One of my biggest concerns looking forward for this country has to do with the way that we handle children. It isn’t just that parents have become more protective, or that the world has suddenly become more dangerous. What worries me is the trend towards having a diagnosis for everything.
So when I saw the following news item on BoingBoing on Friday I was particularly concerned: Temper Tantrum in the DSM
DMDD [disruptive mood disregulation disorder] seems to be nothing to do with mood, but instead covers a pattern of misbehavior which is already covered by not one but two labels already. Why add a misleadingly-named third?
Well, the back-story is that in the past ten years, many American kids and even toddlers have got diagnosed with ‘child bipolar disorder‘ – a disease considered extremely rare everywhere else. To stop this, the DSM-5 committee want to introduce DMDD as a replacement. This is the officially stated reason for introducing it. On the evidence of this paper and others it wouldn’t even achieve this dubious goal.
The possibility of just going to back to the days when psychiatrists didn’t diagnose prepubescent children with bipolar (except in very rare cases) seems to not be on the table.
One of the commentors on the post made a point that I had already started to form in my mind as I read this little news snippet: If there’s a diagnosis in the DSM, then they can medicate it.
Tantrums, from my limited experience have a lot to do with children not being able to express their emotions, so instead of expressing their feelings in an appropriate way, they scream. A lot. I’m not a parent, but I’ve spent a fair amount of time working with children under the age of 10, and all the tantrums I have witnessed (with a few minor exceptions) came from a place of frustration.
Which makes me wonder – have people lost their ability to understand that children are children? Have we as a society made the choice to medicate rather than teach? One of the reasons that I choose to not take anxiety medication is that I firmly believe it is something I can master without medication. Do I falter sometimes? Certainly, like many others do. But if we medicate children instead of teaching them how to sort through and communicate about their frustrations or their feelings, when they become adults they will not be able to have the kind of dialogue needed for marriage, or having a boyfriend, or even in a job. By medicating, we’re taking away a learning experience – a valuable one which could affect the way that children interact with society in the future, not just in the right now.
There certainly are some children who need medical assistance, but after 2 years working with special needs youth, I can say from observing that any temper tantrum which comes from a place of psychological duress has a lot of other symptoms going hand in hand – and the job of parents, psychologists and teachers is to notice those differences – not to give labels that don’t allow for growth.
Furthermore, what kind of medication would be given in these instances? Tranquilizers? Mood stabilizers? How would those kinds of medications impact a growing child and their mind? Medications do have side effects, and who knows what the results would be from such interventions?
I think, as a society we need to take a good hard look at what is helpful and what is harmful when it comes to the damage we do to children when it comes to psychological care.
It’s a difficult issue. I tend to agree with your thoughts on it, but I can’t say whether medication is appropriate for anyone else’s child. That decision is between that child’s parents (w/ input from older children) and that child’s doctor. To the extent the standard of care is changing to encourage unnecessary medical care, it is probably fueled by what is billable rather than what is medically appropriate.
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