Did you medicate your child for mental health issues?

Parent Cafe
1

As I’ve posted before, i’m wracked with guilt about 8yo who is both blindingly bright and a passionate learner (would happily read books about science, nature and history for 10+ hours per day) and aggressive in school. By aggressive I mean spitting, kicking, jabbing with a pencil, and verbally threatening.

When he is not tasked with school work (complete this worksheet, write this essay) he is a very charming child. Typical school tasks trigger a defensive stance, avoidance behavior (ripping up the worksheet, breaking the pencil) and if those don’t work, aggression.

He has been diagnosed with autism (Aspergers profile) and generalized anxiety. He just finished a fresh neuropsych evaluation and we are awaiting the results.

He is in public school in a model inclusion program aimed to keep high-functioning spectrum kids with mainstream peers. However, many staff has voiced concern that his needs are too great for the program (who wants to get spit on?).

He is unmedicated. In two weeks we meet for the 3rd time with a child psychiatrist with solid experience working with his profile. She is recommending we medicate him with guanfacine (Intuniv, Tenex). I’m worried that it could:

a) make things worse - giving complex kids psychoactive drugs can have unexpected results
b) change WHO HE IS, flatten him out, extinguish his spirit
c) work for awhile, them stop working leading us down a rabbit hole of trying drug after drug, or medicating the side effects, etc.

I would love to hear from parents who have faced a similar “medication threshold” and what their experience has been – good bad an ugly.

Many thanks.

2

I have no medicated my own children but I did work for a long time with children on psychotrophic medications as an RN. You can inbox me if you have questions

3

I have also worked with children with a variety diagnoses inclusion ADHD, depression, anxiety, OCD, schizophrenia in an evaluation facility. I’ve seen medication work remarkably well with children when they are properly evaluated and monitored by a good child psychiatrist . My guess is that you know children right now who are properly medicated , but you have no idea that they are medicated . It truly is a personal
decision.

4

@Aspieration, have you found the Davidson Institite message boards?

http://giftedissues.davidsongifted.org/BB/

A lot of posters out there have gifted kids your son’s age. You may find more people dealing with similar issues than on these forums geared more for high school & college.

5

I ache for your son and your family. While our experience with the decision to medicate was much less fraught with worry–it was for a fairly straightforward ADD diagnosis–we came to the conclusion that all of our options to that point were unsuccessful, and he was suffering. Our son was not thriving in his academic or social life. He had no idea what it felt like to be successful in school, and the viscious cycle continued to grow ever more powerful. He had no idea just how “off” his behaviors were because they were all he ever knew. Once medicated, he said, “So this is what it feels like to be normal like the other kids.” It was that clear–for him. I know your situation is more complex, but I hope you are able to find a way (medicated or not), that allows your sweet boy a chance to feel successful, in control and happy. Hang in there.

6

Speaking as a pharmacist, Tenex has a well-studied safety profile. It’s been around for about 15 years so is well-studied (versus a brand new product which sometimes end up with unpleasant surprises after being released)
It was originally introduced to lower blood pressure but is now used in children for ADHD and impulse control and is shown to be effective for that purpose. (blood pressure and pulse may be monitored).

I understand your fears about losing your child’s “spirit” but I believe they unfounded in this case. I do not believe you would be “going down the rabbit hole” by trying this.

The decision of course is up to you but my personal thought is you should really consider trying this for your child.
It may or may not work as hoped but you won’t know unless you try.

If it does not work after a fair chance which may be several weeks (don’t expect overnight results)- the meds will be discontinued with no ill effect–he’ll be weaned off the drug (don’t abruptly discontinue the med)…

If it DOES work, you’ve given your son the chance to go to school and be accepted by peers and teachers.
He must want that as much as you want it for him. And you give your family a chance at normalcy which is a huge gift.

And…medications are given for a specific purpose. Life and children change. Just because he may need medication now does not mean he’ll need them forever.

7

Are you (and your child) OK with the way things are now? If so, then there’s no reason to medicate. If not, then I can’t see any reason not to give it a try. If it doesn’t work or if there are intolerable side effects, you can stop the meds. It’s not permanent.

8

When we were considering medication for our ADHD child, my husband said, “it’s a pill. If you don’t like what it does to him, don’t give him another one.” Trying medication is not a lifetime commitment.

9

Absolutely agree with both posters above me. If your son were diabetic would you be agonizing over the decision to medicate him? If he has a biochemical issue that can be addressed with carefully chosen medication, why would you not at least give it a try?

10

Thanks for the really helpful feedback. @shellz I originally flinched at the word “suffering” when applied to my son. It is not like we are Syrian refugees. But every day we are on pins and needles that he will hurt someone in school and most days have a variety of incidents. So @brantly no we are not at all happy with the way things are going. S1’s life is full of failure and as parents we are in constant anguish over S1. We are all under chronic stress and fear.

@gouf78 I really appreciate your professional perspective. My main concern is that a common side effect of guanfacine (tenex, intuniv) is irritability. Irritability is the #2 most problematic behavior we are seeing in S1 (the #1 problem being aggressiveness).

So I’m terrified that he will become more irritable, catalyzing more negative feedback from the adults in his life and - essentially - we would be punishing the kid for being on a drug we’re giving him.

My other concern is that he has a very specific triggering - school tasks (doing worksheets, and especially writing) but has so many strengths outside those triggers. He is a voracious reader, he loves discussing ideas with people, he loves to draw. I worry that he would lose some of these strengths.

Overall, I guess what I’m mainly worried about is that the container that we call school is just the wrong container for this child right now and that we are trying to drug him into submission.

But on the other hand, there is the larger container called “modern life” that he needs to be able to navigate.

I’ll likely be dead and gone in 50 years and he’ll be a 58 year old man with decades to go.

What if by (for example) homeschooling him, I’m actually removing him from a trajectory that could lead to independence.

Put another way, it doesn’t matter if he has a bright spirit and beautiful mind if he can’t deal with the mundane parts of life. The worksheets and essays of today are the bills and dull professional presentations of tomorrow. We all just have to to it. So better to get on that path of being forced to do what is asked of you now.

Sorry to ramble… I’m so lost on this mothering path.

11

I would like to say some positive things about homeschooling, particularly because all of the problem behaviors you mention are school-related.

Just as someone mentioned above that medication is not permanent, neither is homeschooling. Your son might not have the maturity right now to handle some of the specific requirements of school, but that could change over time. You could homeschool for now, and re-evaluate in a year or two.

School is not the real world. Your son can grow and develop with you by his side, living an interesting life in the real day-to-day world. You can be nearby to help him with difficulties.

I’m typing with thumbs and it’s tough! I can write more later if you’re interested. I also have a lot of resources for you to read. Let me know.

12

Rambles are okay.
Actually it is very helpful to know where you get your info from, how you feel and the concerns you have.
We can all learn.
It’s very valid.

Every drug has a side effect profile. Nobody would EVER take anything if they saw the whole profile.
(A lot of pharmacists won’t take anything!) It can be overload shock. Most of us learn to weed things out.
)
Drugs seemingly cause both constipation and diarrhea–at the same time. Sleepiness and sleeplessness–at the same time.
How can that be? Because every side effect that happens to anybody in a study is listed.
. Nobody reacts the same to any drug. It’s one reason why so many drugs exist. Even when they are in the same
" drug class" and supposedly act in the same way people react differently to any particular product.

The “irritability” side effect may be a side effect listed from lowering blood pressure.
Or in some cases be related to combining different drugs or be an extension of a diagnosis totally different from the one you are treating in your child.

Or poor monitoring and dose control.
It is near to impossible to extrapolate one person’s results when it comes to medications.

You will find “irritability” listed as a real threat in the internet world. Realize that the people who are thrilled with results from a medication don’t normally post because they already have their solution. The internet world can be very lopsided. You have no knowledge of the back story.

Ask your doctor about the specific triggers. It’s a fair question. Tenex helps with “impulse control” ( in autism) which fits totally into triggers. Perhaps some other cognitive behavior therapy would help in conjunction. What is their experience? Don’t be afraid to ask the questions. Make a list with your concerns.

You are afraid things will get worse if you start the medication.
. Studies (Emory has a fairly large one) says it does work positively.

13

Not a parent, but as I said on another thread, anti-depressants and anti-anxiety meds absolutely saved my life. My parents didn’t hesitate for a minute, just as they didn’t hesitate to treat pneumonia, asthma, or any other various ailments I had as a child.

14

It’s not “medicating him into submission.” It’s helping him by giving the tools he needs to be successful in the context of the life of a typical American child. His love for reading and learning won’t disappear when he takes medicine. This is not plastic surgery, where you change his appearance forever. What is the worst that can happen if you try the recommended medication for six weeks?

15

Hugs to you, @Aspieration You are in a good place here…with so many wise and experienced parents. Please keep us updated…we all hope for the best for you and your son.

16

“S1’s life is full of failure”

“but has so many strengths outside those triggers. He is a voracious reader, he loves discussing ideas with people, he loves to draw.”

I just want to point this out to you -your own words - with or without medication, his life is not “full of failure”! No matter what path you take, always ALWAYS nurture these strengths!

I also want to say, over the months you have posted about S1 here, I have developed a soft spot for him. Hugs and cheering you both on!

17

I have not dealt with the medication issue personally, so cannot offer firsthand experience. In addition to your decision about medication, I wonder if you could seek out some testing around the trigger of writing.

Some children that age have issues with hand strength and small motor skills that make writing both painful and frustrating. In this case, occupational therapy can help. Others may suffer from dysgraphia, which is maddening - particularly for a bright kid. There are strategies to address this as well.

This is all to say that while your son’s reaction to frustration is extreme and is one thing to address, the cause of the frustration may also be something you can try to address. Not sure if that’s helpful or just off the mark.

18

We wrestled with many of the same questions you did when trying to decide whether to allow our daughter to take medication for her mood disorder. In the end, though, we concluded that her life, in its current state, just wasn’t working. Therefore, it made sense to intervene any way we could.

Medication isn’t turning your child into someone else. It disrupts a pattern that is already broken.

19

@FrancescaBennett Homeschooling is something we have discussed. The main downside of homeschooling would be that I would need to leave my career. I just got a new job at the American Museum of Natural History, a job that enables me to have effectively no work commute (it is 10 blocks from our front step).

I would my lose my salary, my benefits, and retirement contributions (as well as my contribution to saving for college). I would lose my foothold here (it was really hard to get a job here!). There is a BIG part of me that would love to do it, but I think a major component of that is fantasy that it would make life less stressful and we would have fun learning and exploring together.

Maybe. But I could also see the possibility for tremendous burnout too. And I have S2 to consider. He’s only 6 and needs me fresh for his childhood too.

I think it is fair to say that S1 needs to be comfortable spending chunks of his day with people that aren’t going to be constantly vigilant and customize inputs to minimize his outbursts.

One of my biggest regrets is being too accommodating when he was a young child. He could have cried a bit before getting picked up. I could have insisted that we play a rules-based game before he got to disappear into a bin of legos. I really bent over backwards to create a safe space for him in the early days (so no games with rules, no playdates - too stressful, etc.), feeling like that’s what “good” mothers do. (Feeling guilt about being a working mom too, truth be told.)

I now feel that it is much more important that he learns to navigate the world with increasing independence, more than “be happy” or even “develop his talents.”

I’m still not sure about medication. Here is another way to frame it. Right now, all of his behavior is “him” whereas if we medicated, I worry we would be trying to figure out what is the kid and what is the medication. And there would be all these grey areas. Guanfacine makes you drowsy, so would refusing to practice piano because he was “tired” be kid or med?

I do hear all of the voices ( @romanigypsyeyes, @Massmomm, @brantly) urging me not to think lobotomy when it comes to psychotropic meds.

@abasket you have good taste.

20

Just want to give you a (((hug))).