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Blue Mountains
Blue Mountains

My unsolicited opinions

"Unsolicited opinions" is my blog on various topics of interest to both the general public and the psychiatric and broader mental health communities.  The information on this webiste and this page in particular are intedned for your information and education. It is NOT to be used as specific medical advice for you. I will be happy to discuss your particular, individual situation with you if you decide to become a patient.

Unsolicted opinion #1: Football

Kids should not play football because it is bad for their brains.  Repeated head banging causes cognitive impairment, even if no outwardly detectable concussions occur.  Please read this perspective from Steven DeKovsky (one of this country's foremost experts in brain injury and dementia) in the September 23, 2010 issue of the New England Journal of Medicine. Since March is National Brian Injury Awareness Month, National Geographic Magazine is also covering the issue, here.

Unsolicted opnion #2:  Bipolar disorder

"My teenager is moody - I'm sure s/he's got bipolar!"
No, No, and a thousand times   NNNOOOO!!!!!

Real bipolar disorder is uncommon in adolescents, and virtually unknown before puberty.  There has been an unfortunate trend in the 2000's to diagnose all moody kids as "bipolar." Since no one can agree on the definitiion of bipolar in prebubescent kids, this is truly problematic. In fact it is usually harmful because it steers people away from a more nuanced approach to a child's problems.  One reason that this diagnosis has become popular amongst both clinicians and parents and even kids is that it locates the cause of the trouble in biology and allows people to underplay the importance of environmental factors such as school, parents, peers and drugs that need addressing in order for things to get better.  Furthermore, when kids get diagnosed with bipolar, they get prescribed powerful medications with potentially harmful side effects when individual and family therapy would probably be both safer and more helpful.

"But his brother/mother/uncle has bipolar, and I read it is very genetic!"

If someone has a first-degree relative (parent, child, sibling) with bipolar disorder, then the risk that the person will develop bipolar disorder in their lifetime is about 4.5 percent.  Conversely, they have a 95.5 % "risk" of NOT developing bipolar disorder.  Compare this to a 1% to 1.5% risk of developing bipolar disorder for individuals with no family history of the condition.  Even if a person has TWO first degree relatives with bipolar disorder, then their lifetime risk of developing the condition is still only 26 percent, and the chances are 74% that they will NOT develop it.

I say "NO" to pediatric bipolar disorder!
 

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