Children with Multiple Mental Illness Diagnoses

This reaction paper is based on a newspaper article from the New York Times. The media piece covers the trials and problems that surround a family that has a child with multiple diagnoses. At the time the article was written, in 2006, Haley was ten and diagnosed with “bipolar disorder with psychotic features, obsessive-compulsive disorder, generalized anxiety disorder and Tourette’s syndrome;” the family explains how the illness “dominates every moment, every relationship, and every decision.”

The Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV) diagnostic criteria for bipolar disorder is “the essential feature of Bipolar I Disorder is a clinical course that is characterized by the occurrence of one or more Manic Episodes or Mixed Episodes. The essential feature of Bipolar II Disorder is a clinical course that is characterized by the occurrence of one or more Major Depressive Episodes accompanied by at least one Hypomanic Episode” (American Psychiatric Association).

The American Psychiatric Association defines OCD :

 “As the presence of obsessions, compulsions, or both. Obsessions are defined by (1) and (2) as follows: 1. Recurrent and persistent thoughts, urges, or images that are experienced, at some time during the disturbance, as intrusive and unwanted, and cause marked anxiety and distress. 2. The person attempts to suppress or ignore such thoughts, impulses, or images or to neutralize them with some other thought or action. Compulsions are defined by (1) and (2) as follows: 1. Repetitive behaviors (eg, hand washing, ordering, checking) or mental acts (eg, praying, counting, repeating words silently) in response to an obsession or according to rules that must be applied rigidly. 2. The behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a way that could realistically neutralize or prevent whatever they are meant to address, or they are clearly excessive.”

The Diagnostic and Statistical Manual of Mental Disorders provides the following diagnosis of Generalized Anxiety Disorder (GAD):

“A. At least 6 months of "excessive anxiety and worry" about a variety of events and situations. Generally, "excessive" can be interpreted as more than would be expected for a particular situation or event. Most people become anxious over certain things, but the intensity of the anxiety typically corresponds to the situation. B. There is significant difficulty in controlling the anxiety and worry. If someone has a very difficult struggle to regain control, relax, or cope with the anxiety and worry, then this requirement is met. C. The presence for most days over the previous six months of 3 or more (only 1 for children) of the following symptoms: 1. Feeling wound-up, tense, or restless, 2. Easily becoming fatigued or worn-out, 3. Concentration problems
4. Irritability, 5. Significant tension in muscles.”

The Diagnostic and Statistical Manual of Mental Disorders provides the following diagnosis of Tourette Syndrome (TS), for a person to be diagnosed with TS, he or she must:

“1. Have both multiple motor tics (for example, blinking or shrugging the shoulders) and vocal tics (for example, humming, clearing the throat, or yelling out a word or phrase), although they might not always happen at the same time. 2. Have had tics for at least a year. The tics can occur many times a day (usually in bouts) nearly every day, or off and on. 3. Have tips that begin before he or she is 18 years of age. 4. Have symptoms that are not due to taking medicine or other drugs or due to having another medical condition (for example, seizures, Huntington disease, or post viral encephalitis).”

Having a diagnosis is an answer, for the families, but it rarely makes the symptoms go away. After the diagnosis, the battle begins to find the right amount of medication. However, over time the patient can adapt to the medicine and the trial and error of finding a medication will begin again.

The article did a good explaining that some friends and relative members might stay away from the family because the behaviors of the child make them feel uncomfortable, and people fear what they do not know. Haley tries to hold herself together while she is at school, but when she gets home she often can’t hold herself together, so her family feels the brunt of her behaviors.

 The article also described the feelings that parents can have of “guilt, anger, and helplessness, and that siblings can feel “neglected, resentful or pressure to be problem-free themselves.” There is normally a financial strain on parents that have a child with multiple mental health diagnoses because of the care and attention that they need. In this case, the mother lost her job because she needed to take off to take care of her daughter, but the family really needed the income.

This article is useful to all individuals, because mental illness effects one out of every four people. The descriptions described in the article help individuals to understand what it is like to have a mental diagnosis, and it describes the effect that diagnosis has on the whole family. The article was written in 2006; and as a society, we have a long way to go to decrease the stigma that surrounds individuals with a mental health diagnosis.

 

References

Belluck, Pam (2013). Living with Love, Chaos, and Haley. New York Times. Doi: http://www.nytimes.com/2006/10/22/health/22kids.html?_r=0

American Psychiatric Association. (2013). DSM-IV TR. Doi: http://www.psychiatry.org/practice/dsm/dsm-iv-tr