World of Psychology

The Death of Bipolar Child Rebecca Riley on 60 Minutes

By John M Grohol PsyD
September 30, 2007

Tonight, Katie Couric interviewed both the mother of Rebecca Riley (the former is charged in the latter’s death) and Dr. Joseph Biederman, the guy who basically helped “invent” childhood bipolar disorder (as we reported here and here, ). The mother is basically implicated in killing her child because she overmedicated the child. And yet, the child’s psychiatrist diagnosed the child as “bipolar disorder” just before her 3rd birthday (according to the 60 minutes report). Bipolar disorder is only recognized as an adult disorder and diagnosis. It’s use in children is highly controversial.

The “symptoms” of Rebecca Riley that were described in the 60 minutes report suggests that it could’ve been anything — normal childhood development or who knows what. The biggest problem with the supposed childhood bipolar diagnosis is that it is so broad as it cannot differentiate between normal childhood behaviors (or those that fall just somewhat outside of the norm) and a serious, real mental disorder.

Shouldn’t we wait before prescribing adult-strength, mind-changing psychiatric medications to children, you know, until more safety and efficacy studies are done on actual children? In the common cry amongst doctors and researchers that justify their findings, they pull out the sympathy card that is supposed to substitute for good science:

“[...] The patients that come to me, these families in tears and despair, with these kinds of problems, I in good faith can not tell them to come back in 10 years, when we’ll have more data than we have today…” — Dr. Biederman

Actually, Dr. Biederman, you can. Because the first thing you agreed to is “do no harm.” If you don’t know what or to what extent medications you prescribe (or those who follow your religion) will negatively impact their target population — e.g., children — then you shouldn’t be recommending it.

And that’s a good excuse to pretty much let people do anything they want to do with any medication, damn the FDA. But that’s not how our country works, and for good reason — it’s darned dangerous!

Who’s to blame for Rebecca Riley’s death? I think that the prescribing psychiatrist is partially to blame, as well as her parents who administered the medications. Should the mother be standing trial for murder, though? Absolutely not. That’s as much an overreaction to the case as any.

Living with the death of her own child will be punishment enough.


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From Psych Central's World of Psychology:
Social Anxiety Disorder and Its Cure - World of Psychology (10/1/2007)

9 Comments to
“The Death of Bipolar Child Rebecca Riley on 60 Minutes”

My 10 year old son was diagnosed with a “mood disorder” at the age of 9. He cannot take SSRI’s, as they cause violent and aggressive behavior in him. His psychiatrist is hesitant to call it bipolar disorder because of the lack of long term studies, etc., but what I have read and seen causes me to feel unequivically that my child is indeed bipolar. While I do understand the need for caution, I also have spoken with many parents whose children have been helped by these medications. My own child is on very low doses of Risperdal and Lamictal, and we only increase very carefully as he grows. I’m also an RN, and realize how dangerous these medications can be. Perhaps more parent education…and perhaps the psychiatrist needs to be the one to make sure the parents fully understand how powerful these drugs are.

Most parents do not enter lightly into the decision to use medication. In many cases, it is the last resort. Parents must weigh the benefits of the medication against the fear of the side effects. For many children, they could not function day to day without the medications they take.

The right medication combination can make the difference between functioning or not, and in some cases life or death. However, the thing I urge parents to remember is that medication alone is not the total treatment plan for a bipolar child or any child with a mental illness. It requires therapy, and the right accommodations.

Because we live in a fallible society, this adds even more to the burden that parents bear when dealing with a child with mental illness. The parents are expected to learn to be health experts, education experts, and an overall super parent. Due to the reports of skepticism in the diagnosis of bipolar and the clearly divided medical community parents of bipolar children feel even more turmoil and isolation.

I too will say on a personal note, that had my docotrs tried to mediate me as a child then I may not have tried to commit suicide at age 11.

For more on this topic I suggest reading Tracy Angalda’s: Making Sense out of the Tragic Death of Rebecca Riley: How to Help Children and Families Living with Bipolar Disorder.

http://www.bpchildren.com/index.asp?PageAction=Custom&ID=66

I really like what you wrote, particularly about the skepticism in diagnosis. I am fortunate that my son is in a wonderful school district, and his medications have helped tremendously to stabilize him. But it is hard, particularly when the people around you think that you are a lousy parent, and if only you would set better boundaries, or not yell so much, or be more strict, or be more consistent…blah, blah, blah. Some kids ARE bipolar. Perhaps there is overdiagnosing going on right now. Isn’t that what happened with ADD? But that doesn’t mean that bipolar disorder doesn’t exist in children.

My child was dx at age of 4 with ADHD and bipolar at age of 9. By the time he was 10 he had attempted suicide 3 times, he had numerous accidents from his high risk behaviors, he was violent and raged several times a day. Life in my home was hell until the meds. I don’t take the meds lightly and thoroughly research and undersatnd each and every med he takes and we keep him at the minimal dose. It sickens me to think that people think parents want their kids to be on meds. That isn’t even logical. Without meds my son is both suicidal and homicidal, has tried both several times in 17 years. I think the death rate for bipolar is somewhere around 35% but I am not sure that is accurate because I don’t think it factors in the “accidental” deaths from high risk, impulsive, delusional and/or grandiose behaviors, ie jumping off roof, because don’t realize won’t get hurt, or thinking they are superman and can fly. The nay sayers need to live with an unmedicated bipolar child for just even a few hours. Then you would clearly see the difference between normal behavior and bipolar. bipolar behaviors are not even close to the far end of normal behavior. Unbelivable that there is such irresponsible reporting and at the expense of sick kids.

My wife is the one that is better with words. All I have to say is before there were advances in treatment and medication they locked most mentally ill away in asylums. At least we are working with our children and trying to keep them in the mainstream and teach them how to be productive citizens. I often wonder if the persons who are so critical of us parents who are trying to help our children are not from the same breed that thought it was okay to lock our children away in asylums.

My 25 year old son was diagnosed on 1/13 as bipolar by a psychiatrist. He was placed on Lamictal, Cymbalta, and Ambien. Within 2 weeks, the doctor doubled the dosage of Lamictal and doubled his Ambien. On January 30th, he added Xanax. My son was dead on the floor within 2 weeks. The MD says it isn’t his fault. Well, whose fault is it then? What did he expect my sons brain to be thinking with uppers, downers etc. 2 1/2 weeks of treatment with no pre testing, bloodwork or anything. Do you blame the drug companies or the doctor? Thank you. My only child is gone. It feels as if your guts are ripped out. I sympathize with this family. I know exactly how they feel.

My 19 year old daughter was put on Lamotrogine. 2 months after she was admitted for one night with a mixed episode,dysphoria. She apparently was “distressed” without mentioning that she was suicidal (she had been). After discharge, she apparently was showing signs of pressured speech, off at tangents, in her day hospital visits but the psychiatrist did not notice when she went for her outpatient visit and he said she was “stable” (the professionals don’t seem to communicate with each other). We had no support or information due to “confidentiality” issues so we did not realise that she was at risk. How stupid do I feel! She had been having group therapy and had brought home a hat “manic depressive, I growl, I bite”. Oh,I recognise that, give her space, it appears to help. “You don’t understand, don’t talk to me” - “Ok, why don’t you get some help” She was in the system, apparently attending the “recovery” unit, could ring her named nurse, who had cancelled the day before due to illness, there was also an emergency number and she could turn up anytime at the A&E Dept. Why would I think the unthinkable and then it happened, 5 weeks after her discharge, and life is just shit!

My Brother was 20 when he was finally diagnosed with bipolar. His behavior changed significatly when he turned 19. He was on 2 medications one being Risperdal. My dad thought it was all an act and told him not to take the medications. My mom was trying constantly to get him help, take him to the doctor, and help him live a normal life. Well, he stopped taking the medication, I think because of the constant push from my dad. He had a manic episode and after 3 days of going non stop he was fired from his job which he loved (we did not know this at the time).When he came home he collapsed. My parents put him to bed that night, my mom relaxed a little because she was sure the manic period had passed and was going to take him to the doctor the next morning. I got a call at 5 in the morning, my mom was hysterical. My brother had overdosed on his medication. We never thought for a second about leaving the medications out where he could get to them. I think it was accidental because he didn’t take the entire bottle. Bipolar disorder is so real, it devastated our family. You have to be so careful with the medication, and if the person is over 18, there is not much family members can do until they literally become a danger to themselves. I don’t else know what to say…it is just horrible. He was only 22 years old.My brother is gone because of this disease and there is nothing I can do about it.

“Punishment”? How dare you? As the father of a bipolar adult child, I feel great empathy for the mother–and great sadness for her loss. Instead of judging people involved in tragedies like this against their wills, you could be directing your talents toward increased funding for psychiatric research. It is a hit-and-miss process which is overly dependent on feedback from the ill, and their relatives. Bipolar illness is one of the cruelest afflictions that can befall a family.

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    Last reviewed: By John M. Grohol, Psy.D. on 30 Sep 2007

 


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