Buyer Beware: Medicating Children with Psychiatric and Behavioral Disorder

BUYER BEWARE: MEDICATING

Buyer Beware:

Medicating Children with

Psychiatric and Behavioral Disorder

Tiffany M.

CM220-17

        If you discovered that your child had a disorder, you’d do anything to fix it, right?  Some parents are going to great lengths to “fix” their children, including extensive pharmacological therapy.  In fact, the incidence of children using prescription medication has more than tripled in the last twenty years.    However, it does not statistically make sense that an epidemic of psychiatric illnesses and behavioral disorders would present so suddenly.   This is cause for great concern when it comes to unnecessarily medicating our children.  Therefore, many children with behavioral and emotional disorder do not require pharmacological treatment, because of the questionable existence of disorder, risky and sometimes unknown side effects of medication, and serious ethical concerns surrounding the topic.

Disorder is a term used frequently in the field of Psychology and in Psychiatric practice.  Merriam-Websters defines disorder as “to disturb the normal functions of” (Merriam-Webster Online.  2010.)  A childhood psychiatric disorder or behavioral disorder would, in this vague terminology, cause dysfunction in certain aspects of their life, if not globally.  However, being met with challenges and discomfort is a recognized part of the natural process of maturing into an adult.  The way in which each individual handles these challenges and expresses themselves uniquely is part of their innate personality.  When we begin naming personality traits as being dysfunctional or part of a disorder, then we begin classifying unique behaviors as distinctly acceptable and unacceptable.  For example, there is a new birth control medication on the market named Yaz, that has been named the only oral contraceptive that will reduce mood swings during a menstrual cycle.  Many teen girls have been prescribed Yaz for a naturally occurring ailment!  Yet, many will not hesitate to classify “mood swings”, however small or brief, as symptomatic of a disorder, when it is really just a part of the regulation of hormones in the newly developing sexual system; thus, it is a part of a maturing woman’s life.  Then it will become a question of whether an active, extraverted child has symptoms of ADHD, a shy, sensitive child has Major Depressive Disorder, or a socially awkward child has Pervasive Development Disorder.  Even the DSM-IV states that “neither deviant behavior nor conflicts that are primarily between the individual and society are mental disorders” (DSM-IV. 1997.)  It is a subjective point of view of what is “normal” and “abnormal” childhood behavior that makes the diagnosis.  The point is, children are still in the process of developing and their expressive symptoms are not necessarily resulting from a suspected disorder and may better be explained by environmental or physical stressors.  It may be better to take into consideration that this may just be the child’s response to their environment, provoked by their unique personality instead of haphazardly slapping on a label and pumping the child full of medication to make them comply with society’s idea of normality.

It is these reasons and more that there is a suspected epidemic of over-diagnosis and therefore over-medicating children in our country.  Labels such as ADHD, behavioral disorder, and emotional disorder are leading parents searching for answers and doctors and pharmaceutical companies to provide them in the form a pill to answer their prayers.  “American children are taking four times as much psychiatric medications as any other country in the world” (Frontline, 1999) although the rest of the western world has the same medical technology and advancements.  One of the reasons may lie with the legislation of free education and related services for those with disabilities, known as the Individuals with Disabilities Education Act being passed into law in 1990.  Many parents and educators saw the advantages of additional assistance, services, and educational grants.  The average number of children taking medication in two to three in each classroom (Frontline, 1999).  “About ten percent of ten-year-old American boys are taking such medicine” (Washington Post, 2006).

There are a great deal of often overlooked or negotiated risks for taking prescription medications, including cardiac arrest and suicide.  In October 2004, the Food and Drug Administration released a list of psychiatric medications suspected to increase the risk of suicide in children and young adults (National Institute of Mental Health. 2010).  The National Institute of Mental Health sought to investigate this claim further.  They discovered in a 2006 study that there were no completed suicides by a vast increase of suicidal thoughts and behaviors (National Institute of Mental Health, 2010).  However, many of these medications are fairly new, such as Abilify and Yaz, and have not had been thoroughly tested.  Yaz, an oral contraceptive used to treat mood swings associated with menstrual cycles, is now showing a higher incidence of women developing life threatening blood clots.  Even medications that are much older are starting to show new effects when prescribed to a larger population.  The Washington Post reported in 2006 that ADHD medications, including Ritilin, first created in 1955, were about to carry their own “black box” warning concerning the risk of sudden cardiac arrest.  Many medications of all varieties, including Yaz and Lamictal, have warnings about Stevens-Johnson Syndrome.  Stevens-Johnson syndrome is a life threatening skin rash resulting in an allergic reaction to a medication, therefore it is possible that it can happen with all medications, including over-the-counter pain relievers.  Plainly said, there is no safe medication.

Long term side effects and consequences of many medications are still very much unknown.  However, researchers are starting to have an inkling and the prognosis is bleak.  Anti-depressants are found to cause neurogenesis, or new brain cell growth, but the implications for children are unclear (Homes, 2005.)  Evidence from research concludes “that the use of neuroleptic and psychotropic medication makes long-term, if not permenant changes in the brain structure” (Sparks and Duncan, 2004.)  Unfortunately, there is no research available for lifelong usage effects since prescribing these psychiatric medications to children is a fairly new trend.  In fact, it is advised that long-term treatment of adults on the same medication must be reviewed, such is the case in Lamictal.  Lamictal is the only FDA approved medication for treating Bipolar Disorder, besides Lithium.  Research on the Lamictal website is provided but only for as long as 18 months.

Medications also have side effects that are not life threatening but carry huge consequences.  Many anti-depressants and benzodiazapines, prescribed for anxiety, cause weight gain and drowsiness.  This may adversely affect their already damaged self-esteem and their overall functioning, both in the academic and social area.  Oppositely, medications for ADHD may cause patients to lose weight and while that may be desirable for females, it may not be for males, who are the typical patients.  Many mood stabilizers cause hair loss, irregular and painful menstrual cycles, and acne.  Sometimes, in the cases of sleep and appetite changes, doctors will prescribe another medication to combat the side effects.  (Breggin, 2010).  Although psychiatric medications have been proven to be effective in a number of cases to treat a disorder, they may have unwanted side effects when it comes to an aspect of their personality.  Many patients with Bipolar disorder report feeling “emotional deadening” when using mood stabilizers.  Others who are prescribed these medications, particularly those who are the more creative type, feel less like themselves and the medication “completely took your inspiration away” (Smith, 2010).  This leads us back into the original argument that some dysfunctional traits associated with disorder may be an integral part of one’s fully functioning personality.

Then, there is the concern of misdiagnosis.  Often, mood disorders can be misdiagnosed (DSM-IV, 1997.)  Major Depressive Disorder may be a result of an environmental cause, such as a bad home or school experience.  Bipolar Disorder is often misdiagnosed as Major Depressive Disorder, Schizophrenia or Attention Deficit Hyperactivity Disorder when either the depressive or manic episode is more prevalent.  Most of the symptoms that occur in childhood Bipolar Disorder are atypical (Weller, 2002.)  A single misdiagnosis can cause years of agony for the child and delay the psychological help that is desperately needed.  Not only are these children still plagued by a disorder, but they are treated with potentially toxic medications that do nothing to ease their symptoms, often reaching a disturbingly high dosage.  The illusion that is created when a host of medications do not work is that these children are damaged beyond repair.  Many teens may seek to start self-medicating by using illicit drugs and alcohol.  The National Institute on Drug Abuse examples comorbid mental illness by stating that “people addicted to drugs are roughly twice as likely to suffer from mood and anxiety disorders” than the general population (NIDA, 2009.)  All of these issues combined can generate the potential for more serious problems like delinquency, promiscuity, delayed development in the cognitive and social areas, poor academic performance, and dropping out of school altogether.  Worse, misdiagnosis can lead to death.  One family had both of their daughter’s lives taken, one by overmedication and the other by misdiagnosis.  Two daughters in the Hall family were both diagnosed with ADHD.  One, Stephanie, died the very same day her medication was increased.  The other, Jenny, began to have seizures and was later found to have brain tumors that mimicked ADHD.  It is wise to have a second opinion and have all of the other factors checked into before settling into a diagnosis.  According to Janet Hall, “Don’t trust your doctor. Question him over and over. If you are not happy with what he says, if you have an intuitive feeling that something doesn’t seem right, it’s not. Get second and third opinions. It may not seem reasonable to have to go to that extent, but if it’s at the price of your child, it is” (Null, 2001.)

These concerns raise a great deal of ethical issues revolving around the issue of medicating children.  Children certainly have rights, but those rights are being violated when they are forced to take medication.  One mother, Robin, went as far as getting a court order to force her son back on medication (Frontline, 1999).  Children in psychiatric wards are being dosed through “chemical restraint”. (The Columbus Dispatch, 2005.)  Children should have a voice.  Some would say that highly medicating a child borders on abuse.  Forcing children to take medicine when they refuse violates their rights.  After all, it is their bodies and their minds.  The long term consequences are their own to bear.   It should be their decision ultimately, because we cannot “discount the accuracy of the youngest voices to tell us what is working and what might help” (Sparks and Duncan, 2004.)  Honestly, professionals and parents alike only rely on circumstantial evidence, colored by personal emotion and investment.  If a parent puts faith in a medication to solve the problem, then the slightest progress can be magnified.  However, the only person who really knows is the child.

Contrary to popular belief, many children who remain unmedicated or are only medicated for a short period of time have a great prognosis.  In one of the longest research studies done on the performance of Ritilin versus Behavioral Therapy for ADHD, Ritilin patients only slightly outperformed the BT group.  After a six month follow-up, the BT group was maintained throughout the 14 month study.  More impressive, the BT group was the only intact group after the 24 month follow up!  Most parents see the best results through at the very least combined therapy, and the medication is often short-term when it is felt necessary.  That is why “nonmedical intervention particularly important because effects of stimulant medication, though beneficial in the short term, do not last beyond medication termination” (Sparks and Duncan, 2004.)  The same goes for any medication.  Once the medication is terminated, the noticeable changes and advancements seem to disintegrate.  In many cases, Behavioral Therapy and Cognitive Behavioral Thearpy are a better route to go.  Although they may not produce the instantly gratifying results that American’s are so accustomed to, the long term benefit outweighs everything.  As we’ve previously discussed, no medication is safe and therefore cannot be expected to be maintained for life.  Therefore, if we build the skills within the child to manage their condition, then they can live medication free and have full, happy lives.

In the end, it’s all about the happiness and health of the children.  Many parents are desperate for the quick fix to the problem, due largely in part of parental anxiety.  The other part is most likely the strain that disorder brings into the family and their lives.  Yes, medication will provide the relief that parents and children may be looking for, but will it in the long run?  Many times, we’re used to focusing in on the smaller picture, the point of the problem, rather than standing back to examine the bigger picture.  Parents and doctors do not stop to think seriously about the dire consequences that medicating their children and patients may have.  Children have needlessly died, been brutally tortured without having a hand laid on them, and suffered at the hands of medical science.  Parents beware; fight for your children’s lives, protect your children’s rights, question everything and get as many opinions as you need before taking the leap into medicating your precious babies.

References

Antidepressant Medications for Children and Adolescents: Information for Parents and Caregivers. (2010, March 16). NIMH. Retrieved March 16, 2010, from http://www.nimh.nih.gov/health/topics/child-and-adolescent-mental-health/antidepressant-medications-for-children-and-adolescents-information-for-parents-and-caregivers.shtml#Bridge-JAMA

Antidepressant Use in Children, Adolescents, and Adults. (2010, March 2). U S Food and Drug Administration Home Page. Retrieved March 15, 2010, from http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/UCM096273

Antidepressant Use in Children, Adolescents, and Adults. (2010, March 2). U S Food and Drug Administration Home Page. Retrieved March 15, 2010, from http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/UCM096273

Comorbidity: Addiction and Other Mental Disorders – InfoFacts – NIDA. (n.d.). National Institute on Drug Abuse – The Science of Drug Abuse and Addiction. Retrieved March 15, 2010, from http://www.drugabuse.gov/infofacts/comorbidity.html

Diagnostic and Statistical Manual of Mental Disorders (DSM IV). (2004, May 15). Psychology Classroom at AllPsych Online. Retrieved March 15, 2010, from http://allpsych.com/disorders/dsm.html

Gaviria, M. (Director). (2001). FRONTLINE: Medicating Kids [Documentary]. USA: Pbs (Direct).

Holmes, L. (2004, June 16). Should Children Take Antidepressants?. Mental Health – Information on Mental Health. Retrieved March 16, 2010, from http://mentalhealth.about.com/cs/psychopharmacology/a/kidzoloft.htm

Lanham, T. (2010, January 14). Mindy Smith on the rebound. San Francisco Examiner. Retrieved March 15, 2010, from http://www.sfexaminer.com/entertainment/Mindy-Smith-on-the-rebound-81337537.html

McEvoy, V. (2008, August 11). Go slow on medicating children. Boston.com. Retrieved March 15, 2010, from http://www.boston.com/news/health/articles/2008/08/11/go_slow_on_medicating_children/

Mercola. (2000, August 13). US Courts Forcing Parents to Medicate Children. Natural Health Articles – Latest and Current Health News and Information by Dr. Mercola. Retrieved March 15, 2010, from http://articles.mercola.com/sites/articles/archive/2000/08/13/courts-adhd.aspx

NIMH · Mental Health Medications . (2010, February 24). NIMH · Home. Retrieved March 16, 2010, from http://www.nimh.nih.gov/health/publications/mental-health-medications/complete-index.shtml

Null  , G. (n.d.). The Drugging of Our Children. American Family Rights Association :: The Voice of America’s Families©. Retrieved March 17, 2010, from http://www.familyrightsassociation.com/bin/white_papers-articles/drugging_our_children/#1

Pyle, E. (2005, April 25). Forced medication straitjackets kids. The Columbus Dispatch. Retrieved March 17, 2010, from http://www.dispatch.com/live/contentbe/dispatch/2005/04/24/20050424-A1-00.html

Sparks, J., & Duncan, B. (2004). The Ethics and Science of Medicating Children. Ethical Human Psychology and Psychiatry, 6(1). Retrieved March 15, 2010, from http://psychrights.org/research/digest/ADHD/MedicatingKids.pdf

Stevens-Johnson syndrome: Causes – MayoClinic.com. (2009, April 10). Mayo Clinic medical information and tools for healthy living – MayoClinic.com. Retrieved March 15, 2010, from http://www.mayoclinic.com/health/stevens-johnson-syndrome/DS00940/DSECTION=causes

Vedantam, S. (2006, February 10). Warning Urged for ADHD Drugs. washingtonpost.com. Retrieved March 15, 2010, from http://www.washingtonpost.com/wp-dyn/content/article/2006/02/09/AR2006020902325.html

Your Legal Right To Refuse Medication. (n.d.). Advocacy, Inc. – Home Page. Retrieved March 17, 2010, from http://www.advocacyinc.org/IR8.cfm

Zimmer, G. (n.d.). DSM-IV, Diagnostic and Statistical Manual of Mental Disorders – Mental Illness, Disease, Health. Say No To Psychiatry – The Danger and Harm of the Sham Pseudoscience Known As Psychiatry. Retrieved March 17, 2010, from http://www.sntp.net/references/dsm_definition.htm

One thought on “Buyer Beware: Medicating Children with Psychiatric and Behavioral Disorder

  1. Pingback: Buyer Beware: Medicating Children with Psychiatric and Behavioral Disorder « Sunny With a Chance Of Armageddon

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