The Medicated Child

 I love documentaries, I prefer documentaries over movies any day. I am well aware that this makes me a giant geek. I can live with that. I sometimes watch them and it presents a new argument and a way of thinking I hadn't considered before, I both love and hate when that happens. I love it because knowledge is the single most valuable thing you can attain and I hate it because then I have to re-evaluate everything I had once thought.
    Two nights ago I watched Frontline's: The Medicated Child and it was frightening. It's no secret that kids today are medicated  more than we were as kids. I'd even make the argument that a lot of kids are over medicated, but to see a FOUR year old on Clonidine , Resperidone,  and Trileptal among others is just...terrifying. I wanted to reserve my judgement though, I am a parent of a child with a severe mental illness and I know that can be exceedingly hard to treat. The scene that blew me away (I even rewound it to make sure I heard it right) was when the mother of this four year old was in the psychiatrist's office specifically to ask if there was something besides medication she could be doing to help her son. He said no. Unbelievable. It only gets worse from there. She explains that he is doing OK, but has a lot of anxiety about going to school. He is fine as soon as he gets in the door, it's just getting him there that's the problem. He throws a tantrum for about two hours. When you've got a mentally-ill kid the word "tantrum" doesn't do it justice, but the bottom line is he was exhibiting behaviors that would indicate the transition from home to school was difficult for him. I'd be looking for a Behavioral Interventionist and try to pinpoint what in the environment is setting him off. Nothing we do is completely random, no matter how severely ill the child is the behavior always serves a purpose. I am waiting for the psychiatrist to say something along those lines, but he didn't even bother to ask a single question about why the child would be throwing a fit. He suggested Xanax. I about fell over. I told Josh "This kid's brain is going to be soup before he hits 5 years old!" So mom came in hoping to get alternatives to medication and walked out with another perscription.
                                      Welcome to the wonderful world of child psychiatry.
As parents we are the bottom line, but I think we put too much trust in professionals and ignore our gut instincts. We aren't experts after all, who are we to argue how to treat a mental illness? The fact of the matter is that there really is no expert, psychiatry and psychology isn't a science like the rest of medicine and if you ask 3 different psychiatrists about one symptom you are going to get 3 different opinions. It isn't like when you go to the doctor with a sore throat, they do a swab, diagnose you with Strep and prescribe an antibiotic to make you better. That's cut and dry. Mental illness, especially in children is anything but cut and dry.
   I am not anti-medication, Cole is on three different medications to control his OCD and ADHD symptoms. I feel like he needs them. It took me a while to realize that when you go to a psychiatrist you are going for medication and most of them will dole it out unabashedly. I went to one doctor who wrote Cole five prescriptions after a 15 minute "evaluation" in which he never even spoke to Cole! You just don't mention symptoms to a psychiatrist unless you want a medication for them.
   Cole is on a medication called Methylphenidate, otherwise known as Ritalin. He has developed motor tics and so I just really don't like this medication... but he is hyper personified without it. I decided to take him off of it for the summer, to see if the tics improved. 50% of people with OCD have tics as do about 50% of people with ADHD. Cole has a diagnosis of both, plus tics are a side effect of the medication. That leaves us with a tangled mess to unravel. Stopping the meds to see if the tics stop seems a logical first step.
   He is driving me INSANE. He laughs like a maniac, spins, flips, makes noises, and literally acts like a kid that is on speed, crack, and meth combined. Two days before I watched the documentary I cracked and called his psychiatrist's office and asked for a refill. The change in him when he is off the medication is notable, he lacks impulse control and has zero tolerance for frustrating situations. He has the attention span of a 2 year old. He melted down during his social skills class and I had to come get him. I am a hard-ass, I want him to deal and I won't allow escape from situations when he has behaviors. I am torn between the behavioral approach and the medication approach. I am left feeling like the medication is the easy out. Is it? Could I be doing more? I guess more research needs to follow. I am always researching and then scaring the life out of myself.
  To make matters worse, I know Aiden has ADHD. How could he not have something? I have multiple diagnoses including ADHD and his dad is no stranger to psychiatric labels. Aiden is 4 and while friends and family have mentioned many times that he is hyper, oppositional, difficult, and so on to a degree that isn't exactly normal... I still don't want a diagnosis. Am I in denial? Am I a bad parent? Would medication help him get into less trouble and enjoy life more or is it just to make my life easier? I go back and forth in my head. Chloe has ADD (the teacher's at the school made that abundantly clear many times) I do see an improvement with medication, but there is an increase in focus when college students take these meds illegally to cram for exams...it doesn't mean they lacked focus to begin with. I don't want her medicated, I want the school to accommodate her needs. I also don't want to hold her back from achieving her full potential. It's a slippery slope and as a parent you just have to make sure you get a good grip on every bit of information available to you.
   I think parents need to have more information about mental health before they are able to make decisions about medicating young children. They need to know the research that's been done and the controversy that's out there. I think too often they assume it's well-known because the doctors seem quite sure. Psychiatrists should be more aware of alternatives to medications and they should prescribe medication with extreme caution in situations where the illness is terribly severe or other approaches have failed. We should be asking more "why" questions, both as parents and physicians.