Dear FRONTLINE,

I was diagnosed with bipolar disorder II as a teenager; I will be 30 in 2008. I was put on loads of meds back then, including Depakote. I was living life in a zombie state, unmotivated and depressed. In my early 20's I quit taking all of my meds, because I felt like a lab rat with no way to move ahead. I wanted to function. Life has been hard throughout.

I wish instead, that I had been introduced to alternatives such as yoga and eating right at an early age. Talk therapy has been an immense help to me always! Just recently, I have been considering the aid of medication again; the doctors tell me, 'a lot has changed in the last 10 years'. From my experience, try all the alternatives first and only used medication when it is really the only option left. We need to learn to cope and function as human beings first. And don't forget, lots of great things have come from those of us whom are bipolar.

douglas douglas
los angeles, ca

Dear FRONTLINE,

A good documentary - but it amazed me that no attention was paid to possible environmental factors in the etiology of Attention Deficit and related childhood brain disorders.If brain scans objectively verify the increased incidence of these childhood disorders in the US, then we need to know: are they on rise because of enhanced diagnostic skills or possibly also because of something in the natal or post-natal environment that is affecting the developing brains of children?Have statistical analyses been done to compare incidence of these disorders in the US, with children in less-developed/pre-technological societies?These questions of causation need to be addressed by scientific researchers (and by PBS) with at least the same vigor that multiple pharmeceuticals are experimentally dispensed to children by doctors!

James Azzara
Missoula, Montana

Dear FRONTLINE,

i am adult bipolar and i have noticed that the mothers are usually overweight. Fasting is the only treatment that has ever helped me. Is it possible the mothers diet affects the childs hyperactivity upon birth. Each one of those mothers were on poor diets. My mother included. I read about fasting to clear the mind and aide with mental illness years ago. It has been the only thing that has ever helped me.

jennifer wahl
camarillo, ca

Dear FRONTLINE,

As a parent of a bi-polar child 7 years old, I do believe that my son has a genetic chemical imbalance,that is on both sides of his family, that makes him depressed and manic all within a very short time period. I do believe that the symptom of rapid cycling is much different for a child instead of adults, it could relate to how children precieve their enviornment, remember how as a child everything felt like it took longer.

For people that have not lived with a "difficult child", it is very hard to understand what a day is like, but lets just say that every morning I get up and think to myself what am I in store for today? Will I be get a call from school that my son's masterbating in class again, that he hit another child, that it was a great day and he was an angel, did he feel someone touch him and no one was there, will he try to kill himself, and will social services be coming today? Each day is a new challenge and nothing is the same.

However, I do believe that my son has a very bright future, because I have become an advocate for my child. Which I felt was lacking by some of the other parents in the program. It is tough, but taking the time to be an informated parent, I learned how to handle the situation better and make positive changes in my child and not by just giving a handful of pills and hoping it will get better and go away.

I started my son on an intentsive exercise program (to releive stress and curb depression), Cognitive Behavior Therapy, counseling, high dosages of Omega 3 (which a Harvard study did indicate had positive effects for children with BP), B-12, HTP5, Gama Relaxer and a diet that removes processed foods. Somethings work, somethings don't, but through all the research-online and books, my natural treatments are just as tested as what the doctors are prescribing to these children, and less dangerous. And I test more, by having blood, allergy, urine and hair sample test done and I monitor daily events.

I do not want to drug up my son so much, where he losses his personality and energy for life, I want him to learn how to handle social situations, anger, stress, depression, and aniexty so he can deal with his life and become a happy productive member of society.

Denver, CO

Dear FRONTLINE,

How can they believe that they can help the children with these drugs when they still can't help the adults with the same drugs. After 5 years and 35 different drugs, I gave up on the medication. But the medication did not give up on me. Even though none of it helped for more than a few weeks, quite a few helped not at all, some of the side effects are still with me (4 years later), and will be for life.How can they sentence these young children to a life of these side effects ... I'm already old so I only have a few years to cope with the side effects, even so, that thought is daunting.When you have to choose between losing your body in order to treat your mind ... well, that should not never be the choice. Mental health or physical health! The loss of either one takes away your quality of life.Think of it, these kids could have 50, 60, 70 years with these damaged bodies. There has to be a better way to treat the mind and its problems.PS. How can they diagnose these problems in 2 and 4 and 5 year olds ? And pre-teens and teens ? A 13-year old will have mood swings!PS. Are these new illnesses or were they ignored for the past century? Is there something in the environment (lifestyle) causing these illnesses in young kids? Maybe look for the cause and eliminate it ... rather than destroy these kids with tons of drugs.

Medicine Hat, Alberta

Dear FRONTLINE,

First, a medical correction: Risperdal (i.e. risperidone) and other antipsychotics have not been associated with causing tics and in fact are a treatment for tic disorders. They actually are associated with a different form of movement disorder (Tardive Dyskinesia or TD) and with Parkinson's-like side effects that may mimic tics. Second, no mention was given to the bigger picture associated with the overdiagnosing and overmedicating of children (and possibly adults for that matter). This is driven by the health insurance companies that have led to an inability by psychiatrists and other prescribers to provide enough time with patients and families to get the "full" picture of a child's mental health. As a child psychiatrist I require 90 minute assessments and usually obtain questionnaires from more than one source (e.g. teachers, therapists, other family). This is becoming a rarity in this country, and was only briefly mentioned in your program when it was alluded that primary care providers diagnose and prescribe medications in some cases with little time spent talking to the patient. Even psychiatric hospitals and residential / day treatment facilities are being forced to minimize the amount of time a child is allowed to be treated or evaluated, making their treatment and evaluations suspect. This is something that has been negatively impacting adult mental health and is now affecting child and adolescent mental health as well. I hope you will be able to do a Frontline report on the overall crisis in mental health gripping this country.

Alfredo Soto
Lake Oswego, Oregon

FRONTLINE's editors respond:

The viewer is correct that the side effect associated with long term use of Risperdal and other antipsychotics is Tardive Dyskenisia and not, technically speaking, tics. But Tardive Dyskenisia does cause involuntary and abnormal muscle movements that, in common parlance, would most likely be described as "tics." It was in this sense, for simplicity, that we used the word. In fact, the two are distinct conditions. In the film, Dr. Bacon is concerned that prolonging DJ's prescription to Risperdal will raise the chances of his developing Tardive Dyskenisia -- not tics, for which, as the viewer notes, Risperdal is a common treatment.

Dear FRONTLINE,

My son was diagnosed with BP-I at the age of 19 after a psychotic break. He have been diagnosed ealier (age 13), but was incorrectly diagnosed with ADHD. He was given stimunlants- which according to Chang- likely hassened the onset (through kindling) of BP-I. Accurate diagnosis is so important. Some of the things that I did not see addressed in your program -but I tuned in late, so it may have been addressed- was familial loading.

My son's father is bipolar and was hospitalized at the age of 15. He was also missdiagnosed with schizophrenia (a more popular diagnosis in the 1970s). After being given ADHD meds, my son had symptoms of psychosis and spoke of violent acts- unlike many BP kids, my son was NEVER VIOLENT TO OTHERS- although he would injure himself. He is now... years old, he is stable on lamictal and trazadone, was recently married and is doing well. He still has difficulties with cognition/learning and gets manic once a year. I think that because I have become so educated (finishing my PhD, with specialization in bipolar disorder) I have been able to educate him. Another thing that I find interesting is that, although it is optimal to have equal amounts of omega 3s to omega 6's, it is common -in the american diet- to have 10 times that amount of omega 6's to omega 3s. There have been some studies that indicate omega 3s help with depression. although with full onset BP they can increase likelihood of manic onset....I still wonder about the diets of these children and if-before full onset- omega 3s might be very helpful.

I have memories of my son's father and how he would eat sardines several times a week....and crave them...they are very high in omega 3s.

medford, oregon

Dear FRONTLINE,

I was born in 1989 have been considered overly smart, overly emotional, and overly talkative my entire life. This was given a label at fourteen when I was diagnosed with bipolar after my third suicide attempt (my first was at ten). I'm now eighteen and have been through antidepressants, antipsychotics, outpatient therapy, inpatient therapy, hospitalizations, tranquilizers, group therapy, support groups, and multiple diagnoses. I still, however, am bipolar. I'm very concerned what a silent group we've been kept.

On this list there are many people who are arguing there should be no medication for minors. There are also people who think we should be drugging our children beyond recognition in hopes they'll "be normal". I'm against both, and I'll tell you why. Although I never have had a month without an "extreme" in one end of the spectrum or the other, I am somewhat functional.

Of the six minors I personally know who have been diagnosed, one is now suffering from paranoia, possible schizophrenia, and a mountain of physical problems (he was taking about 6 different psychotropics a day on top of at least 5 other medications for purely physical side-effects). One just passed away after a four-year vegetative state in late December caused by a suicide attempt when he was fifteen (he had been on no medications), he would have been nineteen when he died. Another lives in her parents' basement and heavily uses hard drugs (she was taking about 4 prescribed-drugs a day and now refuses to take anything she can legally get). One is coping with psychosis he believes started after taking heavy doses of antidepressants (bringing him into a manic phase) and has a heavy alcohol addiction problem (he was medicated when he was young and refuses to take anything now). Then there's me. I'm certainly not ideal, but I'm sober, I'm in the "fair" category for social standards, and I have been fighting tooth and nail to have a manageable dosage. I've been off and I craved a quick fix to make things go away. I've been on so much that I have no memory of months of high school and have developed more severe symptoms. For me, and for the people I see that are "success stories" (not dead, injured beyond repair, addicted, or closeted in their caregiver's home), we are all on one or two medications that work for us, we're in therapy often, and effectiveness of treatment changes so we have to fight to be believed by psychiatrists. I firmly believe all psychiatrists have their own agendas, and that it's compassionate, ordinary people (some with bipolar) that will control the lives of bipolar children in the future.

Ogden, UT

Dear FRONTLINE,

While watching your very interesting, very frightening program tonight on medicating children, I found myself frustrated by the apparent co-option of the APA by the pharmaceutical industry. Interviews of the various doctors (aside from Lawrence Diller) might lead one to believe there are no nonpharmacological approaches to helping these children and their families. What a fear-inducing, disempowering strategy by those we trust as experts and authorities.

It has been suggested that when a new medication is developed, the diagnosis it is determined to treat becomes nearly epidemic (e.g. ADHD and childhood bipolar disorder).

Such dangerous marketing or product development practices, seem to then determine the accepted standards of practice in treating a vulnerable population. If nothing else, tonight's program was an effective means of recognizing this phenomenon, and how we naively accept the current paradigm.

Barbara Lamb
cape may, NJ

Dear FRONTLINE,

These medications must be studied for their long-term effects in children and only a skilled child and adolescent psychiatrist should prescribe them so they can be monitored closely.

I have a Bipolar child diagnosed at age 7 who is now 17. We suspected the diagnosis since Bipolar runs in my family. After 10 years of lithium therapy, he sustained kidney damage. The risks are real and every parent must know and weigh those risks carefully with their doctor. For us, the benefits outweigh the risks. Thanks to these medications our son has the chance to live a normal life and pursue his goals. The bad news is that he has a terrible disease, the good news is that there has never been a better time to have it with all of the treatment options available today.

Cincinnati, OH

Dear FRONTLINE,

When I was diagnosed with bipolar at 17, I was put on Prozac and Lithium. I was walking death. My tiny teenage body blew up and I just wanted to die. Eventually I took myself off of the drugs thinking that I didn't have a problem. This was one of the best decisions I could have made as it gave me 7 years of med free time to have to myself. And I have to say that I didn't have any depressive or manic episodes then either. (I definitely do NOT recommend taking yourself off of medication. Work with your THERAPIST and DOCTOR closely!)

I had a manic episode when I got out of a 6 1/2 year relationship. I was med free for 7 1/2 years. (Severe stress can be a trigger to manic episodes.) My doctors and I tried several meds other than Lithium. Finally, my last doctor and I found the right dose of Lamictal at 200 mg once a day and Risperdal at 3 mg once a day.

When I was 17 I was on a sandwich bag full of medication twice a day and now I am on TWO low doses. The good news...today the medications are SOOOO much better than before. But it is crushing to me that little children have to endure manic episodes and periods of helplessness like I have gone through. I do however caution parents this...kids need to be kids and live. Don't take away their innocence. Love them. Respect them, and do what ever it takes to help them live a happy, healthy, and fulfilling life.

I would say, the biggest key for me is that I go to my therapist for cognitive restructuring. THIS IS KEY! You have to work on how you feel and think before you medicate the brain. Maybe you are just you and not someone with real medical problems. Diet, exercise, and a good outlook on life even when it looks grim will help anyone get through life. I am happy to say that I am healthy, happy, and living a fulfilling life. Also, my parents, family, and friends are the reason that I am alive today. Thank God for people looking out for your best interests. Be Proactive not reactive!

But most of all, find alternatives. Do NOT believe that medication will make all your problems go away. I have had to work VERY hard to be the successful, happy, and HEALTHY person that I am today. Therapy was the real key to my success as well as love...

A H
College Park , MD

Dear FRONTLINE,

I have been diagnosed with bipolar for several years now. Initially, I was diagnosed major depressive at the age of 12, and was put on my first medication. I remember being very depressed, unable to function, and having frequent thoughts of suicide. Since that time, I have gone through several more medications, some more successful than others, and undergone a transformation into full blown bipolar disorder. As sometimes comes with bipolar disorder, I experience hallucinations (in the form of a voice telling me to harm myself and others) when not on my medication. I first experienced this in eighth grade. I don't think I was even fifteen yet.

As it stands now, I am 21, take two medications (Lamictal and Invega), and I am very stable. I understand fully that I must take these medications, more so now than ever, as a result of my decision around the first week of October to stop taking them all together. After three weeks, I was incredibly manic most of the time, only punctuated by extreme bouts of depression every ten or so days. After two months, I could barely function, and my friends were so concerned that they held an intervention of sorts for me. It was scary.

When it comes to medicating children, I only know what I have experienced and heard from others my age. I personally think that medicating four- and five-year-olds is not good medicine. Kids that age are too young to properly diagnose. Once a child begins to think more individually (around 11, 12, and 13 years old), they become easier to diagnose because they are more self-aware. Also, as I understand, bipolar does not always (indeed, usually) manifest until later in adolescence. I may be wrong, as I am no medical expert. However, I cannot deny that without medication, I cannot function. Sadly, I may have killed myself years ago were it not for the medication. I will never know.

One final word: medication is great, but talk therapy has done wonders for me. Even on meds, I have problems that I may not have been able to work out were it not for my therapist. Sure, meds are a quick fix, but without the therapy that many neglect, the problem will just be covered up with a chemical.

Life is good.

Matthew Maniaci
St. Louis, Missouri

Dear FRONTLINE,

Thank you, Frontline for a balanced presentation on a controversial and emotional issue. Medicating children spans a spectrum as wide as these comments. Sometimes children are medicated to ease the burden of parenting for those not up to the task. Other times, it is as necessary as insulin for a diabetic. Unfortunately, most children who end up in the psychiatrist's office are somewhere in between. Yes, diet IS important, yes, therapy IS important, and effective parenting skills are VITAL. Good psychiatrists consider the patient's whole environment and approach treatment from a "bio(meds)-psycho(therapy)-social(school, parenting)" model. As a psychatric social worker and soon to be psychiatrist, I make this my goal in all patients I work with. For patients and parents, I encourage you to seek out psychiatrists who will work with you, listen to you, and compromise with you - but on your end, you must also be willing to be open minded and work with your psychiatrist. He/she knows the brain and the meds better than you, but you know yourself/your child better than he/she ever will. It's an artful dance - you must search in earnest for your partner in becoming healthy who doesn't step on your feet, and you must be willing to let him/her take the lead at times. Good luck to everyone struggling with this issue!

Amie Kafer, MSW, MS4
Phoenix, AZ

Dear FRONTLINE,

I would like to share my story with all parents out there. We adopted our seven year old grandson almost three years ago. Before the adoption he was in the custody of DCFS,so we had no say as far as school and medical issues. He was removed from school and sent to a school for the physically and mentally handicapped because of his severe temper tantrums. He began seeing a psychiatrist and was put on various meds that did'nt seem to help. Recently he was sent to a mental health hospital about 300 miles from our home and we had to travel back and forth to see him. Before going there he was on Paxil, Risperdal, Seroquel and focalin. The doctor there took him off the paxil and the risperdal and he is now taking 500 mg. of seroquel and focalin every day. We can't see much of an improvement although we did recently remove him from the school that he has attended for the past three years and began homeschooling.This seems to be helping some and after watching the show tonight we plan to change his diet, get more counseling for him and try to cut him down on the meds. We love our grandson and we don't want to see him become a victim of what is happening to so many children in the world. If only they were able to speak for themselves maybe this would not be happening. Brokenhearted Grandparents from Illinois

Aledo, Illinois

Dear FRONTLINE,

I thank you for your unbiased report on pediatric bipolar disorder. My daughter who is 6 was diagnosed a year ago with bipolar. This was a difficult diagnosis to get. Before trying meds we tried counseling, nutrutional changes, supplements and behavior modification. Nothing worked. We were very reluctant to medicate her, but her quality of life was very poor. She was out of control, couldn't keep friends, in trouble at school etc. It has been a rocky road figuring out the right meds for her. We have found what works for her. I am finally seeing my true little girl behind the illness. We are still continuing with counseling and watch her diet. She does not eat sugar or many processed foods. These support her wellness, but we cannot exclusively count on the them to help her. We hate medicating her, but feel it would be cruel not to. She is finally able to have relationships with peers, is succeeding in school and our family is not as chaotic. There are no easy answers. Thank you again for your report.

Prescott Valley, AZ