January 9th, 2008
|12:12 pm - Psych meds for children|
teaotter and I watched Frontline on PBS last night, and it was about psych meds for children, and specifically about the new (and rapidly growing) alleged epidemic of bi-polar disorder in children, especially in very young children. This diagnosis and the use of anti-psychotic medication on children as young as 2 were seriously questioned in the show, but perhaps not enough.
There was one psychiatrist discussing how a child of perhaps 4 or 5 presented classic bipolar symptoms, and then they showed a video he made of an interview with the girl and her parent. The kid was allegedly manic, this was supposedly proven by her repeatedly standing up and sitting down in a chair while talking about going to a store and feeling like she could fly (she didn't try to throw herself off anything, she merely talked to her mom about it), and going on to talk about gutting people's heads off or bashing their heads in. My first reaction would be to wonder if anyone would think there was a problem if the child were male, and my second I thought that a good thing to try before medication might be cutting back on caffeine and violent TV.
I had a student in one of my intro to Wicca classes that I used to teach who was in her mid 20s and had classic bipolar. Bipolar is very scary stuff, manic adults are sometimes severely delusional (my student certainly was) and medication helps many quite significantly. However, while I avoid children, especially young children at all costs, because I dislike being around them, it remains clear to me that children are not adults and behavior that is insane for an adult is perfectly reasonable for a child of 4 or 5. Similarly, I have known a goodly number of people who have been helped a great deal by antidepressants, but as various studies pointed out, most of these drugs either have no affect on children or have negative affects and few positive ones. I'm a firm supporter of responsibly-used psych meds, but that's not what I see here.
There was another young woman of 12, who was clearly moody and anxious. Of course, her dad had just shipped off to Iraq, and many kids of that age are moody and anxious. She clearly seemed troubled, but counseling seemed an obvious option to try first. In any case, least anyone see a pattern in their choice of subjects, there were also an equal number of male children being discussed, one of whom seemed mildly retarded and with the sorts of behavioral problems I commonly saw among mildly retarded children when I was a young teen and helped out over the summer at the school for the handicapped that my mom was a principle of (I had a choice of doing that or getting a summer job). There was also another young boy, of 4 or 5, who seemed somewhat overly aggressive and excitable, but hardly a candidate for powerful anti-psychotic medications.
It was also significant, that in no cases did anyone suggest any sort of environmental problems, such as the fact that parents rarely let children out of their sight, children go outside far less than they did 20+ years ago, or that they eat a diet that contains little food – we saw the boy of 4 or 5 being fed a lunch of packaged corndogs and gatorade, which definitely did not impress me – a lunch made worse because one of the drugs he was on turned off his ability to know when he was full and so he would just keep eating if allowed to.
Schools have been underfunded and undervalued for several decades and so we now have overworked teachers desperate to control classes that are too large telling parents to medicate their children (and occasionally kicking them out of various programs if they aren't medicated, or at minimum if they don't act "normal"), we now have parents so overworked underslept, and overstressed that they have little time to spend with their children, we have an average diet that is provably worse that it was 20 years ago, and we have a culture that demands conformity and fear its children even more than it has before (with post-Columbine paranoia stiff going strong after 9 years) and all of these conditions are significantly worse in the US than any other first world nation. As a result, parents must deal with both the high levels of stress caused by of dealing with a persistently unruly child or perhaps just one who many people (the parents often included) assume isn't normal and needs to be modified in some way. So, people choose the solutions being offered – psych-meds, often including anti-psychotic medications.
The result of all this mess is that definitions of normal and acceptable behavior has shrunk (for adults, and especially for children) and that children are under far more stress than ever before. Nowhere in this episode of Frontline did anyone mention if anyone had suggested reducing the amount of caffeine in their diet, increasing the amount of exercise they get, making certain they have a balanced diet that contains actual food and not overly processed, pesticide containing junkfood, and maybe even spending some time outdoors. A number of the parents said they were worried about all the medication their children were on, but none said that they had tried alternatives. Perhaps they had and they failed, but maybe they didn't. Also, I have no idea how many of these children would have been considered to have behavior problems 20+ years ago, and I strongly suspect many fewer would have. It's always been my assumption that much of this alleged epidemic of mental illness among children is nothing other than shrinking definitions of normal that now exclude the behavior of many children.
In any case, I know a number of people from Britain, Australia, and various Scandinavian nations read my lj. Have instances of various alleged mental illnesses in children skyrocketed over the past 15 years in your nation? Are one in six children (the latest figure I've heard for the US, but it might be higher now) in your nation on psych meds?
Current Mood: thoughtful
|Date:||January 9th, 2008 08:35 pm (UTC)|| |
===I encountered the early wave of this damned medicating with high-powered drugs while I worked in Foster Care Reunification...I actually met one of the "doctors" that had diganosed a child at the age of 3...and started giving them Lithium. She had a rather....odd...relationship with the parent of the child in question. (the child eventually was adopted by a theraputic foster home, I believe...a very good one. The biological parent sabotaged herself rather well.)
===The political connections of this "therapist" should be no suprise.
"The kid was allegedly manic, this was supposedly proven by her repeatedly standing up and sitting down in a chair while talking about going to a store and feeling like she could fly (she didn't try to throw herself off anything, she merely talked to her mom about it), and going on to talk about gutting people's heads off or bashing their heads in. My first reaction would be to wonder if anyone would think there was a problem if the child were male, and my second I thought that a good thing to try before medication might be cutting back on caffeine and violent TV."
Thank you! If a small child (under 6) is sitting quietly and being perfectly still for a very long time in a boring environment, I would suspect a) the kid is coming down with something and needs to be put to bed or b) the child is terrified to move for fear of punishment. Small children sitting too quietly is never a good sign.
|Date:||January 10th, 2008 12:49 am (UTC)|| |
Mental health counseling grad student here, just took ethics last summer. Not clear on the specifics of laws concerning medicating prisoners, but do have a good general sense of what the principles are about consent to treatment here where I am (Massachusetts): required of adults (who are not otherwise legally incapacitated of granting consent, e.g. those declared incompetant by a judge and those observed to be unconscious by a doctor).
Which brings us to the crux of the problem. A school can't actually force a student of theirs to be drugged (though they might be able to withhold services from an unruly student). But parents can have their child medicated over the child's will.
And they do, and they do, and they do.
As far as I can tell, the problem isn't at root the schools. The schools predominantly just legitimize parental desires as medical problems. The problem is that enormous numbers of parents want -- and have always wanted -- to control their children more totally, and drugs give them the means to fulfill this atavistic dream.
And I say this as someone who fully approves of psychopharmaceuticals in the treatment of mental illness, and sees them as life-saving drugs. I did my practicum with schizophrenics; my emerging specialty seems to be depression. I say this as someone who believes, just as deeply, that real mental illness in children goes woefully underdiagnosed and treated.
I am totally with you on qcuvier
regarding the changing environment and culture occuring. I will add that the culture around parenting has changed, too, breeding in more fear, thanks to the media, and the tendency to look for the quick fix for something broken.
I was in an office gathering today to congratulate the impending births of a few coworkers. Afterwards, I was speaking to one of the mothers, who I considered smart and pretty sane, and found out that she never leaves the house without dvds for long car trips...and benedryl. Another mother nodded vigorously in agreement and mentioned nyquil. Ok, benedryl is a multifaceted drug with a number of uses...but it's now ok to knock your kid out at will? And I do realize the latter could be stressful mom joking...but the former was very serious. My mom was a nurse and the three of us drove her batshit, but she never got that extreme (though lots of folks would think the spankings we'd earned extreme!)
Anyway, it was just a surprise to me. Pills to fix everything...to fix every behavior
you find to be a put out or unattractive or not "normal". *shakes head*
|Date:||January 9th, 2008 09:49 pm (UTC)|| |
When I was growing up, I never heard of the use of OTC drugs as ways of drugging children. I don't know of that means it happened far less or if no one talked about it, but that's utterly horrifying.
I'm even more certain than ever that I'd like to see people have to pass a test in order to have children - this would both reduce the population and largely eliminate vile crap like that.
|Date:||January 9th, 2008 09:31 pm (UTC)|| |
I'm mostly in agreement with you - psychiatric meds are generally being overprescribed for behaviours which ought to be consider normal, and our society has changed to be less tolerant of those behaviours. I'm less in agreement that diet is a factor. I've yet to see anything which convinces me that caffeine and "overly processed, pesticide containing junkfood" causes any of these problems. I know that folk wisdom has held for decades that sugar makes children "rambunctious" but such claims have been consistently debunked; I'm dubious about similarly unproven claims.
|Date:||January 9th, 2008 09:43 pm (UTC)|| |
I'm somewhat dubious about sugar too - I think the whole "sugar high" is a myth. However, some preservatives, artificial sweeteners, and similar products do have various physical and psychological effects on people (for example, I know several people who get migraines from aspartame). Also, there have been studies (IIRC, including one in a prison) where behavior was improved by improved nutrition. More importantly, caffeine is a stimulant and I have been small children drinking coke and similar beverages. Given that 1 can of coke has a mild stimulant effect upon a adult weighing 150 lbs, I'd assume that it would have significantly more effect on someone weighing 50 lbs. Also, I've read various studies about average American diets, and they are provably unhealthy (here's an interesting article on average height and how it can be used to track health
Not as far as I know, but I'm no expert.
|Date:||January 9th, 2008 09:44 pm (UTC)|| |
It's all over the newspapers here (both the degree of medication, and various panics about likely mythic psych conditions). If Australia lacks both sorts of reports, I'm betting it's a lot less of an issue there.
I was diagnosed with ADD when I was six, and forced to take Ritalin for it. The medical records I have of this is extremely disturbing. My mom took me in there for a number of things that were complete crap (including the school/my mom claiming that I was sexually promiscuous, when the reality was that there were some seriously messed up people around who did things that the school refused to put blame on the people who caused the problems.) and the impression I get from reading my medical records is that the doc just put me on the hot drug of the time, to make people happy that he was doing "something" about it.
I'm skeptical as hell about people claiming mental instability in such large numbers as what is being described. Especially in regards to bipolar disorder. In my mind, there is a huge difference between personality quirks, problems that people don't want to pretend don't exist, and mental disorders.
People don't seem to know how to raise children anymore. Some whako tried to pin ADD on my nephew because he's strong willed. Thankfully I think I knocked some common sense into my sister, and he's not taking anything that I know of. People need to let kids be kids. I've met some kids who are more mature than most adults. The fact that people see a problem and say "medicate it!" so much these days is really worrying to me.
Let's just say I'm glad I'm in China right now, because I can contemplate murder against your mother all I like and not be in any position to do anything dangerous.
|Date:||January 9th, 2008 10:46 pm (UTC)|| |
|Date:||January 9th, 2008 10:51 pm (UTC)|| |
I have to admit that I am kinda twitchy about people talking about 'overmedicating' kids because for a long time, I did not go on medication. For a brief period, I did go on Ritalin, Mom thought it made me act like a zombie, she stopped it. I think she tried her best, but due to external and internal circumstances, I went through purgatory. As a tween, I had suicidal ideations, no idea how to make or keep friends, and while going to counseling, had no real idea how to ask for help--or even what could be helped. Ritalin may have not been best for me, but I wished that much more was known about how children reacted to life events. I suspect we still have no idea.
I get twitchy over the implication any kind of chemical help is a cop-out. Which I do not see in this post, but I have implied to me on different occasions. It was not the only thing that helped, and I figure that the more I use other methods, the less I may need of the meds. However, that level of self-care was not as apparent when I had nothing. As I grew older, I think I lost a lot of opportunities because I couldn't see how I'd get anywhere. I got into messed-up relationships because I was trying to find some way, any way, to stop this horrid feeling of worthlessness.
Now, kids as young as five, I can understand not wanting to do any damage, much like not giving an adult dose of aspirin for a headache. However, I worry that the opposite reaction will be 'benign neglect' of children, and ignoring problems like bullying or confusion. This is what is most likely to happen rather than a massive change in what is considered 'normal' behavior, availability to decent food and exercise, etc.
Also, groups like Scientologists (through CCHR) tend to use honest worry about drugs to wedge in stuff like Xenu, engrams, and whatnot, which end up being expensive and traumatic to boot. I have to watch myself that I don't go the total opposite extreme on people, who, um, are worried about side effects on children.
(Oh, and caffeine makes me really focused. How it would have made me acted as a child, I have no idea. My mom banned caffeine from the house until the children were old enough to go and get their own)
Edited at 2008-01-09 11:22 pm (UTC)
|Date:||January 10th, 2008 12:17 am (UTC)|| |
but I wished that much more was known about how children reacted to life events. I suspect we still have no idea.
That seems far too vividly true.
Also, groups like Scientologists (through CCHR) tend to use honest worry about drugs to wedge in stuff like Xenu, engrams, and whatnot, which end up being expensive and traumatic to boot.
Agreed, and I have no patience with nutjobs who claim that psychmeds are all bad for everyone. I've known too many people who were helped by them. The problem is that no one knows how any of these drugs affect children, combined with a rather frightening conflation of being annoyed that a child won't sit down and shut up when you want it to with childhood mental illness. Of the two, the second worries me most.
Actually, at least in Texas, it's a really bad idea to suggest medication to parents, even if you think the children might need it. It opens you up to all kinds of legal liability. We never mention medication.
I didn't see the show, but the kids you described all seem well within the range of normal for their ages. And I agree that many of the "problems" we see with kids now can be traced back to diet, lack of exercise, being cooped up inside all the time, and the culture in general. The lunches at my school are ridiculous and PE consists of walking around the field or playing sports if the student feels like it. If they don't or if the parents have indicated that the child should be excused, the students sit on the bleachers.
|Date:||January 10th, 2008 12:24 am (UTC)|| |
Actually, at least in Texas, it's a really bad idea to suggest medication to parents, even if you think the children might need it. It opens you up to all kinds of legal liability. We never mention medication.
Very odd, out on both coasts this is very common and I've seem multiple reports about it.
The lunches at my school are ridiculous and PE consists of walking around the field or playing sports if the student feels like it. If they don't or if the parents have indicated that the child should be excused, the students sit on the bleachers.
That's somewhere between deeply pathetic and criminal. Republicans, with their deliberate 25+ year attack on public school have a great deal to answer for.
|Date:||January 10th, 2008 12:16 am (UTC)|| |
> a good thing to try before medication might be cutting back
> on caffeine and violent TV.
I would add cutting out sugar, MSG, fake foods. Plus having the main liquid be water, not some crap out of a bottle.
I had a student in one of my intro to Wicca classes that I used to teach who was in her mid 20s and had classic bipolar.
Adults are harder to make change lifestyle habits. But getting rid of tobacco, sugar, fake foods, MSG, food colorings and fake flavorings can do wonders for bi-polar, without resorting to shrink drugs. Minimizing TV, getting fresh air and exercise also helps.
|Date:||January 10th, 2008 12:22 am (UTC)|| |
I would add cutting out sugar, MSG, fake foods.
I've read a number of recent serious medical studies on MSG, it's harmless. I'm also skeptical about the link between sugar and behavior, since many people I know (myself included) show no behavioral effects from sugar, but people clearly differ on this, so it's definitely worth considering. OTOH, I definitely agree wrt fake food. An industrial corndog and a large glass of gatorade is not kind of lunch for a child (or an adult).
But getting rid of tobacco, sugar, fake foods, MSG, food colorings and fake flavorings can do wonders for bi-polar, without resorting to shrink drugs.
In a word, hogwash, but you and I vividly disagree on almost everything to do with real medicine (and what we consider to be such).
There's also a social component in that there is a great deal of pressure on parents to have kids who behave *everywhere* not just in school. I tend to view kids playing in a restaurant as "normal", while many people view such behavior as "unacceptable".
|Date:||January 10th, 2008 08:28 am (UTC)|| |
Oh, it's normal, but it may be unacceptable as well. ;)
|Date:||January 10th, 2008 03:41 am (UTC)|| |
There is not a single pharmaceutical treatment for bipolar that does not have significant side effects. "Significant" does not begin to describe the effects of these drugs on human development in children. I am sick with anger over this stuff. People are talking about affecting the amygdala in children without really knowing what the amygdala does!
There are very few cases where I, as a mental health professional, would prescribe something other than love and patience for someone under the age of 20. Kids can acts in ways across a huge spectrum and grow up to be healthy, happy adults. Kids need drugs less than they need a world that accepts their nature.
I have a 4 year old who is diagnosed with Sensory Processing Disorder/ ADHD/Oppositional Defiant/ and r/o Bi-Polar, as well as the clinical term for not using the toilet. The only med she is on currently is Focalin (a stimulant), but she was literally incapable of sitting still for more than a minute. Even if she was engaged in a movie she was running around the room. Her counselor saw her for 6 months before she even mentioned drug, and that was after we had been through a 6 month positive parenting class. (2 hours a day twice a week) So a full year of trying other methods documented. I tried for two years before that to keep full routines, good nutrition, lots of outdoor time, and lots of attention to the kids (she's my youngest of 3).
I hate psych meds, I tried everything else before we used medicine for her. But the difference is amazing. Yes she still has meltdowns, she still has poor impulse control, she still sees' and hears monsters (and no she doesn't get to watch violent movies she never has, she watches Dora Explorer and Diego and Dragontales and other shows like that.) the monsters cut off peoples hands and kill people (these aren't dreams they are things she sees and hears while she's awake) But now she can tell me "mommy the monsters are over there".
The only negative side effect the med has on her that I know of is her appetite is poor (but she is eating more now than she used to because she can sit down and eat instead of taking a bite running around the table a few times taking another bite. . .)
Yes the doc mentioned an anti-psychotic as a possibility but it isn't what she is on and it wasn't the first choice of her doctor.
|Date:||January 10th, 2008 08:28 pm (UTC)|| |
It definitely sounds like you are lucky to have found good doctors and counselors.
|Date:||January 10th, 2008 07:47 pm (UTC)|| |
Have instances of various alleged mental illnesses in children skyrocketed over the past 15 years in your nation? Are one in six children (the latest figure I've heard for the US, but it might be higher now) in your nation on psych meds?
I haven't been in much touch with children, but if the kids around here are getting medication, it's not spoken about - I don't think I recall hearing of one single incident of a child being on any sort of psych meds, and I have difficulty imagining that any child here would be prescribed them unless they had truly serious problems.
|Date:||January 10th, 2008 08:29 pm (UTC)|| |
I rather suspected as much. The US is an impressively screwed up nation is a host of different ways.