Motley Moose – Archive

I have touched on the topic of stigma against the mentally ill before, so I’m taking bits and pieces of research from that previous diary. But I’d like to revisit it here in a slightly different way. There was a statement made in another diary the other day that brought this to mind. Someone elsewhere in the blogosphere suggested that the mentally ill should be imprisoned “just like sex offenders” until doctors could determine that they were safe for society. I’m assuming that it was not intended as it was written (I certainly hope not), but unfortunately, there are many out there who do actually think this way.

Ouch.

Stigma is a more complicated concept than one might initially guess upon mere casual consideration. Definitionally relatively simple, the causes, mechanisms, and consequences of social stigma are myriad and complex. You can find stigma, of one sort or another, most anywhere you look. Stigma will thrive in society wherever ignorance or fear or hatred of that which is “different” are acceptable mentalities. The tendency to stigmatize, label, and set certain groups/individuals apart from the rest of society as “other” is, to an extent, human nature. The need to categorize people, places, and things is normal — it’s just a function of how our brains work. We run into problems, however, when we begin allowing categories and labels to exclude and define people.

This diary is basically a republishing of a paper I wrote awhile back. The original paper — written when I was 20 taking a graduate class in my undergraduate program — was over twice the length of what you’ll find below the fold. I trimmed it down and reused it for a paper at my current university, and that’s what you see here.

I am sharing this diary about pediatric bipolar disorder (which is not listed separately from BD in the DSM) because I think most educated people have at least a rudimentary idea of what bipolar disorder is. Pediatric bipolar disorder is less talked about because it is less accepted and therefore more controversial. This makes sense for plenty of reasons. For one thing, the criteria being used to diagnose it are often different or fewer than those formally listed in the DSM. Many people believe that bipolar disorder never fully manifests until late adolescence or early adulthood, and will not accept a “pediatric” form of the disorder as being valid. Further, it is very controversial because of the generally accepted notion that bipolar disorder requires pharmacological intervention, and the medications used to treat it can cause a plethora of adverse cognitive and physiological side effects. The idea of giving these medications to children in their formative years is disturbing to many (including myself, due to intimate personal understanding of how dangerous these medications can be even for adults). Then, of course, there is the argument that bipolar disorder may be over-diagnosed, and that to label a child with such a debilitating, chronic illness is inappropriate.

I have my misgivings about the way bipolar disorder is diagnosed in children, but after years of off-and-on study of the topic, I have come to the conclusion that the early manifestation of the disorder is, though rare, a reality. I also have doubts about the degree of “rapid cycling” described by some authors in the field. Still, it makes for intriguing reading. If you have a few free minutes, follow me below the fold for a review of the current literature.