Jett Rehm’s temper tantrums had taken control of his family’s life. Several times a day, two-year-old Jett would fly into violent rages of crying, screaming and attempting to physically harm himself and others. The outbursts were almost always followed by periods of sorrow, where Jett would weep and feel guilty about his behavior. These episodes occurred without provocation, making them difficult for Jett’s parents, Kerri and John, to predict.
“A good analogy would be a hurricane,” John explains. “They were something that took on a life of their own and left a path of destruction in their wake.”
Behavioral health issues affect more than 20 million children in the U.S. – more than the number of children with cancer and diabetes combined. Children with untreated behavioral health issues are at a higher risk for academic failure, substance use, criminal activity and suicide.
The Division of Child and Adolescent Psychiatry at MassGeneral Hospital for Children (MGHfC) specializes in the early intervention and treatment of mental health issues. The goal is to ensure a healthy future for children and their families.
On the outside, Jett was a cherubic-looking preschooler, but internally he was tormented. Kerri and John, who own a real estate development and custom building company on the South Shore, consulted with more than a dozen local pediatricians and psychiatrists. Some chalked up Jett’s frightening behavior to the “terrible twos.” Several blamed Kerri and John for dressing him in dark colors and spiking his blonde hair. Feeling intuitively that something more was going on inside their son, the couple turned to MGHfC.
Over the course of eight months, specialists observed Jett’s behavior. They ruled out autism, food allergies and sensory issues as the causes of his frequent rages. “It was such a relief that somebody was finally listening to us and saying there might be something more going on,” Kerri recalls.
At age 4, Jett was diagnosed with bipolar disorder, a severe behavioral disorder that causes an inability to control mood states. People with bipolar disorder suffer from dramatic mood swings — often shifting rapidly from total elation to depression and melancholy. The condition can also cause sleeplessness, extreme irritability and aggressive outbursts.
“When I think of bipolar disorder, I think of going from happy to mad, mad to sad,” Jett explains. “It’s like going from sun to a raincloud.”
Kerri and John were relieved to finally have a diagnosis; it allowed them to look for a specialist.
MGHfC clinicians connected them with Janet Wozniak, MD, director of the Pediatric Bipolar Disorder Clinical and Research Program. Dr. Wozniak is an internationally-recognized expert in the diagnosis and treatment of pediatric bipolar disorder. Her research reversed the belief that bipolar disorder only occurred in adults. She was also at the forefront of studies that showed antipsychotic medications to be the best first line of treatment for children with bipolar disorder.
“This was a perfect match of Jett’s needs and my expertise,” Dr. Wozniak explains. “Before the work done by my research group, children like Jett would have been inappropriately treated with high doses of stimulant medications, which would have worsened his course. Fortunately, he came to the right place, at the right time in history.”
Dr. Wozniak recommended a treatment plan that involved both therapy and medication. Kerri worried about the implications of medicating her young son. “But I recognized Jett’s pain level,” she says. “And I realized that if he continued down this path he would be facing troubles in school, with friends. He would be alienated.”
Dr. Wozniak prescribed a medication known as risperidone. Within weeks, the medication began to reduce the severity of Jett’s episodes. Rages that would typically last up to three hours ended after 45 minutes. His parents found it easier to predict when the episodes would occur and to draw him out of them. Jett’s newfound sense of control made it possible for the Rehm family to enjoy everyday activities like going to the supermarket or eating at a restaurant, activities that weren’t possible before.
Six years later, 11-year-old Jett is still on the medication that Dr. Wozniak prescribed when he was in preschool. He has friends, excels in school, and loves to play football and basketball. The combination of therapy and medication has enabled him to manage his bipolar disorder. Jett himself now recognizes situations that will trigger an episode. He recently passed on attending a field trip to Sturbridge Village, knowing that a long and loud bus ride would be overwhelming.
Dr. Wozniak credits Jett’s success to his parents’ early quest for answers. “A diagnosis is an opportunity to treat,” she says. “Jett is a great example of how early intervention can change a person’s life dramatically.”
With his bipolar disorder under control, Jett feels like his future is full of possibilities. He dreams of becoming a professional athlete or maybe a corporate accountant. “Before, I wouldn’t have been able to get a job, have any friends, or maybe even have a future,” he reflects. “I have many more opportunities because of Mass General. I wouldn’t be the same without the hospital’s help.”