The Medicalization of Childhood?

[DrPhil]

I am watching 20/20's show on foster children being prescribed drugs.

http://abcnews.go.com/Health/doctors...ry?id=15064560

The full episode should be available on the 20/20 website soon. http://abcnews.go.com/2020/

http://abc.go.com/watch/2020/166626


I find prescribing children drugs to be troubling and especially for foster children and other children whose young lives have already been chaotic.

What say you, GCers?

[DrPhil]

So, I watched 20/20 and thought of the Conrad Murray thread. 20/20 was talking about foster children being given multiple drugs. Some of these kids are being prescribed drugs by the age of 4. 4! 4!

One boy said "I was given drugs for ADHD, I'm not ADHD I'm just naughty...I was given drugs for bipolar disorder, I do not have bipolar disorder...I don't have any disorder...."

This little girl who was adopted was given 5 psychopathic(?) drugs for a number of mental disorders. They showed a tape of her "going crazy" and running around the house screaming. These drugs were messing with her head. How can some medical professionals say that CHILDREN have these disorders and need medication? Do they really need to change the brain chemistry of children? Is there no consideration of the side effects?

Another girl gained like 100 lbs from all of the drugs.

They talked about the case of little Gabriel Myers: http://www.cbsnews.com/8301-504083_1...46-504083.html

[KSUViolet06]

I have worked in the mental health field with teens/preteens.

Personally, I've seen amounts of anti-anxiety or psych meds prescribed to kids as young as 10/11 that are enough to put down a fully adult male.

The crazy part is that there are lots of parents who take their kid's behavior and self-diagnose it or compare it to another child's behavior then INSIST to the Dr. and any other professional that will listen, that Bobby has (for example) bipolar disorder.

Part of that comes with the "popularization" of certain disorders, too (if that makes any sense.) Ex: autism is very much in the "spotlight", these days, ergo more people tend to self-diagnose their kids with it based on like one or 2 isolated behaviors.

[PiKA2001]

Generally speaking I think it's ridiculous how people are so eager to take a pill to supposedly solve their (non) problems. Aren't they saying that 60% of kids have ADD now? I'm waiting for the day they start putting Ritalin in the water supply along side fluoride (which by the way is being blamed by some for causing health problems. You apply fluoride, you dont ingest it). I suffer from depression and I've yet to take any anti-depressants or any other mind altering chemicals to "fix" me. Ive heard way too many stories of people getting worse/more depressed/bat shit crazy after getting on a regimen of anti-depressants. I manage it daily with diet, meditation, and exercise and I couldn't be happier with the results.

[CutiePie2000]

This is a semi-swerve, but I really notice the "pushing" of prescription drugs when I am watching the Olympics on TV.

When I watch the Olympics on the Canadian feed, the ads are from companies like Tim Horton's Coffee, Petro Canada gasoline, and Royal Bank of Canada (RBC) and whoever else is the sponsor du jour for the Canadian Olympic broadcaster.

When I watch the Olympics on the US feed, the ads are predominantly from pharmaceutical companies for the sole purpose of pushing prescription drugs for depression/ashtma/heartburn/E.D./sleep disorders, etc. "Ask your doctor whether ______ is right for you".

It gave me reason for pause and not in a good way.

[AGDee]

This is the main reason I left the mental health field. All that anybody wants to pay for is to medicate people (adults and children) and ship them out of the hospital with little to no real therapy. It's ludicrous.

[Honeykiss1974]

I watched this and it broke my heart. These kids have no advocates for them.

On a personal note, my nephew is now 13 years old and his mother (I think she is bat sh*t crazy anyway but...) has had him on psychopathic drugs since he was about 6 years old. She sees something and will shop him around to doctors until she finally finds one that agrees with her and will put him on some medication. He takes bi-polar meds, sleeping pills, pep pills, and ADHD meds and honestly, I don't think he needs any of it. For example, when he was 7 years old, she said that he never listens to her so he must have ADHD (never mind that she never disciplines him) so she shopped him around from doctor to doctor until someone agreed and put him on a medication.

That behavior is from someone WITH a mom, so I can't imagine what foster kids go through - I'm sure drugs are thrown at them from every angle.

[christiangirl]

My 25 cents (it started off as 2 cents but I couldn't shut up).

Originally Posted by DrPhil

So, I watched 20/20 and thought of the Conrad Murray thread. 20/20 was talking about foster children being given multiple drugs. Some of these kids are being prescribed drugs by the age of 4. 4! 4!

This little girl who was adopted was given 5 psychopathic(?) drugs for a number of mental disorders. They showed a tape of her "going crazy" and running around the house screaming. These drugs were messing with her head. How can some medical professionals say that CHILDREN have these disorders and need medication? Do they really need to change the brain chemistry of children? Is there no consideration of the side effects?

1. LOL How'd you get from this to Murray? Just the overprescription piece?
2. The term is psychotropic drugs and they are WAY overprescribed IMO. I'm glad to work with psychiatrists who are very hesitant to prescribe anything to children, despite the push from insurance companies. That is a big part of it--those who are actually in need of psychiatric hospitalization often are not covered by insurance if the doctor does not prescribe anything so I often see prescriptions for very low doses of things (like doses so low they fall out of the range of what's even effective) just so they can show insurance they are on something.
3. @ the bolded: It's a tough call but there are definitely those who are in need. I have had severely depressed teens on my case load whose conditions did not improve with diet/lifestyle changes. The very scariest thing I have seen in my career so far was a psychotic 3-year-old. He was not prescribed anything because of his age but I would not have been against it because his condition was that bad. I had never seen anything like it and haven't since so I know it's not "the norm" at all but I no longer believe that kind of thing can't exist.

Originally Posted by KSUViolet06

Part of that comes with the "popularization" of certain disorders, too (if that makes any sense.) Ex: autism is very much in the "spotlight", these days, ergo more people tend to self-diagnose their kids with it based on like one or 2 isolated behaviors.

iAgree. Both bipolar and ADHD (among other things) are WAY overdiagnosed for numerous reasons, including because those are the ones the general public "knows" so once people learn of it, they think they see the signs everywhere. What are often results of inappropriate diet, lack of structure, normal hormone surges now merit medication and I think that can mess a kid up. Not just their brain chemistry but what message are we sending by telling someone their anger outbursts are abnormal but this pill will fix it? Being socially awkward =/= autism. Having bursts of energy followed by sleeping like a log =/= mania followed by a depressive episode. It's hard because there are children who really do need actual psychiatric help and parents ignore or disregard the signs and tell them to suck it up. Then you have the ones who are being pumped full of every drug on the planet and there's nothing wrong with them at all.

[christiangirl]

Originally Posted by AGDee

This is the main reason I left the mental health field. All that anybody wants to pay for is to medicate people (adults and children) and ship them out of the hospital with little to no real therapy. It's ludicrous.

I wanted to touch on this, too. We (my co-workers and I back when I had a full case load) are trained "therapists" who offer "therapeutic dialogue" (i.e., talk to our patients using some of our skills) but it's hospital policy that we don't provide "therapy." While I agree that therapy would be a much better help then meds in like 90% percent of cases (if not more), providing it in a hospital setting really isn't feasible. Being in a hospital is meant to be short-term stabilization for about 3-7 days, at least here. That's not a fast rule, just an average. I can do some brief, crisis-centered therapy with that but that leaves very little time for any real work. Therapy is a process that pulls out a lot of hurtful stuff then gives tools to heal it back up again. I keep trying to explain to patients' families (who are livid that we don't provide therapy), "Would you want to be responsible for ripping off a person's mask and exposing all the hurtful things inside of them then ship them back into the world before teaching them how to pull it back together?" The thing that would be most helpful is something that needs to be done outside the hospital which is why we will give a referral for an outpatient therapist to anyone who says they want to go. I hope that makes sense--I wish we could do more than that but that could lead to some dangerous situations.

[DrPhil]

Originally Posted by christiangirl

1. LOL How'd you get from this to Murray? Just the overprescription piece?

Yes, the Conrad Murray thread is about overprescription and medicalization.

[MysticCat]

Originally Posted by PiKA2001

Generally speaking I think it's ridiculous how people are so eager to take a pill to supposedly solve their (non) problems. Aren't they saying that 60% of kids have ADD now?

I don't know who "they" might be, but I've never seen or heard a figure -- at least from a reputable source -- higher than 10%.

Our son is on two different medications for ADHD. We tried everything we could think of before going the medicine route. We didn't consider medication until we had a diagnosis from a psychologists based on two days' worth of testing and extensive reports from us and teachers. After a horrible reaction to the first medicine we tried (depression) our pediatrician referred us to a pediatric neurologist, whom we see every 3 months to check on things. We consider the use of these medicines to be an aid while he develops other skills and coping mechanisms, not a permanent solution.

I'm in no way denying that overmedication happens or that some parents are sure their kids need drugs and shop around until they find a doctor willing to prescribe them. But I'm a bit bothered when the reaction to that is to slam the use of these medications or doubt the need for AD(H)D medications in children altogether. That's an overreaction that can foster an environment of shaming the kid who truly do need these medicines or dismissing what they deal with as not really real.

[DrPhil]

Originally Posted by MysticCat

That's an overreaction that can foster an environment of shaming the kid who truly do need these medicines or dismissing what they deal with as not really real.

Some consider prescribing medicines to children to be an overreaction that shames kids into thinking that their mere existence is problematic.

What is the middle ground?

The average family can barely afford medical services and neither has the time nor the money to seek different medical opinions. This is especially the case for foster children. I refuse to believe that so many children actually need these prescriptions. The prescription drug industry has boomed in the past 20 years. A review of the history of illicit and prescription drugs speaks to the different reasons for such a boom, including capitalism.

[DrPhil]

Originally Posted by MysticCat

I don't know who "they" might be, but I've never seen or heard a figure -- at least from a reputable source -- higher than 10%.

I think you're right in terms of formal/official diagnoses. Informal/unofficial diagnoses may be a different story.

[MysticCat]

Originally Posted by DrPhil

The average family can barely afford medical services and neither has the time nor the money to seek different medical opinions. This is especially the case for foster children. I refuse to believe that so many children actually need these prescriptions. The prescription drug industry has boomed in the past 20 years. A review of the history of illicit and prescription drugs speaks to the different reasons for such a boom, including capitalism.

I think these are valid points, and I think they point to bigger problems. And I'll also agree that as a culture we've bought into the promise of pills fixing everything.

But still, I think the conversation needs to be about the problem of overprescribing, not about the terribleness of prescribing at all. Sometimes, it is appropriate.

[DrPhil]

Originally Posted by MysticCat

I think these are valid points, and I think they point to bigger problems. And I'll also agree that as a culture we've bought into the promise of pills fixing everything.

But still, I think the conversation needs to be about the problem of overprescribing, not about the terribleness of prescribing at all. Sometimes, it is appropriate.

Prescribing at all is arguably overprescribing if we are talking about a 4 year old, for example.

Prescribing at all is arguably overprescribing if we are talking about adults and children who may not have the conditions that they have been diagnosed with.