Does my child need medication?

This is probably one of the most frequently asked questions that I get the first time I meet a parent who is planning to bring in their child for therapy.  I am a Social Worker and have a private psychotherapy practice which means I am not licensed to prescribe medication, however, many children I see have taken or are taking medication and I do refer out to psychiatrists, who do prescribe medication, if I believe a child is in need.

The short answer that I give to parents who ask this question is to do what I would do with my own children if I felt they needed medication: try everything else first!  This is just my opinion and it is not shared by everyone in my profession, however, while there was a decade or so that many parents were turning to pills to solve the problems for their children, this is not true today.  I do not mean in any way to offend any parent who has a child on medication, nor do I intend to say that all medications are bad.  I just think it is important to try everything else first.  Now, obviously, if your child is psychotic, they need medication.  More often, I have parents who bring in children who have experienced trauma and are feeling anxious or depressed.  There are many therapeutic techniques that can help with these issues outside of medication.  Before starting medication, I have a few recommendations:

1. Get a full physical with a doctor that is familiar with depression and anxiety.  Even mania can be attributed to physical ailments such as a thyroid issue, as are depression and anxiety.  Depression is closely linked to vitamin D deficiency and research also supports the use of fish oil to increase Omega-3.  In fact, in a recent talk training I went to, physician Andrew Weil taught us that fish oil and vitamin D, combined with regular, moderate exercise are more effective than medication for depression.  Now don’t go out and do these things because I said so please consult your or your child’s doctor before changing anything.
2. Start exercising.  In research with a control group who changed nothing, one group that used only medication and another group that introduced moderate exercise 3x’s/week for 20 minutes or more the group that exercised had the best results in treating mood disorders.  For kids I especially love exercise that gets them focused on controlling their bodies, dance, martial arts, qui gong, and yoga are all wonderful.
3. Look at the food you and your child eat.  I have seen more and more children developing food sensitivities.  The main culprits seem to be food dyes, sugar (you knew that), caffeine, and gluten.  I used to see a kid where you could tell if he got into the pretzels just by looking at him when he walked in the door because his sensitivity to wheat caused him all kinds of trouble.  This is the easiest (and the hardest) one to do because all you have to do (feel free to laugh here if your child is a picky eater like mine) is eliminate each category of food for about a week to see if you see a behavioral change.
4. Learn to meditate.  Meditation is good for just about everyone.  Even kids can meditate.  Just start small and work your way up to 10-20 minutes at least 3 x’s/ week.
5. Check out other alternatives.  Acupuncture and reiki- even with children- have both been helpful to my clients.  Don’t ask me what it does I just know it works for many people.
6. Let’s not forget talk therapy, art therapy, and play therapy are all helpful.
7. Learn EFT (Emotional Freedom Technique).  I use this tapping technique with most children and adults I work with at some point.  It is easy to learn and you can find out how by contacting a therapist who knows it.  They should be able to teach you in one or two sessions.

Like I said before, medication is not all bad.  I have seen quite a few children who have been helped by it, however, more and more, I and others in my field are looking to try alternatives first and with good reason.  Dr. Weil also pointed out more recent research that points to our bodies adjusting to medication in ways we did not expect.  For example, the study he cited found that people who took SSRI’s to increase serotonin production to treat depression also had the effect that once a patient stopped taking the SSRI, their brain had adjusted to making less serotonin as it became adjusted to allowing the medication to stimulate production.  He also used the example that acid reflux medication, when given to a group of young adults who did not have issues with acid reflux, actually ended up causing acid reflux issues in a significant number of participants after they stopped taking the medication.  Why?  Because their bodies adjusted to producing more acid to counteract the medicine to try to reach “normal” for their body.  My point is, there is still a lot we don’t know about medication, especially for children and that the long-term studies on psychotropic meds for kids just isn’t there yet.  Before putting our children on these medications, please, let’s consider less extreme alternatives.

March 28, 2012 Posted by help4yourfamily | help for parents, thinking about therapy? | adolescent, children, counseling, maryland, mental health, parent, parenting, psychology, therapy | 3 Comments

How to know when you or your child need a therapist

“I’ve thought about coming in for a long time but it just didn’t seem that bad.”  How many times have I heard these words?  They are usually soon followed by the wish that the individual or family I am seeing had come in sooner.  Many people delay going to therapy because things just don’t seem bad enough.  I would encourage families to start thinking of therapists not only as people you go to as a last resort, but also as a kind of preventative help, kind of like going to your primary care physician when you have a cold.  How often have you delayed taking yourself or your child to your physician only to find out that had you gone sooner you would have been better off- that cold was actually strep, or that cough was really asthma?  Many people delay for understandable reasons, we are all busy, but by going when the problem starts, you can often (just like in medicine) reduce the amount of time it takes to recover from whatever the issue is.  Take depression for example, a person who is in the early stages of depression takes way less time in therapy to get better than a person who has been depressed for years.

Many people worry that once you start therapy, you end up going for years.  While this is true for some people, there are many people who go only a few times and find relief.  In fact, I have had an increasing number of parents calling my practice who just want to come in for a check in and guidance in helping their child adjust to a major change such as a move, or the death or illness of a relative.  Sometimes I never actually see the child, but the parents want someone to help them tailor their response to a distressing issue for their child since, especially if you have more than one child you know every child is different and has different needs.  Once you establish a relationship with a therapist, even if it is short-term, then you can continue to refer back to that person if any issues come up in the future.

Some signs that a person needs to be seen for therapy can be subtle but if they come in groups, you would want to have yourself or your child seen.  They include:

• a sudden change in mood or behavior that does not seem to be going away.
• lower grades than usual on a report card.
• comments about feeling different from other people and not fitting in.
• excessive worrying or depression.
• an increase in challenging behaviors and/or bad moods.
• increasingly disrespectful attitude or tone with parents.
• sudden interest in death and dying.

If you see two or more indicators from the above list, I would recommend you contact a therapist.

Some indicators in and of themselves that indicate therapy is warranted include:

• a statement from someone (including young children) that they want to die.
• any previously untreated significant childhood sexual or physical abuse or neglect.
• anyone in a family where the parents are separated or divorcing.
• anyone who is self-harming (self-inflicted cuts, bruises, burns, etc.).
• anyone who intentionally starves themselves or makes themselves vomit.
• anyone who has become increasingly agitated and starts to make less and less sense (this could indicate a manic episode and needs to be treated)
• anyone in an abusive relationship (if you do not know if your relationship is abusive, I would recommend therapy).

When in doubt, just call a therapist in your area.  We all know it is part of our job to speak to people who are just not sure if therapy is right for them or their child.  I have had plenty of people who have called where I have told them they did not need to bring their child in (like the parents who called to ask if a young child playing doctor with another young child needed to be in therapy).  Other times, people have called who have been on the fence and I end up saying if X, Y and Z happen, call back but lets see if some of this self corrects.  For example, sadness over the passing of a grandparent is normal, however if the sadness interferes with daily activities after a few weeks then I would want to see that child.

If you are thinking your next step is to find a therapist, please stay tuned for future posts about finding the right therapist for you and your child and on therapy myths- debunked!

For more information on my practice, please feel free to look at my practice website: www.ahealingplaceincolumbia.com

March 28, 2012 Posted by help4yourfamily | help for parents, thinking about therapy? | adolescent, children, counseling, maryland, mental health, parent, parenting, psychology, therapy | 13 Comments