Paul Raeburn
Download 'Too Hot', an exclusive Specials track from iTunes
The first time I left my son strapped down on a gurney in a psychiatric hospital, I thought I would die, right there. Alex had always been a happy, sociable kid, reasonably independent. He wasn’t perfect, but then whose child is? He was nine when his problems really started. First, it was disciplinary issues at school: he was answering back, not doing what his teacher asked. At home, though, he was fine.
I wasn’t worried. I thought it was a good thing, being able to stand up to authority. I certainly didn’t think he was mentally ill. I didn’t even think he had a behavioural problem, so we didn’t engage in that ridiculous debate – you know, the way middle-class parents excuse their kids’ bad behaviour by dressing it up as something else, such as ADHD. And I certainly had no idea that children could suffer from depression.
That’s why I didn’t think about seeking help. Why would I? I had never been in therapy myself. I thought it was a sign of weakness. Therapy was for Woody Allen.
In the autumn, though, Alex’s problems became more severe. He was hugely defiant at school, angry and easily irritated – classic signs of childhood depression. He misbehaved constantly, and the stress started to carry over into the home. I tried to deal with it by disciplining him: if he’s going to talk back, he’ll stay in tonight and the next night and at the weekend.
It escalated into a battle of wills. He would be grounded for weeks to come, then I would decide that the punishment was too severe and let him off. My inconsistency meant that his boundaries were all over the place. Of course, our parenting was at fault here, but no parent wants to feel they are responsible for their child’s bad behaviour. There are plenty of people who would rather be given a clinical diagnosis than accept that their badly behaved child is psychologically normal.
What finally convinced us that Alex’s problems were more than just misbehaviour was an outburst he had at school: he got so angry with his teacher, he stormed out of the classroom, punched in the glass face of a clock and marched right out of the building. The police had to be called. They took him to the station, for his own safety. He had crossed a very big line. The little guy was obviously suffering, and we had to do something.
We decided to take him to a psychiatrist. We live in New York, where there must be more therapists per head than anywhere else in the world, but there were no child psychiatrists on the list of providers from our medical insurance. The doctor we saw talked to Alex for 15 minutes and told us: “He’s depressed.” How could he possibly diagnose something so subtle in a child in that amount of time?
The doctor prescribed Mellaril, an antidepressant, and within days of starting to take it, Alex became manic. He just went wild. We quickly discovered that antidepressants are a recognised trigger for mania, so we took him off them immediately.
In desperation, we called the school, which suggested we see a child psychiatrist it used as a consultant. As soon as he saw Alex, he diagnosed ADHD and prescribed Ritalin, which is a stimulant – and Alex became manic again. Different diagnosis, same result: the drugs were making him worse.
One morning, he ran out of the house and down to the railway track: he said he was going to jump in front of a train. Was he bluffing? I’m not sure even he knew. But I was terrified. We called the police, who talked him into a car and took him to the station. He had to be hospitalised – we just couldn’t keep him safe.
After that, I worried all the time that he would take his own life. In the house, I hid the kitchen knives, the tools, stuff in the medicine cabinet. But you quickly realise that if somebody is determined to do it, they will. You can’t make your house safe: it’s impossible.
He was in and out of hospital several times, but never stayed for more than a week: that is all the insurance company would allow. And we couldn’t afford to pay: it was $1,000 (£500) a day. He would see a psychiatrist maybe once; the rest of the time, he was just confined. As soon as he was “stabilised” – whatever that means – he was out. And when he came home, it would all start again: up and down, wild and emotional, numerous times in the course of a day. It was hard to know how to react. One minute, he was manically happy, giddy and high; the next, he would be face down on the table in misery, unable to raise his head.
It was so sad – he was such a great kid. It was hard for us to see these changes in him and accept that it was a chemical thing. Physical illness you can understand, but when an illness is mental, and the symptoms are changes in the person you know, in the way they behave and think, it’s hard to grasp that they are not responsible. Misbehaviour and mania can look the same, so you find yourself wondering: “Is he choosing to behave that way or is he really ill?” Somewhere along the way, one of the numerous psychiatrists we saw diagnosed Alex with early onset bipolar disorder (EOBD) – or manic depression – and it all made sense. “Thank God,” I thought. “Finally, we know what it is.”
In 1996, 13 out of every 100,000 children in the United States were diagnosed with EOBD. By 2004, that number had increased to 73. I don’t blame the previous doctors for their misdiagnoses. EOBD has only recently become a recognised condition, although it has always existed. It turned out that Alex’s journey was classic. Many children who “misbehave” are mistakenly thought to have depression or ADHD before the real cause comes to light.
Things didn’t turn around for Alex as soon as he was diagnosed, though. It took a couple more years of struggling until, thankfully, we got an appointment with the head of child psychiatry at Columbia University.
This psychiatrist started afresh. He believed the bipolar diagnosis was correct, and he did what turned out to be the smart thing: he tried Alex on a mix of drugs, including Depakote. He would see him every week and tweak the dosage. Alex responded beautifully.
One evening, a couple of months later, I was home early. Alex came down, and the two of us watched television together. We laughed and kidded around. What happened? Nothing.
We just hung out, and it was a huge breakthrough. He was relaxed enough just to be – to be “normal”. I didn’t realise until then what we had been missing. The worst of it was behind him. And it remains behind him today.
My kids and I are much closer now. We went through this as a family and we really had to bare our souls to one another. But good things do come of these horrors. There is reason to be hopeful, even in the really dark times. And it helps to know you’re not alone.
Where to get help
The Child and Adolescent Bipolar Foundation is an American organisation offering help and advice to parents: www.bpkids.org.
Young Minds provides information on child mental-health issues: 0800 018 2138, www.youngminds.org.uk.
The Royal College of Psychiatrists provides a list of symptoms of common childhood psychiatric disorders: 020 7235 2351, www.rcpsych.ac.uk
Paul Raeburn was interviewed by Mia Aimaro Ogden. Acquainted with the Night by Paul Raeburn (Broadway £6.69)
Win a luxury weekend to Newcastle and its neighbour Gateshead, find out more here
Risk, resilience and embracing new technology
Industry sectors news at a glance. Interactive heatmap, video and podcast
Discover the power of collective thinking. Submit a solution and be in with a chance to win a Media Hub Home Entertainment System
The inside track on current trends in the charity, not for profit and social enterprise sectors
Everything the Business Traveller needs to know to make a better trip
Make the most of the summer and enter our fabulous photographic competition, you could win a £5000 holiday
Corsica is an island of beauty and contrast, an ideal holiday destination
Enjoy further reading from Travel to Fashion, Business to Sport, discover more
Shortcuts to help you find sections and articles
The clever way to lease a new car is with Car leasing made simple™
2009
per month on 36-month
Personal Contract Hire (PCH)
2008
42850
Car Insurance
£24,250 - £30,346
MI5
London
£60,000
The Environment Agency
Bristol
Up to £90K
Boots
Midlands
OTE £85k
Credit Protection Association
Nationwide Opportunities
Completely London
Luxury Condo's in Manhattan with NYC views
The best new homes in Wimbledon?
Nationwide
Fabulous Cruise And Cruise & Stay Offers Including Virgin Atlantic Flights Prices Start From Only £699pp!
Last Minute Cruise And Cruise & Stay Offers. Med From £499pp, Caribbean From £699pp!
5 star quality at a 3 star price.
8 fabulous Canadian cities ...you won’t find cheaper
Contact our advertising team for advertising and sponsorship in Times Online, The Times and The Sunday Times, or place your advertisement.
Times Online Services: Dating | Jobs | Property Search | Used Cars | Holidays | Births, Marriages, Deaths | Subscriptions | E-paper
News International associated websites: Globrix Property Search | Property Finder | Milkround
Copyright 2009 Times Newspapers Ltd.
This service is provided on Times Newspapers' standard Terms and Conditions. Please read our Privacy Policy.To inquire about a licence to reproduce material from Times Online, The Times or The Sunday Times, click here.This website is published by a member of the News International Group. News International Limited, 1 Virginia St, London E98 1XY, is the holding company for the News International group and is registered in England No 81701. VAT number GB 243 8054 69.
Janne - depakote isn't a neuroleptic. Bipolar disorder does show up on brain scans: it causes atrophy of three key parts of the brain. I have bipolar disorder and I have had brain scans. Research has shown that depakote (and a number of other things) can promote regrowth of the connections between the brain cells.
I do not have any financial interest in the marketing of depakote but it has seriously improved my life. I had first symptoms of manic depression at ten, which is not unusual for people with manic depression, but waited more than the average nine years between onset of symptoms and diagnosis. I am now middle-aged.
Maybe EOBD is over-diagnosed by some doctors, but thank goodness that it is diagnosed. I wish that I had had depakote when I was at school.
Sue, Birmingham, UK
Many patients including children may present like depression initially. When antidepressants are prescribed, mania will show up. Close follow up will pick up bipolar disorder.
Ron, Detroit, Mi
A nice piece of marketing of antipsychotics to children
The different psychiatric labels put on children cannot be described in terms of "the right or the wrong diagnosis" - they are always wrong. None of them are like diabetes and none of the drugs described for them are like insulin. They cannot be compared to real medical disorders.They are completely subjective, lacking physical or chemical abnormalitiies. They are not medical disorders, they are just labels put on unwanted behaviour for the purpose of prescribing toxic psychiatric drugs. The new fake disorder is "bipolar disorder" in children - or as said in this article "early onset bipolar disorder (EOBD)". It is said in the article to be a recently "recognised condition". And the solution as said in the article is a "mix of drugs" - in actual fact the stongest and most toxic drugs in the psychiatric "treatment" arsenal - neuroleptic drugs. For the sake of children - don't buy this bougs disorder and its destructive solution
Janne Larsson, Stockholm,
Your story saddens me. I have bi-polar disorder, which onset at 15. It's sad to think you could have to go through that sort of turmoil and upset at only 9. I'm glad the worst of it is behind you all and I hope it stays so.
Lottie, Christchurch, New Zealand