Recently, a parent came to me, conflicted over whether to follow her pediatrician's recommendation of placing her young son on medication. His difficult behaviors had escalated in recent years and after trying behavioral strategies and food elimination diets, there simply hadn't been much progress in his maintaining himself. His behavior at school was deteriorating to the point where the teachers were concerned about his progress academically, psychologically and socially. When the medication suggestion came up, Jane (not her real name) was distraught.
"Drugs scare me", she said. "I guess it's an option I need to think about, but I'm not happy about it".
No parent loves the idea of using medications for children who are exhibiting behavioral problems and I believe that other strategies should be explored first, before reaching for the prescription pad. But for many, all the best parenting strategies, counseling sessions, elimination diets, exercise, etc. just may not be enough to help a child manage his/her behaviors- behaviors that can be dangerous to himself or others; behaviors that are unfortunately, out of his control, and that make him feel badly about himself. This poor self-regulation can cause him to be excluded socially, resulting in repeated reprimands, punishments, teasing and taunts till his self-esteem is totally shot.
We as Americans come from a mind set that if we'd just try HARDER, we can achieve anything. If we try harder, we can get into the top ranked university in the country. If we exert more effort, we can be the winning football team in the district. If we really wanted to, we can climb to the top of the socioeconomic ladder. If we put more effort into ourselves and into our children, we will embrace that American Dream of happiness, fortune and good health. Let's not kid ourselves.
All the hard work in the world will not, with few exceptions, change a child's neurology or biochemistry. Asking a child with, say attention deficit disorder, to try harder and concentrate, veritably backfires. Studies show that the part of the brain involved in executive functioning actually shuts down when forced to work harder than one is capable of doing.
The child with bipolar or other psychiatric conditions often simply can't "turn off her feelings". The autistic child who is overwhelmed by the onslaught of stimuli can't always find ways to self-calm and self-regulate his behaviors.
Under these conditions, it's important for parents to begin working through their own feelings about medications. Many reluctant parents worry that their child will be "drugged" into compliance. Or that he may become dependant or even addicted to medications. But in reality, what we discover is that these children NEED that external control- medication- to help them normalize. No child likes to feel out of control, different, depressed or anxious. Using medication as a way to help them feel IN control can change a child's life drastically, not to mention the health of the entire family unit.
When parents refer to the word "drugs" in discussing medications, I remind them that the connotation is a negative one and that it might be helpful to explore their fears and anxieties. Medications, when used as directed by a physician can be a Godsend, giving a child control over himself and drastically improving his quality of life.
So next time you cringe at the idea of medication for your child, think about it more as an aide, like wearing eyeglasses. If we are near sighted, we can squint as hard as we can, but that doesn't do much for improving our vision-we accept that there is a physical reason for our near sightedness and simply get fitted for glasses. Likewise, we need to recognize that when there is a chemical or neurological imbalance affecting our child's happiness and well-being, we need to be open to the idea of exploring medications to help balance his biochemistry so he can gain better control of himself. It's not a matter of trying harder; it's offering a tool, like the eyeglasses.
That doesn't mean that medications are always a magic bullet. We as parents still need to use behavioral strategies to help teach our kids appropriate ways to act. But until their neurology/biochemistry gets some medical support, it is often a waste of time to expect major changes. Again, it's like teaching our child to just "squint harder".
Re-framing the idea of medications in this way may make it easier to accept your doctor's suggestion. Questioning the professionals and their recommendations for medications is good. It shows that you care and that you want what is best for your child, rather than looking for a "quick fix". You want to use all the tools in your toolbox to help your child live the best quality of life possible.
Terry Matlen, MSW., ACSW, is a psychotherapist and consultant specializing in AD/HD in adults. She is the director of http://www.addconsults.com and myADDstore.com and serves on the board of directors of the Attention Deficit Disorder Association (ADDA). A popular presenter at local and national conferences, Ms. Matlen has a passion for raising awareness of the special challenges for women with AD/HD and the unique issues parents face when both they and their children have AD/HD.