I had an epiphany the day I first saw my son in a coffin after his suicide. The moments following his hanging himself were a blur of sirens, screaming, people running, violent medical interventions, the nightmare of panic and noise that accompany a violent death. By contrast, walking into the quiet, peaceful atmosphere of a funeral home and seeing my child apparently asleep but never to wake again was a very different experience than that of the immediate aftermath of his death.
As I looked down on him, stroked his hand and kissed his forehead, the meaning of life became clear to me. There was no doubt in my mind that it is to watch your children grow up and have their own children. For me anyway, understanding what I am here for, what my purpose and legacy are is as simple as that. I understood it, at the moment it was taken away from me, when the SSRI he was prescribed led my only child to put a noose around his neck and end not only the life I had given him, but the lives he would have given the children he often talked about having.
Those who know me, know how deeply I grieve for the daughter my son often talked of having, who he and his girlfriend jokingly referred to as ‘Princess Leia.’ The child of Toran’s imagination who lives on in mine, who never got to be born because her father became a victim of the dogma of psychiatry. Of a pseudo-science in which people are viewed as a set of deficiencies and drugged for being sad or scared or different.
The Princess is my imaginary friend now. I see her everywhere I go. In the face of the baby one of Toran’s friends had recently and the smile of the little girl who put money in the CASPER collection bucket on Sunday. I see her in my son’s baby photos and feel her arms around my neck whenever a child hugs me. She is a fantasy child, who lives a perfect life of smiles, cuddles and bedtime stories. She is never sad, never feels afraid and never, ever naughty. She lives in Aotearoa, New Zealand where she has Christmas on the beach, a pukeko at the bottom of the garden and a pair of jandals in every colour of the rainbow.
But the Princess also lives in a country where people like psychiatrist Dr Denise Guy peddle the notion that 12-15% of 10 month old babies suffer psychopathology in the form of a raft of mental disorders. Where ‘infant mental health’ is the new black, and advising government that significant percentages of our 0-4 year old kiwi kids are mentally ill produces a steady stream of funding.
As is typical of psychiatry, a range of assessment and diagnostic tools have been developed and published to assess mental illness in babies. Also typical is the fact they are completely deficit based, providing checklists of poor parenting (over involved, under involved, emotionally, physically and sexually abusive) and ‘abnormal’ responses in newborns, infants and toddlers.
Most commonly used is the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood-Revised (DC: 0-3R) a diagnostic manual that provides clinical criteria for categorizing mental health and developmental disorders in infants and toddlers.
Used alongside the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-R), and the International Statistical Classification of Diseases and Related Health Problems (ICD-10) of the World Health Organization it is a tool promoted as providing a robust system for the assessment, diagnosis, and treatment of mental health problems in infants and toddlers by allowing for the identification of disorders not addressed in other classification systems.
Two commonly diagnosed mental disorders in babies are ‘excessive crying’ and ‘dysphoric fussiness.’ The first is what we used to call colic.
According to research published last year, “the the clinical syndrome of excessive crying in early infancy is a precursor of clinically significant behavioral and emotional problems at 30 months.” Apparently international consensus is that the scientific criteria for differentiating between normal and excessive crying at the age of 6 weeks draw on the “rules of threes” – crying and fussing for more than 3 hours a day, for more than 3 days a week, and for more than 3 weeks, in an infant who is well-fed and otherwise healthy. The author claims the prevalence of excessive crying of all infants aged 0-3 months at 29.4%.
According to the literature, excessive crying and feeding disorders precede later sleep disorders in 64.3% and 20.0% of infants and when coupled with dysfunctional sleep-wake organization precede later feeding disorders in 55.5% and 59.2% of cases, respectively and with with later excessive clinginess (69.5%) and excessive defiance (64.8%).
Frighteningly, research from 2008 on excessive crying in adults found that “There is a remarkable similarity between the precipitating factors in normal crying and Excessive Crying” and advised that treatment with low doses of antidepressants yields promising results.
In New Zealand we recorded a 140% increase in the prescribing of antidepressants to babies and children aged 0-4 years in a 12 month period, the period in which infant mental health units became an established feature of our mental health services. We do not record the diagnosis that precipitated this prescribing and so do not know whether recommendations that antidepressants be prescribed for adults who cry ‘more than normal’ is being adopted for babies who do the same.
According to the baby psychs, Dysphoric fussiness replaces excessive crying and peaks at age 9 months. It’s diagnostic criteria is a lack of interest in play. Dysphoric fussiness is estimated to affect almost a third of children this age with prevalence estimated at 30.1%.
After Toran died, his girlfriend and I both hoped she was pregnant. She wasn’t. When I gave up on the miracle of Toran being revived from the dead, I turned my attention to hoping that one day, a girl would arrive at my home with a baby that looked just like him and give me his daughter to raise. The refusal of Toran’s school guidance counsellor, for a period of 18 months after he died, to provide me with his records on the basis that he had disclosed something confidential fuelled this fantasy (the disclosure was that he had come to school without lunch!).
Imagine though, if the Princess had been brought to me. If she had been a real baby born after her daddy’s tragic death and raised by her grieving grandmother. I have no doubt that first year would have been difficult. She might have cried a lot. The sadness in our house might have made her less interested in playing. I have no doubt that in cherishing her like I would have, I would have been seen as ‘over-involved.’ Most definitely I would have refused to have her involved in any way in infant mental health services and I wouldn’t let her in the same room as an antidepressant let alone let her take one. And despite the fact I would have loved and nurtured her like I loved and nurtured her father, I have no doubt she would have been taken from me.
And so, while I cry for her loss as I cry for Toran’s, I am sometimes glad she exists only in my dreams and fantasies. She’s safe there. But I worry for the children Toran’s friends are starting to have, who with Dr Denise Guy and her colleagues around, are not safe from the labelling and drugging that harms and even kills kiwi kids.
 Joon Sik Kim, MD Excessive crying: behavioral and emotional regulation disorder in infancy Korean J Pediatr. 2011 June; 54(6): 229–233