Malika: Answering your question...

tictoc

New Member
Hi, In a different thread Malika asked a good question: If your child takes medications, what is he like without them?
Here is here quote:
"If your son is taking medication and his behaviour is still very disturbed and disrupting, what would he be like with no medications? I often feel confused about the fact that children who are medicated seem to be manifesting violent, aggressive or disruptive behaviour - making me wonder what the point of medicating is."

I'm sure the answer to this question is different for all of us and depends a lot on the child's diagnosis. My difficult child has Bipolar Disorder 1, among other things, and we recently had the chance to see what he was like with-o medications (due to an illness...long story). It was awful...His mood cycled multiple times a day and he was way more aggressive and violent than he is with medications. I will never again say--in a moment of frustration--that his medications are doing nothing. They might not do as much as we need them to do, but they definitely help. We had "forgotten" to some extent what life was like before our difficult child took medications.

With medications, our difficult child has some bouts of mild mania, but he doesn't have the horrible depressive drops afterwards. He can be irritable and whiny. Without medications, the mania is higher and the depression is dramatic and dangerous. Without medications, our son borders on psychotic when he is depressed.

The wrong medication can be worse than no medications, but the right medications can make life better for the child and the whole family.
 

BusynMember

Well-Known Member
My son does not need medications, but I do. I am suicidal and depressed without them and have anger outbursts. I am so different on them.

I never tell people not to try medication. I just think you have to make sure you have the right diagnosis first. I had a lot of BAD experiences on medications before I found the right ones. It took ten years to find the right ones, but even an antidepressant that didn't work as well as it should kept me alive and able to enjoy life some of the time.

My problem is with misdiagnosed kids/adults, like my son. If it's not bipolar or ADHD, the medications will make the child even worse. My son is on the autism spectrum and does really well medication free. I have mood dysregulation disorder, anxiety disorder, and severe panic disorder and can not function without medication. I can not even leave the house on my own...and, yes, I tried all sorts of therapy for it. Nothing worked for me but the medication.

Depends on the child and if the diagnosis is right.
 

Star*

call 911........call 911
My son tried or trialed over 65 medications and combinations of medications over a period of ten years. TWO that I know of for certain caused him to attempt and nearly be successful at suicide. One medicaton was Zoloft, which oddly enough was the same medication that was prescribed for me as an adult and caused me to have idealizations of suicide. Both of us wanted to use hanging as the way to leave the world. He tried twice. Once at age ten, and again at age 15. Both times nearly successful.

The other medication that made him suicidal was (I think not sure) Trazadone or Tramadol? It was a long T name. Other medications made him very violent. Abilify was one of them. Geodone was supposed to help and it made things worse. The tdocs kept giving him medications for BiPolar (BP) and we kept telling them he was NOT BiPolar (BP). Every time they gave him BiPolar (BP) suited medications? He became very aggressive.

Eventually around age 15 he just got to the point where he said NO MORE, and we agreed. None of the medications seemed to be the help or crutch he needed to even get him to a place that assisted him over any therapeutic hurdles, or helped him sleep. They had him at one time on so much clonodine we had to keep a mirror handy to see if he was breathing and at that point I said NO MORE. They never could help us with any medications or regime that would help with encopresis - and if you live with that, plus behaviors, and anger, and defiant disorder, and conduct disorder, and yadda so on and so on? It's like you find yourself standing in the middle of the room having a conversation with God - and just saying "No, really? twelve things? How about eight - and YOU keep the pants messing thing - I'll deal with the rest." Tack on a crazy x that is trying to hunt you both down and kill you, jobs that fire you and won't ever understand about your chlid having to leave school all the time - and a SCHOOL system that had NO clue about what YOUR kid was about - and NOW you can add MY medications to the mix - and we started with valium which did nothing. So We added AD's and well - back and forth - you kid yourself that you don't need any of it - but in the end - 15 years later? I'm fine with taking whatever I need PLUS therapy, PLUS friends, PLUS relaxation candles, tapes, walks, exercise, diet, eating well - taking to trees.........my higher power.......Does not matter to me WHAT I need to make it through the day - it was THAT bad, and however I can cope or HOWEVER I can help my kids cope? I'll take it.
 

InsaneCdn

Well-Known Member
medications... when they work, we wouldn't trade places with anyone. When they don't...

Depends on the child and if the diagnosis is right.
Its also important to have ALL of the diagnoses... we're working with multiple diagnosis and more to come - and the things that help one diagnosis, are a problem for the next! So it can be really tricky.

Start with the simplist, fastest-acting, "proven" options first... for example, for ADHD, the old standby is Ritalin (and the generics and alternative delivery mechanisms of the same chemical compound). You take it, and it has about a 4-hour half-life... in other words, half of it is gone from your body in 4 hours. It works - or it doesn't. Dosage can be adapted fairly quickly (we've done 1-week cycles... increase dose, measure results, increase again a week later, etc.). For some diagnosis, there are no "standby" drugs, and/or none without considerable side-effects. But it helps to start with the simplest class of drugs first where possible.

Where possible, one medication is better than multiple - fewer interaction risks, less chance of one medication causing problems for a different diagnosis than prescribed for. BUT - sometimes, one medication just won't do it.

Deal with the risk inherent in medication, in comparison to the risk without medication - if there is little benefit and definite risks, no need to go there... but for significant benefit and marginal risk, I'll take medications risk.

Biggest factors in medications are... right diagnoses, right professional working with the medications trials (NOT family doctor!), and right timing (if school is the source of anxiety, it doesn't work to adjust anxiety medications over the summer break...). And then, you have to monitor and update as they grow... some medications stop working (person develops "tolerance"), sometimes intolerances develop, sometimes puberty changes the effectiveness...

A couple of weeks back, we were wondering if K2 even needed to continue medications - things are going very well. Then, one Saturday (thank goodness not a school day!) K2 actually forgot to take the medications in the morning - and we didn't notice until after lunch... but BOY OH BOY did we ever notice the difference - totally draggy, nothing got done, "space cadet"... after spending the morning trying to kick butt and get her going... we discovered the un-taken pills. Ah-Ha! Ok, we know what's going on... bring on the black tea, we'll get you through the day (with lowered expectations!)... but yes, K2 needs those medications (at $127/month... wouldn't mind not needing to buy them, but...!)
 
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ready2run

New Member
our difficult child has alot of problems even though he's on his medications and i also wondered wtf he was taking them for if he still has all these problems... well he had to go off them for about 3 weeks and let me tell you the day we got the go ahead from the doctor to start him back on his medications was one of the happiest days of my life. during the three weeks being unmedicated he was threatening to kill people, assaulting people, got expelled from school, attacked his teacher with a pair of scissors, cut off all his hair and spent most of the week screaming and crying and threatening anyone in sight. yes, he is still difficult and violent medicated but nothing like before.
 
It's all a matter of degree. Yes, my medicated son will hit, yell, and be horrible. But unmedicated, he could rage for what felt like forever. I am not sure I would have a house standing if he wasn't medicated. It would be marvelous if taking a drug were like flipping a switch that made a "normal" child out of a difficult child. But even when that happens, there can come a time when the drug doesn't work anymore. Bodies change, brain chemistry changes. But I'll take my relative peace over the chaos that used to surround us any day of the week. Remember the quote about not letting the perfect be the enemy of the good?
 

Malika

Well-Known Member
Yes, I think that quotation is deeply meaningful - attachment to the perfect can be an enemy to the good. Yes, indeed.
The state of your medicated boy sounds rather like the state of my unmedicated boy.. so where does that leave MY decision-making about medications, if you see what I mean? I suspect I may be kidding myself that some sort of medication exists that is going to transform him into a shy, quiet, timid child who does not constantly cross boundaries of one sort or another....
 

BusynMember

Well-Known Member
For those who's difficult child's were worse after abruptly going off medications, the act of going off the medications also messes up the brain chemistry and makes you pretty screwy for a while. Unless it is an emergency, medications should be weaned slowly (except for stims). The one time I was forced to go off an antidepressant cold turkey I felt so crazy and even more suicidal than ever. The child needs to be off a few months before you get to see how well/bad he does unmedicated. Takes a while for the body to get back in sync.

I do find it disturbing that they try to medicate away every single symptom. in my opinion you can't. in my opinion also some psychiatrists overdiagnose and overmedicate. If a child has Autism Spectrum Disorders (ASD), for example, he will probably have signs of ADHD/anxiety/Obsessive Compulsive Disorder (OCD) and ODD because this is part of the symptoms of the big picture, which is Autism Spectrum Disorders (ASD). But medicating every symptom...I always had a two medication limit for my son. And, beyond Autism Spectrum Disorders (ASD), I sort of knew that the rest was part and parcel of that disorder. To me, if a doctor gives a child four diagnosis., he could be missing the big picture. My own experiences were that too much was as bad or worse than too little. I would feel like a zombie so I'd insist on being weaned off the least helpful medication. Since I was an adult, I could express myself well enough to help with my treatment.
 
H

HaoZi

Guest
I suspect I may be kidding myself that some sort of medication exists that is going to transform him into a shy, quiet, timid child who does not constantly cross boundaries of one sort or another....

You ever find that, I hope you share. I think the most you'd be looking for is something to curb his impulsiveness long enough for him to think a situation through better.
 
I wasn't thrilled about medicating my son when he was four, but we spent a fair bit of time trying other choices first and I wish I had tried the medications earlier. We would have all been happier. His therapist finally told me that even the wrong medication at the wrong dose (within reason, of course!) would be less harmful than all the stress hormones coursing through my son's body at that time. That made some sense to me. It took a few trials with different drugs, but the Lamictal has calmed the firestorm in his brain. I wish they had had something like that when I was his age. It feels awful to be so angry, so stressed, and constantly at war with the world. Now there is some peace. No, he isn't going to be shy and quiet unless he's so drugged to the point of semi-consciousness, but his life has improved with medications. All of our lives. It's sort of like if you're out in the cold somewhere -- a good down jacket with hood and ski gloves would be ideal, but you wouldn't turn down a good, thick sweater simply because it doesn't keep all of the cold away. And perhaps the right drugs could take your son from his current state to one so much better. We try add-on drugs every now and then to see if we can get difficult child up to something more closely approximating "normal".
 
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keista

New Member
Yes, I think that quotation is deeply meaningful - attachment to the perfect can be an enemy to the good. Yes, indeed.
The state of your medicated boy sounds rather like the state of my unmedicated boy.. so where does that leave MY decision-making about medications, if you see what I mean? I suspect I may be kidding myself that some sort of medication exists that is going to transform him into a shy, quiet, timid child who does not constantly cross boundaries of one sort or another....

Well, there is always hope you'll find the right medication. I never thought I'd medicate my own child at the age of 8 but I did. It's been two years of a roller-coaster ride. Every medication she tried had helped to some degree, but then she started with bad side effects/reaction. I don't ever regret starting medications. Life without them was sooooooooooo much more difficult than even the most difficult side effects/reactions. Right now she seems stable and is hew amazing self. There are still issues (Obsessive Compulsive Disorder (OCD)/hoarding/chronic disorganization) which medications alone don't help, BUT she stays calm enough where we can work on these things without her having a meltdown.

Running's analogy was a really good one. Becasue they all have a bit of a perfectionist in them, I'm constantly telling my kids SOMETHING is better than NOTHING. It's the same with medications.

by the way why would you want a "shy, quiet, timid child" - those qualities will bring on problems of their own.
 

exhausted

Active Member
We were lucky with our son. We started him on ritalin at age 5. He was so active and not focused. He was not a violent kid and did not rage. He did have some tantrums but not bad. We did use the Mandt system once(I had been trained at school), to hold him in time out-he never again left time out. We were lucky with him as we intervened early (sp. preschool and saw the neuropsychologist). He did not suffer in school the way I have seen many ADHD kids suffer with friends and work completion. I was firm and consistant,I used what then was the conventional wisdom-behavioristic methods. Neither my husband or I spanked him or screamed because we had decided before we had kids we did not want to do this-we had both had our bottoms beat many times and felt horrid about it. I won't say I didn't feel like screaming and spanking.This was successful for us-as I've said before he is a great kid and has been off medications. for sometime.

Our daughter on the other hand..... She was first diagnosed with ADHD at age 12-the stimulants blurred her vision so she had trouble playing ball and reading. Next the psychiatric. wanted to try an SSRI-our first hospital admit-when she reached therapeutic dose, she had suicidal ideation which she wrote and verbalized. Later on we tried Straterra and I thought we had some good results in combination with another SSRI-again when she was extremely frustrated, she threatened to end her life. At phospital the doctor, after less than 24 hours decided she was bipolar (something we had looked at for the previouse year and did not see). They medicated her on Seroquel. Once she was home and on full dose, she was irritated and dopy-she pushed my husband and I(never before was she violent) as she tried to run away. We took her off that stuff.
She is now on another SSRI and a sleeping medication. (PTSD makes her sleeping so difficult). She is in residential, so she seems ok, but I am worried at what point frustrations in the real world will make her ideation suicidal again. Her brand of depression is mild until she is tweaked and then she runs and does dangerous, stupid things.(Borderline traits). No medication is going to stop her behaviors, we only hope they slow her brain enough to benefit from the therapy. Medication did benefit our son in this way.

Though it is a difficult decision and it must be made kid and family by family, in my belief system, the brain is an organ in the human body that malfunctions like any other organ can. I would not withhold medication for a bad heart or kidney. The problem with the brain is it is so complex and children are developing. Many medications are not tested on kids and we don't know their effect. Unfortunate that we live in a pioneering time.

Noone can tell you what to do on this issue. You can see it has been a life saver for some and for others it only dims the behaviors. I will tell you I have seen many kids benefit over the years as a teacher. I have also seen that it can sometimes take years to fugure out (this is more rare in my teacher experience). I am the mother of one success story and one that I do not know where it will go story!
 

Malika

Well-Known Member
Thanks for these perspectives. (by the way, keista, I don't really want a shy, quiet, timid child - well, might be nice part-time :) - it was that English humour thing again...) To medicate or not is obviously a big decision and one that does not always seem to be treated with the careful consideration that it deserves from doctors/psychiatrists. I do have the sense of having time, of there being no urgency or rush; after all, there must be a clinical reason why these medications are not recommended for children under 6 in Europe... part of me is curious, obviously, to see what might happen, what improvements may occur, how my son's behaviour would change with medications; another part is scared of playing with what feels like fire. And you hear both sides - you hear that children treated with medications do better in adolescence, that children treated with medications do worse in adolescence, etc, etc. It is clearly a very individual thing. If there were something that could help my son meet with less social rejection, obviously I'm interested... but then what if part of that social rejection is just the very regulated, disciplined society we are currently living in??
Thanks for all your input and understanding. I feel the right thing to do is going to become clearer over time.
 
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HaoZi

Guest
but then what if part of that social rejection is just the very regulated, disciplined society we are currently living in??

I'd lay odds that's part of parcel of it all. A contributing factor to be sure, but not one that rules out diagnosis's being present, just one that aggravates the situation.
 

BusynMember

Well-Known Member
My oldest son (now 33) could be mean when he was young. Trust me, no kids like mean or aggressive kids and it doesn't matter that in our area "different" was accepted. Mean isn't accepted anywhere. He still had to learn how to be a good friend in order to have them. As a child, he was never medicated because he didn't have any childhood disorders that merited it and he wasn't difficult to us (his parents) or in school and he was a gifted straight "A" student.

But when he was around other kids, they happened to get hurt a lot and it was never his fault. He got into therapy. Amazingly, time outs worked magic for him. BUT we had to put him in a time out every time he did or said something that wasn't nice. For a while he spent a lot of time in time out. Then he seemed to learn that sitting in time out is no fun so he stopped his aggression.

He grew up continuing to have problems and they actually seemed to come out around age 13. He ended up having inherited almost ALL of my problems and is on medications...like me he is useless without them. This makes me sad and guilty that I ever had a biological child because he has so many mental health issues. Yet, he is functioning, has a great job, a wife and my precious grandson. For him, he NEEDS medications. So did I. My younger son DID NOT.

It is so very individual. Frankly, if my only option for my six year old was Ritalin, I may take a pass on that. I tried Ritalin and all it did was make me so hyper that I was shaking a nd, at the same time, fearless until it wore off and then I crashed into a despairing depression that lasted for months. I'm not a stimulant fan at all. My older daughter, who did drugs, said stimulants are widely abused. Teens crush them in pillcrushes and snort them alone or with other drugs. This is just my opinion, but if that was my only option, I probably would not use it.

One last comment of my worthless .02 :)) I would NEVER want to medicate any child to the point that he goes from high energy, spirited to totally calm. That is a red flag for being overmedicated and overly sedated. That has happened to me. It doesn't feel good, but you simply no longer have the will or energy to be yourself. It is a tricky happy medium that one must strike when trying medication, especially with kids. They lack the ability to express it when the medications are making him feel worse and often they just act out or veg out in a sedated state.

Having taken medications since age 23 (I am 57) I know pretty much the benefits and pitfalls of medication. It feels horrible to be so depressed that you are actively thinking about how to die. It feels just as bad to be in a total funk because of too much medication yet be too lethargic or confused to even think of a way to end it all. I was in three psychiatric hospitals. There are mixed feelings amongst the patients about medication. Some have had such horrible side effects that they refuse them, even though they know they will be sicker without them.

No easy answers here. Wish I had them.
 

InsaneCdn

Well-Known Member
Malika -

Even here (Canada), they don't like to diagnosis before age 6. We had to fight tooth-and-nail to get k2 a diagnosis at age 5.5... and medications to go with it. She had 2 years of preschool, with NO issues. But one week into Kindergarten, and the teacher was pulling her (teacher's) hair out... this "perfect little angel" was getting absolutely nothing done! (too much distraction - her attention was all absorbed in the rest of the world...)

But this was K2... so we already had some experience - with medications, with specialists, and some "off-the-record" advice... so, that's how we knew about trying the caffeine trick... its what kept her going for the first 6 months of school, until we could get medications. If caffeine had made her hyper (as it does for most kids), then we might not have started a stimulant so soon. Caffeine made her day go better - she got tea with lunch, as her class was in the afternoon - the teacher moved any "focus" work to the first hour of class, and she did OK. But medications had fewer side-effects, for her. (caffeine is dehydrating, for one, and can cause constipation, and has a 2-hour effective window with severe rebound effect...)

They told us that, one reason the specialists like to delay diagnosis to age 6, is that they need the teacher feedback both to do the diagnosis, and to get the medications adjusted correctly. We had enough feedback from the Kindergarten teacher, and the backing of the school's resource teacher - plus, we'd been through it before and the specialist team knew us.

We were less anti-medications, because I got my diagnosis a couple years ahead of the kids - just couldn't hold it all together any more. medications aren't perfect - but I know what they do, and can manage my own dosage schedule, and it makes life go better for all of us. It helps that I'm on the same chemical compound as the kids - just different delivery mechanisms - I know what it does and how it works and what it can't do... but not every parent has that option!!

(or maybe you're ADHD too?????? just joking!)
 

Malika

Well-Known Member
No, I don't have ADHD, Insane :)
Yes, you point to something that I think of a fair bit. J seems to cope with his kindergarten level now (though they sit doing "school" type stuff for extended periods) and I suspect that is because it is still quite fun and lightweight, obviously. Primary (elementary) school here in France is, frankly, dull as ditchwater - learning by rote, only one right answer possible, French grammar and mathematics all day long, little attempt made to make it fun and exciting for kids. And I just can't see J dealing with that very well - and his disruptiveness/inattentiveness may come to the fore. Though as mentioned, J seems far more hyperactive and impulsive than he is inattentive - though obviously those two qualities have an impact on attentiveness also.
I did try the caffeine experiment - he drank half a cup of quite strong caffeine and it just made him more hyper... The knowledge of/treatment for ADHD seems more advanced in the UK (where people complain, as they do in the States, of over-diagnosis and misdiagnosis) than here. But I don't really know that for sure, having proceeded only a little way down the medical/psychiatric path... I spoke to our general medical doctor the other day about J - he has seen him since he was three and has always said that he didn't think he had ADHD (another one!) and that he thought his hyperactivity was due to factors such as the adoption, my divorce, our moving around, etc. Now he says it seems clearer that, after a year of stability here, the hyperactivity is more innate than that... he now seems to accept that he may well have ADHD and said we have to monitor the situation carefully, via a pyschiatrist at the hospital. For whom there is, of course, as always a long waiting list.
Thanks for sharing your experience with medication, MWM. Do medications help with "meanness"?? In J's case, he is basically a sweet, sociable child but it all goes wrong frequently because he does not seem yet to have grasped that blurting out hurtful things or calling other children names when he is upset/thwarted does not go down well... Is there a medication that would magically help him stop doing that?? I suspect not... but find myself fantasising that there could be. And yes, that's right, to drug the lively spiritedness out of children does not seem like it could be a worthy aim...
But I am SO in the dark with it all! No clue about medications at all.
 

BusynMember

Well-Known Member
Malika, you asked a difficult question. If a child or adult is less frustrated, I think it the person becomes far more pleasant to deal with because he/she is happier and not so angry. And also when you can calm down and think clearly, you are not as apt to blurt out something you will regret. On t he other hand, I think the combination of medication PLUS some wonderful therapy combined to help me grow calmer. And now when I say something impulsive I am quick to see it and to apologize. But I do not believe that a medication cures all :) as I suspect you don't either. And every person responds to medication differently.

It's a very hard choice for a parent to make and I don't envy you. Your son is very young. In later years, he may be open to therapy that can help him slow down. Trust me, I am very hyper and had to learn to listen to my body signs and to slow them down myself...obviously your sweet little J. (and I do believe he is sweet) can not do that yet at four years old.
 
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