Disturbing incident in triage .....

RunnerRN, BSN, RN · Jul 17, 2007

I'll be very interested in the replies - maybe this would be more appropriate in the Psych forum. I too have seen this many times, and each time I'm just as floored as the first. I tend to think that ALL 3 year olds are at least a little bipolar :) Isn't that just the way they're supposed to act?!

mer_RN · Jul 17, 2007

i work in ob so i was also totally in disbelief when i was floated to peds and had a 5 years old that was bipolar (and had been for a while) and the parents were also both bipolar. i wondered if this little boy truly was bipolar or was misdiagnosed due to his parents.

Freshman RN · Jul 18, 2007

People continue to amaze me when they medicate instead of parent. I agree how is 3 year old bipolar THEY ARE 3! What is more disturbing is that someone is prescribing, I think that the state should be called on that.

prowlingMA · Jul 18, 2007

i ask you , what 3 year old does not have bi-polar behavior? every kid can turn on the tantrum and crying at some point.

i myself was incorrectly diagnosed bi-polar at 14y.o. ( what teen ager isn't bi-polar also?)

i think it all boils down to parents wanting to have a label to go with every action a child has and if they can deal with it or not.

i wonder what natural chemical reactions are these adult drugs preventing and changing and what the long term emotion health of these children can be if their parents are going to force pills with every " normal" emotional stage. :idea:

Altra, BSN, RN · Jul 18, 2007

I'll be interested to see the replies in the psych forum.

This is a disturbing trend - the subsitution of psych meds for active parenting. The long-term collective consequences of this practice will not be pretty.

DiannaK · Jul 18, 2007

I did end up posting in the Psych forum as well .... haven't heard anything back from them yet. I'll keep you posted.

I'm glad to know that I'm not the only one who thought this was very wrong .....

Dixielee, BSN, RN · Jul 18, 2007

I, too, have noticed a huge increase in people in general diagnosed as bipolar. Our triage form requires us to ask about medical problems, surgical history, and psych history. I bet close to 50% say bipolar, depression or anxiety. I have also noticed a large number of these folks are collecting disability. I understand it is easier to get disability with a psych diagnosis than a physical one. Check please?????

Joe B1 · Jul 18, 2007

It's profoundly disturbing that a three year old is diagnosed as bipolar. I see that as an agenda on the part of the parents to avoid their responsibility or on the part of the psychiatrist for whatever bizarre reason or a combination of the two. Diagnosed and on medications at three years of age does not bode well for this child. You're looking at a life long consumer of health care services now.

I don't know what the solution to the problem is, but it isn't more of the same. At some point, people have to start saying "Enough!".

Joe

moongirl · Jul 18, 2007

When I was in school, there was no Ritalin. No one was dx as ADD. Sure there were a few kids with issues, but they made it thru. I lived in a small town and for the most part the kids I started 1st grade with were the ones I graduated with. My graduating class was 268. No one killed anyone else, no one committed suicide, no one came to school with a gun. When I did my psych rotation, I was in youth residential and was astounded at the amt of kids that are locked up, court order with dx of " depression" all the time I was there I was thinking " where are the PARENTS?" and how this all could have happened. I just dont get it.

kstec, LPN · Jul 18, 2007

Just to give a little personal experience on this subject. I have a son who is now going to be 10. When he first started talking he would repeat and repeat. He had terrible seperation anxiety. He began to develops certain rituals. If these rituals were not carried out he would repeat phrases. When he went to bed he would say "Goodnight I love you" Then I would say "Goodnight I love you" he then said now boink the door. That meant to have the door almost pulled to and make a certain clicking sound. If any of the event went wrong he would go into a major temper tantrum and just continue to say "you're not listening to me, you didn't do it right" Well he also had other rituals at other times. For approximately two years he did this and I did everything I could to get him to stop these rituals so I could avoid these temper tantrums. One day before he turned 4 he was repeating and I couldn't get him to stop. I remembering he had that same weird glazed look in his eyes when he got this way. I slapped him in the face to see if I could please get him to stop. The slap didn't faze him, he just kept repeating. I then took him to a pediatric psychiatrist. He was diagnosed with OCD (obcessive compulsive disorder with bipolar tendencies). He was put on Risperdal (off label of course), within 3 days he quit repeating and stopped his temper tantrums. He is now going to be 10 and has been off his meds this time for appx. a year. After a while of being on the Risperdal he developed mild tardive dyskenesia, so he was switched to Zyprexa. He did wonderful with no side effects. Whenever he starts his severe OCD behavior where he becomes violent, we put him back on his meds, and they work within days and then we take him off after 6-9months. No I didn't medicate him because I was a bad mom, but because my son was having a hard time functioning without his rituals and outbursts if his rituals couldn't be carried out. He now is doing fine, and I'm thankful for the medications that are available. No I do not know what the long term effects are, but the benefits definitely outwayed the risks. I do believe some kids are misdiagnosed, but I know in my heart of heart that my son needed and may again need meds. Oh and by the way I did tell the psychiatrist about he smack on the face and she told me that if that was the worse I'd done with his behaviors that he was lucky. I've never forgiven myself for that, but I also will never remember the blank look on his face. He was definitely in some type of psychosis when his OCD set in. Please if anyone has anything negative to say, don't, I live with my sons illness everyday and prefer not to be judged for doing the only thing that I could.

DiannaK · Jul 18, 2007

When I was in school, there was no Ritalin. No one was dx as ADD. Sure there were a few kids with issues, but they made it thru. I lived in a small town and for the most part the kids I started 1st grade with were the ones I graduated with. My graduating class was 268. No one killed anyone else, no one committed suicide, no one came to school with a gun. When I did my psych rotation, I was in youth residential and was astounded at the amt of kids that are locked up, court order with dx of " depression" all the time I was there I was thinking " where are the PARENTS?" and how this all could have happened. I just dont get it.

when I read this ... I thought .. "wonder if she went to school with me?"

When I was in high school ... worst things kids did was to bring alcohol to school, smoke in the bathroom, and MAYBE smoke pot. They were the really wild kids .....

If 2 thug kids were fighting, they would just throw punches .... no knives, and certainly no guns. My school wasn't locked, either!

I'm not entirely sure what has happened to our world today -- I blame a lot of things -- the breakdown, and general disrespect for the family unit

-- the "everything is relative" attitude -- in other words, nothing's right or wrong, depending on the person, situation, etc

-- the media, as well as health professionals, giving parents the impression that they are incapable of parenting without pharmacological crutches.

Please don't get me wrong .... I fully understand that mental illnesses ARE diseases, just like TB, heart disease, cancer, and the like. I've suffered from depression and anxiety before, and have been on medication. Know what helped me the most?? Therapy, exercise, and a divorce from my 1st husband.

I feel like medication, withOUT therapy, behavior modification, education about the mental illness, is like putting a BandAid on an arterial bleed. The underlying issues are STILL there, being masked by meds.

... off soapbox.....