Dear Tommies

I don’t quite feel like I fit in at my new Graduate School. This will probably pass soon after I finish my Statistics in the Behavioral Sciences class.  We had a movie in Stats the other day. It was the PBS Frontline production about overmedicated kids.  The video was really troubling.  They had about 3 kids, all of whom were on multiple medications, often one to treat the side effects of the other. One kid was clearly overmedicated. His eyes were unfocused and he had a disturbing head-rolling tic. Then there was the little girl who was  obviously not right in the head before medication, but pretty functional on her medication. Lastly was a boy who seemed way too young to be medicated. I think he was about 3.  Seemed clearly like a case of overmedication.

Witnessing the righteous indignation of my classmates after they watched the Frontline documentary about overmedicated kids I’ve come to realize how much being in the trenches as a mom has taught me.  Things it would be good for future therapists to know. I’m trying to write a rant that would actually benefit them and their clients (parents and children).  I’m having trouble coming up with something that isn’t totally vitriolic. Listen to a 22 year old talk about “Parents just need to get up off the couch and do the real parenting” or “Obviously the kid is learning that behavior from someone” or “parents should really try to do more with diet and environment”… Listen to that and think about  who you’ll be asking to help your frayed family.

Dear Psychology Grad-Tommies,

I know you’re smart. I know you want to help. I’m a parent. The vast majority of you are not. It shows. Realizing these few things will help you be a better provider. I realize that most of you are not parents yourself, and as such you are understandably ignorant of what really happens in a family from any perspective but that of a child. Parents have always been blamed for anything their children do or are that is unacceptable. This has happened forever. It’s not new, but it is old. Let me point out a few things that might have escaped your radar.

  • Most of you have no idea what it’s like to have a child at all, much less one who has a mental health problem. Stop judging long enough to listen.
  • If we (as parents) didn’t go and ask for help for our kids and keep insisting until something (meds or other) worked, in the unlikely event that the kid snapped, you’d all be shaking your heads and asking why we didn’t do something more.
  • Frontline has a good reputation, but never trust the media so much that you don’t question the editing of a piece such as the one you just finished watching.Remember that although PBS has excellent credibility, they are producing shows to get watchers. You have no idea what was edited out and how things were spliced together.
  • 30 years ago there was absolutely nothing that could be done for a troubled child. The suicide rate was significantly higher than it is now. When teenagers started on the SSRIs, the suicide rate started to decline. When the big scare about antidepressants and suicide in teenagers hit the press, parents pulled back on allowing their children to be medicated. The suicide rate skyrocketed just afterwards
  • Don’t believe every thing you think, everything you’ve been told and certainly not everything you see on a TV documentary or pharmaceutical company presentation.
  • It is just as likely (in fact, there is evidence) that the parenting style you are blaming for a child’s problems is in fact a response by the parent to the child’s problems. This is how we got the “refrigerator mother” theory of autism. It was bunk.
  • It is just as likely (in fact there is compelling evidence) that the adult you are treating for a mental health issue, the one who remembers being bullied or being leered at, or having a distant father or an overbearing mother, it is just as likely that this person is remembering things from a skewed perspective and focusing on the negative. That adult with a full flown mental problem was once a child with a budding mental health problem.
  • It’s very likely that the simple parenting skills (parenting 101) you are sure would solve the problems of an obviously spoiled or neglected child have already been tried by the parents you have judged to be incompetent. Most parents who are to the point of bringing a child into the clinic have tried the obvious (ignore the pleas for attention, give more attention, talk to the child more, make consequences clear, set clear limits, pick battles, etc.). Notice how many of those are contradictory. Know what that’s usually a sign of? Bullshit guesses.
  • Feel free to doubt the efficacy of medical treatment for mental health problems in childhood, because 30 years ago we didn’t have any of these drugs or any of these problems, right? Except maybe we did have the problems. And maybe we used to marginalize, institutionalize, bully, jail or tranquilize these kids because it was the best we could do. It was the best we could do. And it wasn’t good enough.
  • Feel free to maintain that it’s unethical to try treating kids with adult medications, but try explaining that to a mother who grew up in a family with a history of mental health train-wrecks. Train wrecks people for generations could predict from about kindergarten. Sure, generations of that family were just fine without medications (or even psychotherapy) in childhood. But they weren’t.

Not all troubled kids need medication, but rather than making up your mind that no children should be medicated, try opening your mind. They aren’t little adults, but they are little people. When little people can’t see, we get their eyes checked and get the little glasses if they need them. When little people have asthma, we treat them with real drugs. Of course we check their environments to see what else can be done, but we don’t judge parents who carry inhalers for their kids. Nor do we deign to judge them when the inhaler isn’t enough. But the minute a kid who is (or isn’t) medicated snaps and hurts someone, we all turn to scrutinize the parents. Do you know why?

If we’re not parents, I think we do it because we still blame many of our problems on our parents (although I’m not sure we’re always so generous with credit for our successes). If we are parents, we do it because the thought that our child might be capable of evil terrifies us, and we want to distance ourselves from this family. Not that we shouldn’t investigate every aspect of a catastrophically failed life. But we shouldn’t be so sure we know where to assign blame.

Pharmaceutical companies have too great an influence on doctors and parents. This is almost indisputable if you look at the data. Many kids are overmedicated. Many adults are overmedicated. Too many are medicated instead of getting therapy or lifestyle change. They should be getting all of it.

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4 thoughts on “Dear Tommies

  1. emily says:

    i also like to point out to people that depression and anxiety cause brain damage. the longer a person is depressed, the more damage the brain sustains. regardless of what else might or might not need changing in a child’s environment, it’s in everybody’s best interest — especially the child’s — to interrupt the progress of a mental illness as soon as possible. and also that physical and emotional pain are both easier to prevent than they are to treat once fully blossomed.

    people don’t always accept that from me, though. maybe they’d accept it from you.

  2. Nobody listens to me, Emily. But you’re right. I’m writing a paper right now that includes the point about early treatment preventing years of damage.

  3. Terry McDanel says:

    This is very well written and i really appreciate it. I am more skeptical than average than most about the pharmacological culture, but i am most skeptical about simplistic analyses human dysfunction. I think the good news is that we have so much potential in exploring the cultural, community, spiritual, medical …etc. responses to human problems that could lead to a richer life for all of us. But it is the same simplistic scientific reductionism that “the media” peddles, and the uninitiated often buys, that prevents us from spending our efforts on more holistic responses. Thanks.

  4. TJ says:

    Just read this, thanks. People don’t always appreciate the damage and scars left by a struggle with mental illness that affect people years after the illness itself is under control or treatment. I had a friend who likened the effects of depression to a car slowly running out of oil. To fix the problem, you put the oil back in…but you also have to repair what happened to the engine while the oil was gone.

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