Post by Christine Sipple on Dec 17, 2015 15:00:33 GMT -4
Love this topic. I come from a large family and there are always a lot of children around, so it's been interesting to see how different behavioral issues have been dealt with over the years. As a child in the mid-70s - 80s, it was almost unheard of and considered "weird" for children to be on medication or even to see a therapist or psychiatrist. My older sister had a lot of behavioral issues and epilepsy, so I saw first-hand what it was like for my parents to try to get her the help she needed and find the right medications. The social stigma of her condition and treatment have had lasting effects on her personality as an adult. Fast-forward to the next generation, and it is now common for children to be medicated or in therapy for just about any behavior that is considered outside of the norm. My youngest sister's son was "diagnosed" with ADHD by his 2nd grade teacher, and the private school almost insisted that she put him on medication to keep him enrolled there. This is unbelievable to me. The first medication made him lose weight and suddenly start complaining that he "hated himself." The second medication, which did allow him to perform better in class, was later discontinued when he changed schools. Interestingly, he did not revert to having any issues at all because he was happier at the new school. He is a smart, articulate kid who is also active, sensitive, and opinionated. Is that really a disorder?
Many families have similar personal stories that we will encounter in our practices, and we need to know how to appropriately respond to the queries of parents about the "right" course of action. It is difficult to know what to do given so many of the unknowns. We don't know if these medications, which have been tested mostly on adult men, are truly safe for the developing brains of young children or toddlers. Indeed, they might not even be safe for teenagers or young adults. No one has any idea what the effects of long-term use of these medications are on children. We just don't know yet, and it is almost impossible for us to give parents advice based on evidence.
Furthermore, might it be a better and safer alternative for us to focus more on behavioral therapies rather than medical therapies for a lot of these children? Taking the time to teach interpersonal skills and behavioral coping strategies seems more likely to have the positive result of raising happier, better-adjusted, empathetic young adults than does trying medication after medication and hoping something sticks. There is no doubt that psychiatric medications are beneficial and life-changing for many patients, and this benefit almost certainly can safely be extended to the pediatric patient population. It will take more time, more data and more research before we know how to use them appropriately.
In the meantime, though, what do we do for the families who feel that they have tried everything and that their child is suffering? Do we allow the parents to make the decision on behalf of the child to experiment with using these medications? Do we allow parents and teachers to put kids on medicines to improve their focus and performance so that they can be more competitive? Doesn't this take you back to the other article about children who feel disconnected from their parents and unable to deal with the pressures placed upon them, and end up considering suicide as an acceptable way out?
I say err on the side of caution and utilize only the lowest effective dose of the safest medications when necessary.
Many families have similar personal stories that we will encounter in our practices, and we need to know how to appropriately respond to the queries of parents about the "right" course of action. It is difficult to know what to do given so many of the unknowns. We don't know if these medications, which have been tested mostly on adult men, are truly safe for the developing brains of young children or toddlers. Indeed, they might not even be safe for teenagers or young adults. No one has any idea what the effects of long-term use of these medications are on children. We just don't know yet, and it is almost impossible for us to give parents advice based on evidence.
Furthermore, might it be a better and safer alternative for us to focus more on behavioral therapies rather than medical therapies for a lot of these children? Taking the time to teach interpersonal skills and behavioral coping strategies seems more likely to have the positive result of raising happier, better-adjusted, empathetic young adults than does trying medication after medication and hoping something sticks. There is no doubt that psychiatric medications are beneficial and life-changing for many patients, and this benefit almost certainly can safely be extended to the pediatric patient population. It will take more time, more data and more research before we know how to use them appropriately.
In the meantime, though, what do we do for the families who feel that they have tried everything and that their child is suffering? Do we allow the parents to make the decision on behalf of the child to experiment with using these medications? Do we allow parents and teachers to put kids on medicines to improve their focus and performance so that they can be more competitive? Doesn't this take you back to the other article about children who feel disconnected from their parents and unable to deal with the pressures placed upon them, and end up considering suicide as an acceptable way out?
I say err on the side of caution and utilize only the lowest effective dose of the safest medications when necessary.