Sharon: More than one parent (and too many educators) think stimulant medications are magic bullets that will radically change a challenging child like Theodore into a responsive, compliant, focused, accommodating individual who is happy and has great self-esteem.
Many parents are averse to medicating challenging children. Because there is no blood test for emotional distress or X ray that shows an imbalance in brain chemistry that may be affecting their child, they are unsure if medication is really needed. These same parents do not hesitate to use medication to treat bacterial infections or insulin to treat type 1 diabetes, but they do--and should--have serious reservations about giving their child medication for a condition that is not easily quantified. However, you cannot allow media hype, your own emotions, and pressure from well-meaning but ill-informed family members and educators to make the decision for you.
Medication is generally suggested for two reasons. The first is for short-term use to help a child get through a traumatic situation, such as depression because of a death in the family. In these cases, the child has no underlying chemical imbalance and stops taking the medication when he has recovered. More relevant for parents of challenging children, however, is that medication is often recommended when someone, hopefully someone who's knowledgeable in the field, thinks there is an imbalance in the child's brain chemistry. Some disorders like ADHD or obsessive-compulsive disorder are rooted in the brain's chemistry. In these instances medication is used to reestablish a delicate chemical balance, thus enabling the child to function better in daily life.
Naturally, parents want to ensure that medication is warranted. Responsible professionals feel the same way. They gather a great deal of information before writing a prescription for medication that affects behavior or emotions. Some challenging children, however, are not good candidates for medication. For example, medication cannot correct or even improve most learning disabilities. In other cases, the condition itself does not respond to medication.
The issue of appropriate use of medications is extremely complex. This book should not be considered a primary resource on types or dosages of medication. Nor do we mean to provide a detailed analysis of medication options for different problems, or medication side effects. Other books, such as Straight Talk about Psychiatric Medications for Kids by Timothy E. Wilens, M.D., better address the finer points of psychopharmacology.
Instead, we focus on issues that arise any time such medications are being considered, hassles parents encounter, and problems kids experience. We include recommendations for making the process more productive and less onerous. We focus on Jan and Jamie's decision to use medication therapy, Theodore's feelings about medication, and his opinion of the results.
This last point deserves special mention. As emotional as this topic may be for you, the parent, think how difficult it is for your child. A very young child will generally accept what you and the doctor say. Eventually, however, many will challenge it. "Why do I have to take this stuff?" "I'm tired of taking these pills." "None of my friends has to take medicine every day." By the time he is older, the social stigma and the need to be "normal" can significantly affect a child's feelings about taking medication. In addition, you may be making the process more difficult for him by telegraphing your own concerns.
Be proactive rather than reactive. The prescribing physician can tell you what concerns your child may have about medication and suggest ways to handle them. Talk to other parents whose children are on medication. Find out if other children your child's age (or a little older) are available to talk with your child. Teens will listen to their peers long before they will listen to you. A peer "medication mentor" can be ideal for an adolescent. Education is the key--both for you and for your child. There are excellent books written for children that also make wonderful resources for you. Those listed in the Resources section include several that may be helpful. Reading these before medication treatment starts will better enable you to predict and respond to your child's concerns.
A peer "medication mentor" can help your child, particularly in adolescence, handle the inevitable concerns that arise about medication.