I was doing some random web surfing and came across the case of Rebecca Riley. You can google it or find an article here http://en.wikipedia.org/wiki/Rebecca_Riley The photo in this post is of little Rebecca, not Pajama Monster or Peep.
The upshot is that a little girl who was only 4, Pajama Monster's age, died after her mom and dad and psychiatrist drugged her to death. I'd like to say that I don't understand how this happens. After the fact many people spoke of the child walking into walls and needing to be carried because she was in a stupor. The sad fact is, I've seen this. I knew a child who was drugged to the point of inducing seizures and was functionally a zombie. Fortunately she had a very good psychiatrist who stopped the medication as soon as I reported this. The sad thing was that I only saw her after 9 months on those meds, and neither school, nor parent had said a word. The parents opposed stopping, but the psychiatrist didn't give them a vote, because he wasn't ok with drugging children into submission.
The point of my story? Not all pediatric psychiatrists are pill crazed maniacs. Actually, most aren't. An appropriately medicated child should seem normal. You should have no idea that they are taking anything. They shouldn't seem sedated or lethargic or have memory lapses. They shouldn't be extremely quiet and easy to manage. If you can tell they're on medication, especially at 4, then something is wrong. Talk to your doctor and tell them that zombie-preschooler isn't ok. Try a different dose or a different medication. How do you tell if they're overmedicated: when you see the meds and not the kid, or when anyone has any idea after meeting your child that he/she is on medication. That's how you can tell. Your child should have personality, and lots of it. If they don't, something is wrong. You should also never medicate anything that can be handled by other means. If your child isn't sleeping, move the bedtime, try a new bedtime routine, star charts, etc. If your child sasses you, use behavioral techniques or I'm sorry but you may need to grow a thicker skin. Meds are for problems that are hurting your child and making them non-functional. They're for the 2 hour fit and smashing walls and stabbed my sister with a fork kids. They're not a shortcut to compliant kids without the hard work of parenting. Most of us have climbed this mountain with caution and forethought and love, but sadly a few just want meds to shut their kids up and they're the ones that everyone sees when they think of childhood medication. They're also often the ones whose kids are reacting to poor attachment and poor parenting and don't really need the meds in the first place.
A child that is sleepwalking through their childhood is missing more developmental stages than I can count. As they fall farther and farther behind they will appear more and more immature relative to their peers. Also, don't mistake sedation for "good behavior." Many parents respond to this lack of development by requesting more meds. If your 8 year old has been a med-zombie for 3 years and acts like a 5 year old, tantruming and not sharing and poor manners...it's because he is 5. He's missed 3 years of his life and is stuck at the last developmental stage in which he was fully conscious. The problem is that even un-zombied he will have trouble catching up because severe immaturity is not well tolerated by other kids. Teasing and shunning will make him even more socially awkward. The safest bet is to never put him in that situation at all.
Rebecca Riley's case was tragic. It was horrible and there is simply no excuse for something like that happening, but it isn't a portrait of pediatric psychiatry. It is a portrait of medical abuse facilitated by a monster or an incompetent, possibly both. Sadly, people point to this as the reason children shouldn't be given meds. It isn't a reason to avoid medication. It's a reason to avoid incompetent psychiatrists (If they let you pick the meds and dosage, possibly even giving your child other people's meds...go elsewhere and also report them!). It's also a reason to watch your child carefully for sedation and other side effects. It's a reason for trying everything psychotherapy has to offer before even considering medication and for having a very thorough, not just one visit, evaluation done before considering medication. It's a reason for being open about your parenting, even the parts you're not proud of, and for allowing your child's team to talk to school and daycare, etc before prescribing medication. Medication isn't always the answer. It frequently isn't the answer. Think long and hard and try everything less drastic before considering medication, but don't rule it out because one parent did something truly horrible, That's like avoiding bathtubs because Andrea Yates drowned her children in one. Like Andrea's children, it was the sickness of her parents that killed Rebecca Riley.
In summary:
1. Don't mistake sedation for "good behavior"
2. Never try meds before you've tried every less invasive method. Yes, I know it takes a long time.
3. Never be afraid to seek a second opinion if the meds seem too much
4. A sedated kid is not a properly medicated kid
5. Meds are not a parenting shortcut and should never be used as one.
6. Some kids truly need meds. I know what that feels like. Have some sympathy for parents trying to find help for their child. Giving your child medication can be a decision made of love. Don't judge based on a glimpse. A bipolar child is bi-polar, meaning 2 polar opposites or 2 opposite ends of a spectrum. They bounce between extremes so of course they have wonderful moments. For many of us the decision to try medication is painful and frightening. Judgement only makes an already difficult decision that much more painful. Try to see things through our eyes before you tell us what we should be doing. We'll try to do the same for you.
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