Susan (not her real name) is an eighth grader, full of life, energetic, outgoing and joyful. She can light up an entire room with her presence.

Yet underneath this joyous facade lies a teenager battling a crippling illness. In the spring of 2007, Susan lay down on the floor of her school nurse’s office and curled into a fetal position, unable to move. She was rushed to the emergency room and evaluated by a psychiatrist who diagnosed her with obsessive-compulsive disorder (OCD), an illness characterized by “recurrent intense obsessions” and “persistent thoughts, impulses or images that are unwanted and cause marked anxiety.”

As many as one in 200 children and adolescents have OCD; and according to the American Academy of Child & Adolescent Psychiatry, between seven and 12 million American youth suffer from mental, behavioral or developmental disorders at any given time. Besides OCD, such disorders include depression, attention deficit hyperactivity disorder (ADHD) and bipolar disorder. Such illnesses can disrupt a student’s thinking, feelings, moods and ability to relate to others and function on a daily basis.

What’s more, according to the PBS “Frontline” documentary, “The Medicated Child,” which aired in January, during the past 10 years there has been a steep rise in the diagnosis and treatment of all childhood mental health illnesses. Given this increase, it’s inevitable that youth workers will encounter students facing these illnesses, something youth workers often are under-trained and ill-equipped to handle.

I know I was when I learned of Susan’s illness. Despite this, I’ve realized youth workers have great potential to impact students facing these illnesses. To do this, we must learn about these diseases, the treatments and the controversy surrounding them.

What’s the Problem?

Much of this controversy involves the diagnosis and treatment of mental health illnesses in children and youth. For example, though bipolar disorder traditionally has been recognized only in adults, since 1996 there has been a 4,000 percent increase in the number of kids diagnosed. According to “Frontline,” this increase is the result of a study by Dr. Joseph Biederman of Massachusetts General Hospital, who theorizes 23 percent of children diagnosed with ADHD also met the criteria for bipolar disorder.

According to Dr. Biederman, rapid mood swings, tantrums and explosive irritability are all symptoms of childhood bipolar disorder. Yet in his interview with “Frontline,” Dr. David Shaffer, Chief of Child Psychiatry at Columbia University, said, “Irritability also occurs in 26 other disorders.” If irritability is a symptom in that many illnesses, how then can childhood bipolar disorder and other mental health illnesses be diagnosed definitively in children and youth?