The Medicated Child; Part II

In 2nd grade, my oldest child began having problems in school, I first thought it was due to having recently relocated from private school to public.

He read at 4, was doing simple algebraic equations by first grade and had the critical thinking skills of a much older child.

How could he possibly be struggling?

I blamed the teacher, the lack of one on one interaction, and the failings of the public school system to treat children as individuals. I told myself he was bored because he was so advanced. I told everybody else too.

But despite my efforts to assure myself, I began to feel some niggling doubt. And, some fear. Things had begun happening at home too. Little things, things that caused most friends and relatives to assert that "He's just being a typical boy."

But I knew better. His academic edge was disappearing as he struggled with routine tasks. His intelligence hadn't evaporated, that I knew. So very slowly, I allowed myself to admit that there was something wrong.

The following year, his teacher, who was Teacher of the Year in our district and for whom I had an enormous amount of respect, requested a conference shortly after school started. She gently suggested to me that he might benefit from an evaluation by the school psychologist.

I asked her if she thought his problem went beyond what was typical distractability for a boy his age. Her reply was simple, but emphatic. Yes.

It was both a shock and a relief. But at least I had somewhere to start. And so, we did it. And then I took the little piece of paper they gave me, which suggested that maybe my son had a tendency towards innattentiveness and anxiety, to a pyschiatrist, unsure of what was going to happen.

I chose his therapist from our preferred provider list.

On our first visit, she took the paper I presented to her, skimmed it briefly, and then said,

"It looks like ADHD. Let's put him on Concerta and Strattera for that, and Paxil for his anxiety."

I looked at her, stunned. She hadn't even spoken to him. She had no idea what was going on with my child, apart from the very vague information on that paper. And yet, she felt comfortable prescribing a powerful chemical cocktail for him.

"Uh. Is there anything aside from medication that we could try first?"

Now she looked stunned. I really didn't think my questions was that unusual, but apparently it was.

"Well, what are his symptoms?"

Perhaps it would have been prudent to ask that question before prescribing three types of medication for an 8 year old child....hmmmmm?

We talked for about 30 minutes, but she barely spoke to Pre-Pubescent One. She really did not know him as a person or a patient, nor, I suspected, did she care to. To her, he was a chart, a case...30 minutes out of her busy day.

Luckily, I had already done a lot of research on meds as well as behavior modification techniques, many of which we were already implementing. I had also spoken with several women whose children had a multitude of issues and who had a wealth of experience between them when it came to dealing with doctors and navigating the system.

I knew that the best approach to these disorders was a combination of therapy, behavior modification and medication. I had already accepted that he would most likely need some medication, but I'd be damnded if I was going to start pumping him full of drugs willy nilly.

I took a deep breathe and said to the doctor,

"We would like to start with a small dose of Strattera and see how that meets his needs. We can increase if necessary. I do not believe he has hyperactivity, so I don't want to consider stimulants yet. And I believe that much of his anxiety is directly related to his problems at school, so I would like to wait and see if that improves on it's own once his other symptoms are addressed."

Again, she looked stunned.

"Well...we could try that approach, yes."

"Good, then we're agreed."

"But in my experience as a licensed mental health practitioner, the combination I suggested would be the most effective."

"Upon what criteria is that opinion based?"

She had no answer for me. She had not conducted a thorough clinical evaluation. She hadn't even spoken to my son. She hadn't consulted his teacher, or even asked ME very many questions.

Finally, she said, "It's based upon historical data, education and experience."

I wanted to tell her that my child was more than historical data. He was a person, a child, with hopes and dreams and tons of unrealized potential. He wasn't a lab rat or a control group. And her experience meant nothing to me, since she had none with my son.

But I held my tongue and took the prescription for Strattera.

And that was that. We did not go back.

I asked our family practitioner if she would be willing to monitor his liver function, blood pressure and growth and prescribe as necessary, which she agreed to do, provded we find another mental health professional to see several times a year.

The Strattera helped him enormously, his side effects were few, and his anxiety lessened noticeably once he began doing better in school. He tested into the gifted and talented program, and began taking accelerated math classes. For the first time in several years, I felt his performance reflected his true capability.

Needless to say, I was relieved.

We had an entirely different experience with Diminutive One, thankfully. I originally took him to see the child psychologist for reasons unrelated to a learning disorder. She was a god send for us both. She did a very thorough evaluation. She interviewed both Husband and me, as well as several of his teachers. She observed him for nearly six months before offering a diagnosis and suggesting a very conservative dose of Concerta.

But aside from just writing a prescription, she offered me a lot of constructive and creative solutions for dealing with his behavior. She listened to me when I was frustrated. And she was a calming influence when I couldn't cope.

She helped him take responsibility for his actions and to recognize when he was getting out of control. She gave him a lot of tools for dealing with the stress of being "different" and helped him to realize that he had great potential. She helped him to believe in himself.

She was everything I had hoped to find for Pre-Pubescent One.

Now both my boys take medication. They are doing well. They may outgrow their respective conditions, they may not. But I have come to terms with being the parent of medicated children.

It is not something I have accepted lightly, however.

I really dragged my feet with Diminutive One's diagnosis. I was reluctant to give him stimulants. Their side effects are much more profound, and it can lead to a cascade effect in terms of medications. I was extremely nervous about going down that road.

But it has turned out to be the right decision to make. It has helped him so enormously, that I initially suffered a lot of guilt over not giving them to him sooner.

What we have to understand as parents, is that medication is a tool. Not a quick fix. Not a solution. A tool.

Diminutive One is a stubborn, defiant, persistent, strong willed, and sometimes, profoundly irksome child. That cannot be medicated away. Because if we medicate that away, we also medicate away the creative, perceptive, intuitive, inquisitive child. And that would be a terrible tragedy. I don't want to change who he is. I just want him to be able to lead the best life possible.

It's true that most of us do not posses a medical degree. But most of us do possess a modicum of common sense, as well as a pretty strong maternal instinct. We know when a clinician has not taken the time to evaluate our children thoroughly. We know when they are prescribing medications for our children injudiciously. And we know when the essence of our child has disappeared in a miasma of pharmaceutical side effects.

My advice to parents facing the decision of whether or not to medicate their children is this:

1. Question everything.

2. Do your homework.

3. Know your child, listen to your child.

4. Trust your instincts.

5. Don't be intimidated by clinicians who presume to know better than you do, how to treat your child. A medical degree is not a guarantee of infallibility.

6. If it feels wrong, it probably is.

7. It's okay not to follow the advice of a clinician.

8. It's okay to seek a second opinion.

9. It's okay to change doctors.

10. It's okay to change your mind.

11. YOU make the decisions. NOT the doctor.

It's truly frightening to contemplate medicating your child, especially when it's quite clear that children are being routinely misdiagnosed and drugs are being overprescribed to an alarming degree.

A defining moment for me with both of my boys, was witnessing the devastating effects these disorders were having on their self-esteem.

Ask any parent who has heard thier child say, "Mom, I'm just too stupid." Ask any parent who has heard anguish and defeat and worthlessness in their child's voice. Ask any parent who has watched a brilliant child fail time and time and time again. It will do a lot to motivate a parent to find what is wrong and how to fix it.

Prescribed and used properly, these drugs can really help a child that is struggling. They can help otherwise deeply disturbed children lead normal lives. They can help intelligent children realize their potential. They can help painfully withdrawn and isolated children step out into the world.

We have more tools at our disposal these days than our parents ever did. More resources. More options. More power to change the world for our children.

And I think we can.

We just have to be smart about it.