A New Diagnosis Dubbed "FOH"
A Newly Identified Mental Illness:
How Understanding “FOH” May Help Save A Child
This is the story of Andre, an intelligent, creative, and inquisitive child who loves superheroes, playing with Legos, and learning about dinosaurs. But, at age 9 he’s on his third school placement and his parents are very worried.
From the time he was a baby Andre’s parents knew things were different with him.
He had horrible nightmares most nights of the week, was angry and irritable all the time, and was always hot even when it wasn’t hot out. Growing up he would often refuse to wear a coat when it was cold out and constantly kicked off the bed covers and removed his clothes whenever he could. He’d wake up sweaty, and shaking from terrifying gory nightmares filled with danger and death that no one could explain. Andre fought going to bed, worried all the time, was terrified of things like intruders and bugs, couldn’t stand to be alone, and seemed to be stuck in a constant state of fight or flight.
Andre’s sleep was completely out of whack. He would get ramped-up at night and was usually unable to stay in bed or fall asleep until he passed out from exhaustion around midnight. He also had trouble staying asleep, and the only deep sleep he got each night didn’t start until 4 or 5am. He’d be angry when he was awakened. He was incredibly sensitive, even the tiniest criticism or redirection crushed him and he’d often react with defensive angry aggression. Andre constantly complained of being bored, couldn’t handle waiting, and lost interest in activities fast, moving from one thing to the next without follow-through.
It was nearly impossible for Andre to keep friends because of his unpredictable moods and behaviors, his need to control everything and everyone, and his impulse to argue and reject suggestions. He would erupt in a rage when his parents tried to set limits, afterwards expressing guilt and confusion about why he’d behaved that way– that is, when he could even remember what he’d done and said. His self-esteem was suffering, he was withdrawing into himself, and he was being labeled “a problem child” at school.
Andre’s parents took him to multiple doctors, counselors, and other specialists. He was diagnosed with Attention Deficit Hyperactivity Disorder (ADHD), Depression, Anxiety, and an “alphabet soup” of other labels (ODD, OCD, CD, DMDD**) each of which almost fit, but didn’t really. Doctors prescribed him stimulants like Ritalin and Adderall, as well as antidepressants like Zoloft and Prosac, but nothing seemed to do much good. In fact, sometimes, the medications seemed to make things even worse, causing more irritability, aggression, and unpredictable moods and behaviors. Andre’s parents, doctors, and counselors were left wondering, what is Andre suffering from, and how can they help him?
The truth is that Andre’s story isn’t one of “a problem child”. On the contrary, he’s experiencing the clear symptoms of a newly identified mental health disorder. But, because this disorder is so new, many professionals haven’t heard of it yet, which makes it hard to get the right treatment. Andre, isn’t alone, he’s just like hundreds of thousands of other children who live with this new phenotype of Bipolar Disorder that’s referred to as “Fear of Harm”, or “FOH” for short.
Fear of Harm was first identified by a team of researchers at the Juvenile Bipolar Research Foundation, led by psychiatrist Demitri Papolos. Their research shows that Fear of Harm, and childhood onset Bipolar Disorder “are major social as well as medical issues.” In 2008 they published a paper in the Journal of Affective Disorders outlining the identification of Fear of Harm. They had studied over 5,300 youth diagnosed with Bipolar Disorder and their research suggested that roughly ⅓ of them had all of the symptoms of Fear of Harm. With an estimated 750,000 kids suffering from Bipolar Disorder in the US, that means approximately 250,000 kids and teens live with Fear of Harm. Misdiagnosis, and ineffective treatments, lead to increasing symptoms which at best make life at home and school more difficult, but at worst can lead to encounters with law enforcement and the juvenile justice system.
The Breakthrough Discovery
Fear of Harm’s symptoms include sleep disruptions, aggression, extreme anxiety, and intense fear that something terrible will happen. While some of these symptoms can be found in other childhood mental
health disorders, what makes FOH unique is that it’s the first psychiatric diagnosis ever to include an observable and measurable physical symptom. People with Fear of Harm overheat, even if they don’t realize it, because their bodies aren’t regulating temperature properly. This symptom is called “thermoregulatory disturbance”, and it’s a trigger for a whole set of other FOH symptoms, like sleep disruptions, aggression, and the fears that give FOH its name.
The researchers who identified Fear of Harm also figured out how to treat this new illness. They’ve repeatedly found success with medicine that targets body temperature regulation and fear sensitization. When combined with proven mood stabilizers the treatment is a safe and effective long term treatment, offering hope for thousands of children and families. For kids, teens and even adults with FOH, early and accurate diagnosis and effective treatment can be transformational, changing lives for the better. As one mother has said, “The effects of the right diagnosis and treatment have been nothing short of miraculous.”
If you think that you or someone you love may be living with Fear of Harm, please visit the website of the Children’s Mental Health Resource Center (www.cmhrc.org) to learn more. Or you can reach out to info@cmhrc.org.
* ODD, Oppositional Defiant Disorder; OCD, Obsessive Compulsive Disorder; CD, Conduct Disorder; DMDD, Disruptive Mood Dysregulation Disorder