The push to label

A study published in September found that the diagnosis among children of bipolar disorder, a mental illness long thought not to exist in kids, grew 40-fold over the last decade. The prescribing to kids of antipsychotic drugs typically used to treat the symptoms of bipolar illness have soared as well, despite continuing concerns over side effects such as weight gain, metabolic changes that can lead to diabetes, and tremors.

Psychiatrists admit they haven't drawn clear lines between problem behaviors and mental illness, especially in kids, and they are debating future fixes. But until those fixes are made, parents -- with their kids' futures on the line -- are left with little to guide them when a child is tagged with a psychiatric label.

Katie's maternal instincts tell her she must protect her child. But from what, she asks -- a disease that threatens health, happiness and future? A bogus label applied to an admittedly challenging kid? Or drugs with potentially harmful and little-studied side effects?

And protect her exactly how -- by resisting or by medicating?

"I don't want to face her as an adult and say I didn't do everything I could to make her well. I feel like I'm answering to her future self," Katie says. "But so much of this is a crapshoot. No one wants to feel that their child is a guinea pig."

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Perception of kids changes

Mental-health professionals have long warned that the stigma of mental illness and the cost of its treatment have left millions of Americans with psychiatric disorders to suffer untreated. But as childhood diagnoses of mental illness have surged, some in the profession charge the field of child psychiatry with the opposite problem. A scourge of overdiagnosis, says a growing body of critics, has come to child psychiatry.

The trend, say these critics, threatens to turn kids like Katie's daughter -- a preteen whose behavior is certainly odd but whose school life remains on track -- into potentially lifelong patients.

And, they add, it has changed the way Americans think about children. Critics warn that as psychiatric diagnosis and medication of children becomes more widespread, teachers, well-meaning neighbors and relatives, and parents themselves are becoming less willing to accept youthful misfits for who they are and to help them adapt without prescribing drugs or attaching labels.