The Depressed Child Is So 1990's

I remember as a young Drugmonkey extern my amazement when I saw the mental health ward of the hospital to which I had been assigned. This was nothing like the state institution in my previous rotation, with it's leaky pipes, drafty windows, and underpadded rubber room that made the screams of the violently mentally ill clearly audible to those of us in the pharmacy below trying to fill carts. What I saw in front of me today was a clean, new, modern apartment with all the amenities life in 1991 could offer. I seriously considered for a second trying to convince one of the doctors I was bipolar so I could finally get out of my parents house and into one of these prime cribs.

"It has to do with insurance" My preceptor told me. "A lot of plans are very lucrative for short term inpatient mental health care" and the hospital has decided to compete for these patients."

He also told me that in his opinion, financial pressures were leading to overdiagnosis of mental health problems in children and adolescents.

Well times certainly have changed. No one talks about lucrative heath insurance plans in 2007. Not to mention the focus on professionalism and integrity throughout our reformed health care system completely ensures that financial pressures in no way shape the type of medical care a patient receives today. Proof comes in Today's New York Times:

The number of American children and adolescents treated for bipolar disorder increased 40-fold from 1994 to 2003, researchers report today in the most comprehensive study of the controversial diagnosis.

Experts say the number has almost certainly risen further since 2003.

Holy Crap! We must be in the middle of a friggin bipolar pandemic!!!! I mean, there's no way financial pressures would have anything to do with this in today's reformed health care system.

The spread of the diagnosis is a boon to drug makers, some psychiatrists point out, because treatments typically include medications that can be three to five times more expensive than those for other disorders like depression or anxiety.

Oh, I forgot. The health care system hasn't been reformed.

Most children who qualify for the diagnosis do not proceed to develop the classic features of adult bipolar disorder like mania, researchers have found. They are far more likely to become depressed.

One explanation for this would be that they were depressed in the first place. Just sayin' that's a theory that might be worth checking out.

Drug makers and company-sponsored psychiatrists have been encouraging doctors to look for the disorder since several drugs were approved to treat it in adults.

What? Would a drug company do something like this? Actually try to influence a doctors practice of medicine in a way that would enhance the value of their stock?

“We are just inundated with stuff from drug companies, publications, throwaways, that tell us six ways from Sunday that, Oh my God, we’re missing bipolar,” said Dr. Gabrielle Carlson, a professor of psychiatry and pediatrics at the Stony Brook University School of Medicine on Long Island. “And if you’re a parent with a difficult child, you go online, and there’s a Web site for bipolar, and you think: ‘Thank God, I’ve found a diagnosis. I’ve found a home.’ ”

You know the answer. The sun will rise in the east tomorrow, water will flow downhill, and corporations are about nothing other than raising their stock price.

I was 15 years ahead of my time. Looks like I might not have that much trouble today with my scheme to get away from Mom and Dad. Of course the nice hospital apartments are gone. A handful of Risperdal and 20 pounds of fat around the middle would be all it would get me today.

I'll bet the rubber room in the state institution hasn't changed though.