Tom Clifton gets a hug from his son Danny, 18, after dinner Thursday at their home in Kirkwood. (KAREN ELSHOUT/P-D)

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New battle lines are being drawn as scientists delve into the mysteries of the teenage mind. Some child advocates say teenagers should be screened to detect signs of mental illness. But opponents are skeptical and fear that young people could be falsely labeled and put on medications that could prove harmful.



Larry and Marian McCord's son died of bipolar disorder.

Depression killed Robin and David Harris' daughter.

Both teenagers committed suicide, but their parents say their killers were the diseases that plagued them, just as surely as if the teens had died of cancer.

And the death of their children has turned the families into advocates for raising awareness of mental illness among teens.

That message is crucial, say Tom and Cindy Clifton and Maureen Saccio. Saccio and the Cliftons have sons who suffer from bipolar disorder. The illness, once known as manic depression, can cripple academic progress and isolate those with the illness from peers, family and the community, and lead to trouble with the law.

Children with mental illness are often "punished" for their disorders in ways no one would dream of treating teens with other diseases, the families say.

Marian McCord, of Oakville, spent her career as a pediatric nurse. The nurses and doctors at St. Louis Children's Hospital treated their patients like the little kings and queens they are, she said.

But when McCord's son Chad got sick, the story was different. Chad had a mental illness, perhaps more than one. His final diagnosis was bipolar disorder, but he'd also been labeled with depression, anxiety disorder, obsessive compulsive disorder and oppositional behavior disorder. Every new doctor seemed to have a new name for Chad's problem. All anyone could say with certainty was that Chad had an illness that shrouded him in the deepest darkness, a black hole from which he never fully emerged.

When Chad got sick, insurance support dried up long before medicines and therapy could help. The psychiatric ward where Chad stayed wasn't as nice as the maternity ward or a cardiac ward, McCord said.

The support families with ill children usually get wasn't there for the McCords. To be fair, that was partly because the family didn't tell outsiders about Chad's illness.

"Chad was so brittle and so sensitive to what people might think," his mother said.

But even had the McCords opened the closet on Chad's illness, Marian McCord said she knew the response her son was likely to get.

"What do you mean, you can't just jump out of bed? You've got good parents. You've got this. You've got that. Get over it!" she said.

Different standards

The idea that people with mental illnesses should "just get over it" runs contrary to the medical nature of the disorders, mental health experts say. No one expects a diabetic child to "tough it out" without insulin or criticizes children with leukemia for needing chemotherapy to fight off their diseases, they say. Mental illness can be just as life-threatening and crippling as diseases that strike the rest of the body, but psychiatric illnesses are held to a different standard.

"People don't feel like a failure at breathing just because they have asthma," said Dr. Kelly Botteron, a Washington University neuroscientist who is leading an effort to uncover brain changes associated with depression in youngsters. "But for psychiatric disorders, people feel like they should be in control."

Teens who know that they are struggling with depression or other mental illnesses are well aware that society shuns people with such problems.

"You get the vibe pretty early that it's not a very glamorous thing to experience," said Dr. Anne Glowinsky, a psychiatrist at Washington University.

Chad McCord knew his return to school after a bout of mental illness wouldn't be greeted with posters and praise from fellow students, the way a cancer patient's would be. "They'll think I'm weird and not want to be around me," he told his parents.

Depression may sneak up on people or strike suddenly. Either way, "It falls on you like a force of nature and it alienates you from your life and isolates you from the world," Glowinsky said. "It's not something you can just shake off."

Danny Clifton, 18, of Kirkwood, and his family know that feeling. Danny was diagnosed with bipolar disorder when he was 12.

"I could be laughing one minute and at the click of the finger I'd be crying. I could be happy and joyous and at the click of a finger I could pick up a desk and throw it across the room," Danny said, referring to the rapid mood swings that characterize his illness.

He has learned to recognize the signs that he is sliding into depression, he said. And yet, even with six different medications, therapy and electroconvulsive treatments, Danny is sometimes unable to completely control his moods.

His disease has landed him in jail and sent him to the hospital numerous times. It delayed his graduation from high school and might have derailed it altogether if not for Kirkwood High School's Project Achieve, a program built to help teens with severe emotional disorders succeed. He graduated and is now one of the top students in a woodworking academy in Fenton.

But Danny's illness has isolated him and his family from neighbors and friends. "We've gotten to the point that the neighbors just look at us," said Cindy Clifton, Danny's mother. "They don't even wave anymore. As far as the neighbors are concerned, he's that crazy kid the police had to haul away."

She said that she hopes her son's illness will stabilize once he outgrows adolescence, and that speaking out about the disease will change attitudes about mental illness.

Other people, particularly children, don't always recognize Danny's problems as an illness, said Tom Clifton.

"Adults don't understand depression," he said. "How do you think a kid feels about it?"

Misery isn't normal

Part of the problem of understanding teenage mental illness is that stereotypes of adolescents sometimes lead parents to believe that their kids are just being kids.

"Yes, adolescents sometimes have squabbles with their parents, and, yes, sometimes they're miserable, but it's not normal to be miserable all the time," Glowinsky said. "The 'fact' that teenagers are deviant monsters who are incomprehensible - especially girls - is a cliche that definitely has a long life."

And the misconception is as false as it is persistent, Glowinsky said.

Other people attribute the problems of mentally ill teenagers to bad parenting, willfulness, drugs or learning disabilities.

At age 4, Thomas "TJ" Saccio was diagnosed with attention deficit disorder.

TJ started taking Ritalin to calm him and help him concentrate. So when his symptoms worsened as a teenager, TJ and his mother, Maureen Saccio, of Ladera Ranch, Calif., thought his attention deficit was worsening. "I could never go to sleep," TJ, now 15, recalled.

His thoughts raced and his mouth couldn't keep up. TJ leaped from topic to topic, sometimes before he finished a sentence. His friends complained that they couldn't understand what he was talking about.

TJ was constantly angry with his mother, even though he didn't know why she made him so mad. TJ began hearing voices and wandered around the house at night. He thought he saw ghosts.

"It scared me to death," his mother said.

Once or twice a month, black moods oppressed him. He felt hopeless. He didn't even come out of his room on those days.

"I would draw my shades and I'd just write poems. It was actually really, really scary," TJ said. "I'd go back and read (my diary) at times when I wasn't depressed, and it didn't even sound like me."

Maureen Saccio blamed herself for her son's outbursts and behavior. She is divorced from TJ's father and works two jobs so she isn't home with her son as much as she wants to be.

"Doctors would tell me I was giving him too much sugar or criticize my disciplining tactics," Saccio said.

But it wasn't too much sugar or bad parenting or attention deficit disorder. It was bipolar disorder, a condition that went undiagnosed for years.

Denial and fear

Although many children like TJ go undiagnosed for long periods, sometimes the problem is that the parents are in denial or fear that taking a child for evaluation will just earn a label for life.

Education is what's really needed to erase the stigma of mental illness and get more kids help, families say.

But mental health education may also be an uphill battle.

Martha Staeheli Lawless of Yale University developed a curriculum called "Not Crazy: Mental Illness Education for Teenagers" for use in schools in Connecticut. Lawless and her colleagues initially wanted to set up a mass screening program to detect children at risk for a variety of mental health problems. But the researchers quickly realized they would never be able find services to help the thousands of children likely to be identified.

"We started thinking, 'Well, if we really start screening kids, what would we do afterward?' We couldn't say, 'We think you may have prodromal symptoms of mental illness. Good luck with that,'" Lawless said.

The curriculum Lawless developed wasn't easily accepted either.

"We thought that we would call the schools and say 'We have this program,' and they'd say, 'Great! Come on by.' But what happened was the schools said, 'No, no, no, no, no, no,'" Lawless said.

Most rejected the six-part lesson plan on the grounds that teachers are already overburdened.

Lawless has persuaded six school districts to sign on to the curriculum, and 25 districts have expressed interest.

The resistance to talking about mental illness at school is nothing new to Robin Harris.

"You can talk about it if a student dies in a car accident. You can talk about it if a student dies of cancer. You can honor them. You can plant a tree in memory of them," Harris said, "but with suicide (the attitude is) you can't talk about it."

Harris is determined that her daughter Kaitlyn's legacy won't be one of a troubled kid who killed herself.

Harris' challenge is to speak up about mental illness. It's not a role she would have adopted without a push, she said.

"This is not me. I'm not the kind of person who would be vocal about anything," she said.

But now Harris has a message she needs to get out.

"I won't stop until my last breath," she said. No matter how uncomfortable the topic makes some people. "If it makes them squirmy and wormy, well, get over it, because I'm going to talk about it."

Marian and Larry McCord also want to get the word out. Marian left her job as a pediatric nurse to work full time with CHADS Coalition, a suicide-prevention foundation the couple established in honor of their son.

Marian McCord says she has a vision. One day the foundation's annual suicide awareness walk will become as big as the Komen Race for the Cure, an event that raises money for breast cancer research.