What Dick Cheney is to the U.S. invasion of Iraq, psychiatrist Joseph Biederman is to the explosion of psychiatric medications in American children. Recently, Biederman was nailed by congressional investigators and the New York Times for overestimating just how greedy an elite shrink is entitled to be. Beyond a peek into the corruption of psychiatry at its highest levels, the scandal is an opportunity to reconsider the Big Pharma financed view of why kids become disruptive and destructive.
On June 8, 2008, the New York Times reported the following about Joseph Biederman: "A world-renowned Harvard child psychiatrist whose work has helped fuel an explosion in the use of powerful anti-psychotic medicines in children earned at least $1.6 million in consulting fees from drug makers from 2000 to 2007 but for years did not report much of this income to university officials, according to information given congressional investigators."
Due in part to Biederman's influence, the number of American children and adolescents treated for bipolar disorder increased 40-fold from 1994 to 2003, and as Bloomberg News reported (September 2007), "The expanded use of bipolar as a pediatric diagnosis has made children the fastest-growing part of the $11.5 billion U.S. market for anti-psychotic drugs."
Pediatrician and author Lawrence Diller notes about Biederman, "He single-handedly put pediatric bipolar disorder on the map." Biederman has been in a position to convince many doctors to diagnose bipolar disorder in children and to medicate them with anti-psychotic drugs. In addition to being a professor at Harvard, Biederman is also chief of research in pediatric psychopharmacology at the Massachusetts General Hospital, which publishes more than 30 papers yearly on psychiatric disorders. And Biederman himself has authored and co-authored approximately 500 articles, 70 book chapters, and more than 450 scientific abstracts, as well as being on the editorial board of many professional journals.
Biederman (and two of his colleagues in the psychiatry department at Harvard Medical School who received an additional $2.6 million from drug companies from 2000 to 2007), by failing to report income from drug companies while at the same time receiving federal funds from the National Institutes of Health (NIH), violated rules designed to police conflicts of interest, according to Sen. Charles Grassley, R-Iowa. Grassley concluded, "Obviously, if a researcher is taking money from a drug company while also receiving federal dollars to research that company's product, then there is a conflict of interest." In one example, Biederman neglected to report his 2001 income from Johnson & Johnson (makers of the anti-psychotic drug Risperdal); Johnson & Johnson reported to Grassley that it had paid Biederman $58,169 in 2001.
In addition to his popularization of bipolar disorder for children, Biederman is one of the most significant forces behind the commonplace diagnosis of attention deficit hyperactivity disorder. Congressional investigators also found that Biederman conducted studies of Eli Lilly's attention deficit hyperactivity disorder drug Strattera that were funded by NIH at the same time he was receiving money from Lilly that exceeded the maximum amount permitted.
NIH rules state that researchers cannot take more than $20,000 in payments from a drug company whose drug they are funded by NIH to research and that researchers must disclose any payment received from a drug company of $10,000 or more. Apparently, for drug researchers taking federal funding from NIH, there is no law against being on the take from drug companies, but there are rules against greed.
Mental health treatment in the United States is now a multibillion-dollar industry, and all the rules of industrial complexes apply. Not only does Big Pharma have influential psychiatrists such as Biederman in their pocket, virtually every mental health institution from which doctors, the press, and the general public receive their mental health information is financially interconnected with Big Pharma. The American Psychiatric Association, psychiatry's professional organization, is hugely dependent on drug company grants, and this is also true for the National Alliance for the Mentally Ill and other so-called consumer organizations. Harvard and other prestigious university psychiatry departments take millions of dollars from drug companies, and the National Institute of Mental Health funds researchers who are financially connected with drug companies.
The corporate media, dependent on drug company advertising, occasionally reports on egregious scandals, but the corporate media is generally timid in reporting the big picture of how drug companies spread around millions of dollars to make billions of dollars.
There are certainly many troubled and disruptive American children who are sometimes extremely destructive to themselves or others. However, any attempt to understand these kids will be corrupted by financial dependency on drug companies, which have a vested interest in viewing all attentional, emotional, and behavioral difficulties as diseases that can be fixed with drugs.
There are several commonsense nondisease reasons why children become troubled and behave disruptively and destructively. For more than two decades, I have worked with annoying, disruptive, and destructive children. Many of these children had been previously diagnosed with attention deficit hyperactivity disorder, oppositional defiant disorder, bipolar disorder, and other serious psychiatric diagnoses, and they were routinely given a variety of drug combinations. Their parents most often reported that drugs were prescribed after being questioned by doctors about symptoms but without any exploration of reasons as to why their children were behaving as they did.
In America's assembly-line medicine, drug prescriptions are routinely written without any exploration of commonsense reasons as to why a child might be behaving problematically. Is the child resentful over a perceived injustice? Is the child experiencing deep emotional pain? Is the child simply bored? Does the child feel powerless? Does the child have low self-worth because a lack of life skills and thus behaves immaturely so no expectations are placed on him or her? Is the child starving for attention? Has the child lost respect for his or her parents because these adults have not acted like adults? Has the child's basic physical needs -- such as proper nutrition, physical activity, or sleep -- not been met? Routinely, few if any of these areas are explored before a prescription is written.
One of the most common reasons that children behave problematically is that well-meaning parents are having difficulty relating to their child's personality. Perhaps the parents are, by nature, compliant and conformist, and their child has a nonconformist and rebellious temperament. Good parents feel guilty when they have difficulty relating to their child, but all of us -- including doctors -- are human, and we all need to admit our limitations. The reality is that children who feel that nobody "gets them" are more likely to be troubled and disruptive. In another era, if a parent had difficulty relating to his or her child, there would more likely be at least one grandparent, uncle, aunt, friend, or other adult in the community who could easily relate. In our increasingly disconnected society (see Robert Putnam's Bowling Alone for a detailed picture of the destruction of American community), there are increasing numbers of children without even one adult who they believe relates to them.
Moreover, as society demands increasing machinelike efficiency, more of us -- children and adults -- will not be able to fit in; but a corporate media cannot confront a corporate culture that produces widespread painful alienation, which in turn creates a variety of attentional, emotional and behavioral problems. The corporate media may at times report on egregious corruption of an individual or an institution, but it does not ask this question: In an increasingly homogenized and standardized society, should we drug those who do not neatly fit in -- or should we consider transforming such a society?
Bruce E. Levine, Ph.D., is a clinical psychologist and author of Surviving America's Depression Epidemic: How to Find Morale, Energy, and Community in a World Gone Crazy (Chelsea Green, 2007).
