The use of medication for children has been an ongoing debate for decades. Medication seems to be winning. Use among children and adolescents has increased by close to 1,000% in the last 25 years. Proponents say the technology and understanding of psychological disorders have improved so much so that we can better identify and treat disorders. Opponents say pharmaceutical companies have been effective in marketing their drugs via commercials, hospital and office visits, and "evidence-based" studies. Here are a few stats (NIMH, SAMHSA, and DHHS):
• One child in 5 (20%)has a mental, emotional, or
behavioral disorder severe enough to cause some level
of impairment. At least one child in ten (10%) has a
mental illness severe enough to cause extreme
functional impairment.
• In 2006, 4.7 million children (8%) were reported to have
a learning disability;10% of boys were identified as
having a learning disability, compared with 6% of girls.
• Four and a half million children 3–17 years of age (7%)
were reported to have Attention Deficit Hyperactivity
Disorder (ADHD). Boys are almost three times as likely as girls to have ADHD (11% and 4%).
• Research indicates that depression is present in 1% of
children and 5% of adolescents at any given time.
These stats are alarming for most. Every parent I have worked with takes the idea of medicating their child very seriously. It's a decision that most struggle with and almost always make with a degree of skepticism, uncertainty, hope, and fear.
However, there is cause for caution. The statistics by themselves are concerning: 10% of children have some sort of disorder. Kids are generally crazy, but in the "I love you but you probably decreased my life-span by approximately 1-20 years" way. Four major concerns:
1) Psychotropic medications are developed for adults and happen to be effective at treating children with anxiety, depression, and other clinical issues. Drugs that have been developed to treat depression sometimes appear effective in the treatment of other disorders (bipolar, anxiety, OCD, etc.). Doesn't seem like an exact science. Very messy.
2) Our brains develop well into our late 20s. Science is gaining an understanding of the brain but there is still much to be learned. What is known is that our brains develop for the first 3 decades of life and one of the last areas to develop is the frontal lobe. The frontal lobe is involved in decision-making, critical thinking, and memory. Makes sense, right? We look back at poor decisions we made during childhood and adolescence and shake our heads, "How could I be so stupid?" Well, maybe it was immaturity but maybe it was our brain still developing. How does a psychotropic cocktail impact the developing brain? The science is still unclear.
3) Side effects of many psychotropic drugs can be the exact symptom you want alleviated. Common side effects of antidepressant and anti-anxiety medications include nervousness, concentration difficulty, irritability, moodiness, and changes in appetite among a host of others. I like to refer to these side effects as "the teenage years". I would argue most of you can think back to your adolescence and diagnose yourself with a psychological disorder?
4) What happens when someone experiences serious side effects or even worse, adverse effects (worsening of symptoms or development of new issues)? Most professionals either try a different medication or add another medication. So initially it was one medication, now it's two, three, or even four or more. Many patients report trying numerous medications until one worked. Scary stuff.
To be fair, empirical evidence suggests medication can be effective...in the short-term. Long-term studies generally show a waning effect in drug efficacy. Furthermore, it is still unknown what effects, if any, these drugs have on us over the lifespan.
So what then? Consult with a mental health professional. Get a better understanding of yourself and your psychological makeup. Develop strategies to manage life, implement them, and determine if it was useful. Rinse and repeat. If after some time (6-12 months) nothing is helping, then have a conversation with a mental health professional about alternative treatment which may or many not include medication.
As usual, feel free to share.
• One child in 5 (20%)has a mental, emotional, or
behavioral disorder severe enough to cause some level
of impairment. At least one child in ten (10%) has a
mental illness severe enough to cause extreme
functional impairment.
• In 2006, 4.7 million children (8%) were reported to have
a learning disability;10% of boys were identified as
having a learning disability, compared with 6% of girls.
• Four and a half million children 3–17 years of age (7%)
were reported to have Attention Deficit Hyperactivity
Disorder (ADHD). Boys are almost three times as likely as girls to have ADHD (11% and 4%).
• Research indicates that depression is present in 1% of
children and 5% of adolescents at any given time.
These stats are alarming for most. Every parent I have worked with takes the idea of medicating their child very seriously. It's a decision that most struggle with and almost always make with a degree of skepticism, uncertainty, hope, and fear.
However, there is cause for caution. The statistics by themselves are concerning: 10% of children have some sort of disorder. Kids are generally crazy, but in the "I love you but you probably decreased my life-span by approximately 1-20 years" way. Four major concerns:
1) Psychotropic medications are developed for adults and happen to be effective at treating children with anxiety, depression, and other clinical issues. Drugs that have been developed to treat depression sometimes appear effective in the treatment of other disorders (bipolar, anxiety, OCD, etc.). Doesn't seem like an exact science. Very messy.
2) Our brains develop well into our late 20s. Science is gaining an understanding of the brain but there is still much to be learned. What is known is that our brains develop for the first 3 decades of life and one of the last areas to develop is the frontal lobe. The frontal lobe is involved in decision-making, critical thinking, and memory. Makes sense, right? We look back at poor decisions we made during childhood and adolescence and shake our heads, "How could I be so stupid?" Well, maybe it was immaturity but maybe it was our brain still developing. How does a psychotropic cocktail impact the developing brain? The science is still unclear.
3) Side effects of many psychotropic drugs can be the exact symptom you want alleviated. Common side effects of antidepressant and anti-anxiety medications include nervousness, concentration difficulty, irritability, moodiness, and changes in appetite among a host of others. I like to refer to these side effects as "the teenage years". I would argue most of you can think back to your adolescence and diagnose yourself with a psychological disorder?
4) What happens when someone experiences serious side effects or even worse, adverse effects (worsening of symptoms or development of new issues)? Most professionals either try a different medication or add another medication. So initially it was one medication, now it's two, three, or even four or more. Many patients report trying numerous medications until one worked. Scary stuff.
To be fair, empirical evidence suggests medication can be effective...in the short-term. Long-term studies generally show a waning effect in drug efficacy. Furthermore, it is still unknown what effects, if any, these drugs have on us over the lifespan.
So what then? Consult with a mental health professional. Get a better understanding of yourself and your psychological makeup. Develop strategies to manage life, implement them, and determine if it was useful. Rinse and repeat. If after some time (6-12 months) nothing is helping, then have a conversation with a mental health professional about alternative treatment which may or many not include medication.
As usual, feel free to share.
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