was very distressed by this program. I would ask if this is occurring in any other country at this level? Are European and Canadian doctors making similar diagnosis'? As with ADD, I am sure they are not. I would like to see a program on the differences between American and European views and what the results have been.The parents should be far more cautious and skeptical of all the experiments being conducted on their children.

Chris Angelou
Tarpon Springs, Florida

FRONTLINE's editors respond:

See Dr. Kiki Chang's interview in which he addresses this question. It is in the "Interviews" section of this site.