A Child Psychiatrist's Philosophy on Medication

 

Many people come into my office with some uneasy hostility to the process. Their child is in trouble - he may have ADHD or depression, an eating disorder, or a mood disorder. He may be oppositional or have a substance abuse problem; he may have separation anxiety, or struggle with Asperger's. They've been sent to me because somebody told them that this child may need medication. And here's the road.

I would prefer not to medicate anybody. I'm a big believer in psychotherapy, family dynamics and in severe cases, placing the child in a better social environment to help them grow. Depression treatment You want to put as little foreign material in the brain as possible because the mind has its own way of healing.

Yet, I medicate all the time. The parents will come in and they'll be upset. "I knew you were going to recommend medicine" (as if they were here for another purpose). "Can't we do it any other way?" The answer to that is usually no - not if they want it to be as effective as possible. The problem here is that the child is dysfunctional and medication is the only thing that can successfully aid the dysfunction to the fullest extent.

You see, children are a moving target. What you see at age 7 is different than at age 12. If a child has ADD and hasn't been treated within those 5 years, it can be extremely damaging. How many times has he been yelled at by his parents, how many times has he caused disruptions in school, how many times has he frustrated just about anyone? This is hard to deal with. These are precious years for the development of self esteem. So I tell parents that medicine gives them a sense of competence during these years and sometimes it's no longer needed when they're older.

I want this child to feel good about growing up, good about school, good about experiences with family and good about his connections to friends. If medicine can help this along the way, so be it. You have to remember that not treating somebody is also a treatment decision, and not giving medicine that can help is a decision to deprive the child of something that can make things a lot better for them. If you don't have a good alternative, then you may be giving a child a bad experience for years and he may not be able to overcome this. When the parents leave my office, they're sober in the assessments and generally agree to medicate their child. Years later they are usually grateful for the decision. It's a heavy decision to use medicine with your child- but it's a decision that could lead to a better life for your child as well.

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