Archive for the ‘Medicating Children for Mood Disorders’ Category

Medicating Children: Is It More for the Parents?   Leave a comment

More and more I see stories on the Oprah Winfrey Network, Net Geo, Health and Discovery Channel and other cable networks trying to catch low hanging reality TV  fruit with programs documenting children with serious mood disorders.  Many have even been diagnosed bipolar.  Naturally, you always see the worst cases for maximum entertainment value.  Like a five year old kicking and biting his parents as he screams at the top of his lungs “I hate you!” trying to simultaneously set fire to the living room curtains.   And naturally the parents profiled are tired, distraught and feel they are out of reasonable options.

Reasonable options might be bear-hugging the child until he calms down, giving him a time out in a “safe room” or diverting his attention to something other than pyromania.  I went through a period of almost a year when my daughter was three trying to get her dressed for pre-school and into the car.  I dreaded mornings.   I would have rather had my leg amputated without anesthetic than face my daughter in the morning.

From the moment she woke up it was non-stop crying, screaming and physically fighting me from getting her out of her pajamas and into her clothes.  I literally would sit on her, pin her legs and arms down amongst wild protest and “force cloth her” while her face turned beet red and contorted into an image so disturbing I almost came down with PTSD.  I often wondered if her behavior was normal?  Was it a sign of what was to come?  Did I need to consult a psychiatrist?  Was there medication to calm her down, which would also have the off-label use of lowering my morning anxiety ?

Many of these cable TV programs depict equally exasperated parents choosing the medication option to settle their hellacious havoc wreaking offspring.  But sometimes they seem to be doing it more for themselves than for their children.  However if your child rips through the house like a cyclone emitting sonic booms in every room and saws off the legs of the dining room table to use against you as fighting sticks at bedtime, any drug which calms them down is just as much for you as it is for them.  And I really don’t think parents should be ashamed for admitting their frustration and exasperation.  But is medicating a child under twelve or thirteen a wise decision overall?

I believe everyone needs to have a baseline for “normal.”  If a person doesn’t know what normal is, even if it’s just for a fleeting moment in time, how can they tell if medication is bringing them back to that reality?  Normal to them may be how a particular drug once made them feel.  If it made them feel amped up and giddy with superhero-powers,  for the rest of their lives they’ll be chasing the dragon for that “hot-wired” sensation from future medications.  Eventually when given proper drug therapies for their mood disorder, they’ll be rejected if they don’t get that same feeling of constant excitement.  Medicating children under thirteen could give them a skewed view of normalcy, causing their mood disorder treatment expectations to be off-balance for life.

Also, young children can not put into words when a drug does not make them feel “right.”  They can’t articulate the nuances of what they are experiencing.  Many won’t say anything and just go about their lives feeling poorly.  Very young children may not even relate it to the medication.  I remember being given an anti-depressant when I was in high school.  Bipolar illness had not been identified back in the early 1980’s.  It made me sluggish, paranoid and more depressed.  I was able to verbalize this.  But how does a seven year old explain “sluggish and paranoid?”  Remember, with a mood disorder finding the right drug or cocktail of drugs could take years of trial and error.  It bewilders me that psychiatrists or sometimes even a general practitioner will prescribe a child a drug, expecting it to be the correct medication and dosage right from the start.

I do not doubt that children show the disturbing signs of bipolar illness, schizophrenia or other mental illnesses at an early age.  And I believe in some instances when parents have tried all the holistic options and their child is still punching them in the back of the head while they drive,  medication is the only answer.  I’m just purporting we reserve it for the worst cases, and if possible stave it off until they are teens and can communicate more articulately their mental status.  Immediately pumping up a kid up with psychotropic medications at the first sign of trouble can create a medication monster, always seeking a mental state that only exists in a far off memory.

I went the “wrestling route” with my daughter and opted against the medication.  I was lucky because she eventually grew out of her morning madness and at twelve years old seems to be a very well adjusted child.  But I often wonder what if her outbursts only got worse?  Would I consider medicating her if I was getting calls from the pre-school that she was terrorizing the teachers and they wanted her expelled?  I’d say, “you never really know for sure until you’ve been there.”  Or, maybe I’d just take the easy way out and have my doctor up my own medications.