Working Dad: Rise in childhood mental illness is perplexing

Working Dad: Rise in childhood mental illness is perplexing

By PAUL NYHANP-I REPORTER

Scrambled eggs and toast were on the kitchen table, a soccer game began in an hour and October sun poured into Elizabeth Coplan's Seattle-area home.
Yet it was 11 a.m., and her 10-year-old son would not get out of bed, remaining tucked under his covers more like a teenager than a fourth-grader.
It was the latest of yellow flags that had been waving since Mark Coplan was born that something was wrong: night terrors, lips rubbed until bleeding, recurring stomach aches, aversion to smell, and never much sleep, maybe four hours a night for mother and son.
By the time her son was 6, a psychiatrist told Coplan the boy suffered from depression, the youngest case she had ever diagnosed, and gave him what would be the first in a series of medications.
"There is nothing worse than having a 10-year-old on a bright sunny day refuse to get up," said Coplan, 53, about that day three years ago. "There were times he was just so sad you couldn't get him to do anything."
Today, a growing number of younger children are diagnosed with depression, attention-deficit (hyperactivity) disorder and any number of other mental illnesses. Overall, 10 million children struggle with psychiatric disorders, according to New York University's Child Study Center.
Today's parent lives in an era of diagnosis. Even if a child isn't coping with a mental disorder, fear often lurks in the back of a parent's mind, put there partly by a drumbeat of persistent media coverage.
Sometimes it seems treatment is struggling to catch up and adapt to this fast-changing and expanding group of children. Health professionals seemingly worry about everything: misdiagnosis, underdiagnosis, overdiagnosis and use of medication.
There even is plenty of debate about what childhood mental illness is and how to treat it, though parents are taking a greater role in treatment.
Those parents, meanwhile, struggle with their own dread that it can mean a lifelong struggle for their children.
"I think the term mental illness is so scary for parents because it sounds like this is going to be persistent, and it's never going to go away," said Dr. Eric Trupin, a professor in the University of Washington's Psychiatry and Behavior Department.
The reality is that mental illness exists among children, but children also change, and a problem in an 8-year-old may be manageable a few years later, Trupin said.
At the same time, psychiatrists, or more often pediatricians, are detecting mental illness in younger children, as the stigma lightens and awareness grows, experts say.
When Elizabeth Coplan was looking for help 10 years ago, it was a different story.
After numerous doctor visits it became obvious her son's ailment wasn't physical, yet she spent the next eight years figuring out what it was.
At age 3, it was sensory integration disorder with traits of autism, though not a full-blown case. By age 5, it was general anxiety disorder, and the kindergartener was given small doses of Valium to help with sleep.
"I was so numb I didn't ask the right questions," Coplan said. "I just blindly filled the prescription because by then both my son and I were suffering six years of sleep deprivation."
Then he turned 6, and his psychiatrist told the family he had depression.
"You want your 6-year-old to be smiling, and if he's not, your heart breaks," Coplan said.
Over the next five years, Mark Coplan, who asked that his first name be changed for this story, tried a series of medications -- the antidepressants Trazodone, Remeron, Wellbutrin and Zoloft, and the hypertension drug Clonidine -- as well as therapy, but nothing worked for long.
Meanwhile, Elizabeth Coplan developed her own symptoms, including fibromyalgia and exhaustion. When her son didn't sleep, neither did she.
Finally, they hit on Paxil, another antidepressant that offered steady improvement, while Mark developed new coping skills, such as learning to leave situations and play piano when stressed.
Then he turned 11 and eased off everything.
But Elizabeth Coplan still struggled, frustrated with the little help she found around Seattle.
"Eleven years ago when I was going through this there were no resources," Coplan said.
In response, two years ago Coplan helped to create the Seattle-based Web site and blog support group A Wild Ride, where struggling parents, with or without diagnosed children, share stories, find resources and get child-rearing tips.
Perhaps the biggest problem facing Coplan and other parents is an acute shortage of child psychiatrists, only 6,000 for the nation's 73 million children, according to Dr. Christopher Lucas, an associate professor of child and adolescent psychiatry at New York University's Child Center.
The shortage means pediatricians are the nation's primary screeners for childhood mental health.
"I don't think you can make a diagnosis of depression in a 10-minute doctor visit, you just can't," said Dr. James Parker, a child psychiatrist at Group Health Cooperative in Seattle.
The challenge is only complicated by diagnoses that often are simplistic or poor, Lucas added.
The good news is resources slowly are improving in Seattle and nationally for mental illness and behavioral problems among children.
These days, Mark Coplan also is markedly improved. He is a typical 13-year-old who plays on a select soccer squad, earns A's and sleeps in a room plastered with posters of Jimi Hendrix, Rage Against the Machine and Kurt Cobain, and littered with clothes.
"I feel like every other kid," he said last week.
His mother still worries, but last week Mark offered her some assurance.
"I've gotten over it once and I can do it again, with a little help from my family."
A GUIDE FOR PARENTS
Childhood mental illness is a complicated, confusing and difficult challenge that should be handled by trained medical professionals. Experts advise parents to follow these guidelines in observing their children:
· Watch for anxiety. It can be an early sign of depression.
· Talk to your kids. They often will tell you how they are doing.
· Eat dinner together.
· Trust your gut instincts about your own child.
· Share concerns with your pediatrician.
· Learn what you can about a diagnosed disorder.
· Take care of yourself.
Resources:
· A Wild Ride: awildride.net
· National Alliance on Mental Illness Greater Seattle, 206-783-9264, nami-greaterseattle.org
· New York University Child Study Center, 212-263-6622, aboutourkids.org
SOURCES: NYU Child Study Center, University of Washington Department of Psychiatry and Behavior, NAMI Greater Seattle