 |
|
|
|
October 24th, 2011
08:17 AM ET
Labeling tantrums a mental illness doesn't helpDr. Claudia M. Gold is a pediatrician and author of "Keeping Your Child in Mind: Overcoming Defiance, Tantrums and Other Everyday Behavior Problems by Seeing the World Through Your Child's Eyes." In the winter of 2010, there was a lot of talk in the news (and I wrote an Op-Ed in The Boston Globe, "Warning label on new diagnosis") about a proposed new diagnosis for children, then called temper dysregulation disorder with dysphoria, or TDD. The committee that is assigned the task of creating the new DSM-V, the diagnostic manual for mental health, got a lot of flak, so now they have changed the name to disruptive mood dysregulation disorder, or DMDD. Many thought that including the word "temper" would make temper tantrums, a normal and healthy part of development, a disorder. So is the new label an improvement? I think the whole discussion is misguided. It diverts our energies for addressing the real problem, namely that there is not enough help in this country, in the form of primary care, mental health care or community support, for struggling parents who are on the front lines raising the next generation.
DMDD is being created as a new diagnosis to stem the rising tide of diagnosis of bipolar disorder in children. But I fear that this label will have the same fate, as clinicians feel helpless in the face of these troubled young families. For the majority of these children diagnosed with some variation of mood dysregulation (it doesn't really matter what you call it - that is the underlying problem), the trouble started way before age 6. This is why, rather than devoting huge amounts of time to what to call this - and really, this discussion is driven by the health insurance industry because clinicians who treat these problems need to know what to bill for - we need to look closely at the origins of these problems. We need to focus our attention and resources on early intervention. Here is a typical case of "disruptive mood dysregulation" that I see in my behavioral pediatrics practice at age 6 or above. Often, the pregnancy was very stressful. There may have been anxiety, depression, abuse or abandonment. There is evidence that stress in pregnancy has effects on an infant's capacity for self -regulation and is associated with later behavior problems in childhood. Infancy is similarly described as stressful. Mothers tell me about babies who cried all the time and were difficult to feed. They speak of terrible depression and feelings of being completely alone. Having a very challenging baby can lead to feelings of inadequacy and severe sleep deprivation, both of which may exacerbate a preexisting depression. Entering toddlerhood, a stage that under normal circumstances is challenging as children strive to assert their emerging selves, can be a nightmare when a child already has difficulty with self-regulation. These children often have a variety of sensory sensitivities. They decompensate in the grocery store, overwhelmed by all of the sounds and sights. Putting on clothes can be an hourlong ordeal if they can't stand the feel of shirt sleeves, labels or "sock bumps." Preschool is similarly fraught. Children may have severe separation anxiety, which is commonly associated with years of conflict and struggle between parent and child. Children often have difficulty with personal space, another manifestation of sensory processing difficulties. The explosive behavior seen at home may carry over into the classroom setting. Parents may describe terrible marital conflict. Or mothers may be raising a child alone. Not uncommonly, mothers and fathers have themselves experienced significant traumas in their own childhoods. I believe that an extended discussion of what to call this "mood dysregulation" at age 6 and above is completely off the mark. These children are certainly not "normal," as is often mentioned as the alternative to giving them a diagnosis. They and their families are suffering terribly. But giving them a label does not accomplish anything. It only makes it easier to bill for services and, even worse, to justify using powerful psychiatric drugs rather than treating the underlying cause.
« Previous entryEducating new parents cuts shaken baby syndrome
|
  About this blog
Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.
 |
|
|
|
The diagnostic description created by the American Psychiatric Association states that a child must be 6 years old to receive the diagnosis. If this entity does make it into the DSM-V, I hope that clinicians respect this aspect of the diagnosis. However, with pediatric bipolar disorder, this has not been the case. Often, parents of children as young as 18 months come to my pediatric practice with the question, "Does he have bipolar disorder?" One 
If you've never been to Vietnam, or if you haven't been in quite a very long time, a Vietnamese woman for marriage is one of the things you need to do if you are currently looking for a possible bride. Not only are they attractive, they may make a great partner. When you haven't lived in Vietnam however, this may be quite a difficult thing but there is a suggestion that you never even lived there, at least not for long. It can assist you in case you've lived in the nation before then, although it is a challenge. You know the best places to find woman. The first step of course is finding a woman who's willing to date a white man. As soon as you have found her, there are some things you will need to do.
First, you will need to locate Vietnamese women. There's an international service that caters to women for marriage. This agency has the capability. It isn't too late if you can not find one locally. International agencies will provide a translator if necessary. You won't have to manage the language barrier.
You don't have to be rich or famous to become successful with an international agency. The thing about having success on the internet is that the Web can make you feel like a celebrity, although individuals are successful. It can make you feel like your own boss, and you can make. You are caring for a Vietnamese woman for marriage, If you discover a woman through an agency. By you being 12, they are not going to feel threatened. Because they have heard this method done thousands of times the reason an agency would use a translator is, and it works.
53348 581472Actually clear internet website , thanks for this post. 939852
I really appreciate this post. I’ve been looking all over for this! Thank goodness I found it on Bing. You've made my day! Thank you again
http://www.froleprotrem.com/
This actually answered my drawback, thanks!
http://www.froleprotrem.com/
482290 482474Wow, wonderful blog layout! How long have you been blogging for? you make blogging appear easy. The overall appear of your internet internet site is fantastic, let alone the content material! 382484
cheap sildenafil 50mg https://eunicesildenafilcitrate.com/ generic sildenafil from canada
tadalafil max dose https://elitadalafill.com/ generic tadalafil united states
alprostadil penile injection https://alprostadildrugs.com/ how to administer transurethral alprostadil
vardenafil sublingual generic https://vegavardenafil.com/ buy vardenafil over the counter online
can viagra be legally bought from canada https://canadaviagrastore.com/ generic viagra order canada
zithromax is used for https://zithromaxes.com/ zithromaz
erectile tissue in men https://canadaerectiledysfunctionpills.com/ what erectile dysfunction pill is the best
buy avanafil canada avana tabs
canada online viagra https://canadaviagrastore.com/ do you need a prescription for viagra in canada
chloroquine phosphate tablet https://chloroquineorigin.com/ who chloroquine
priligy tablets buy avanafil canada
724799 978285I enjoy your writing type, do keep on writing! Ill be back! 932413
combigan coupon brimonidine tartrate 2%
buy cyclosporine usa cyclosporine ophthalmic
combigan eye drops generic brimonidine use
https://tadagatadalafil.com/ tadalafil goodrx tadalafil drug tadalafil price walmart tadalafil cost in canada
generic cialis online fast shipping cheapest tadalafil cost buy tadalafil tadalafil liquid https://cttadalafil.com/
where to buy cialis without prescription https://cttadalafil.com/ – buy cialis cialis tadalafil cialis without a prescription https://tadalafilww.com/
Thank you so much for giving everyone an extraordinarily special opportunity to read critical reviews from this site. It's always very enjoyable and jam-packed with amusement for me and my office colleagues to search your web site a minimum of thrice in a week to see the newest tips you have. And definitely, we are at all times amazed with all the wonderful tactics you give. Selected 1 areas in this post are particularly the finest we have all had.
https://telegra.ph/Suggestions-To-Picking-Out-A-Motorcycle-Helmet-05-29
tadalafil troche cost cheap cialis tadalafil warnings
is chloroquine available over the counter plaquenil 10 mg where to get chloroquine
108475 330136Hey quite good weblog!! Man .. Beautiful .. Remarkable .. I will bookmark your website and take the feeds alsoIm satisfied to seek out numerous valuable information here within the post, we need to have develop far more techniques on this regard, thanks for sharing. 552552
tadalafil 20 mg tablet tadalafil what is erectafil
hydroxycholorquin hydroxychloroquine sulfate corona dosage for hydroxychloroquine
tadalafil from india reviews https://www.pharmaceptica.com/
sildenafil rx drugstore online https://www.pharmaceptica.com/
erectile organs pha https://www.pharmaceptica.com/
sildenafil generic no prescription https://pharmaceptica.com/
plaquenil 200 mg twice a day https://pharmaceptica.com/
sildenafil 680 https://pharmaceptica.com/