August 1, 2023

Books

1/1/2020

Should You Medicate Your Child's Mind

Description:
Millions of parents are struggling with the decision of whether or not to medicate their children for psychiatric disorders from depression to ADHD to bipolar disorder. Now physician and psychiatrist Dr. Elizabeth Roberts explains the risks and benefits of medicating and not medicating children and demystifies and simplifies the process of separating psychiatric illness from the other more common behavioral patterns in children, particularly defiance, or willfulness. Dr. Roberts clearly explains what she discusses every day with the parents of the hundreds of children she treats. How is a parent to know which behaviors are bio-chemical and which are simply the result of willfulness? When should a parent seek a child psychiatrist's help in medicating their child? How can you find a doctor you can trust? When is it more appropriate to use behavioral techniques? Dr. Roberts' insight will be invaluable in helping families wade through all the contradictory recommendations that often come from the media, the Internet, teachers, relatives, friends and neighbors.

The Reviews are in...

Library Journal
May 15, 2006
Elizabeth J. Roberts, M.D.
Should You Medicate Your Child's Mind?: A Child Psychiatrist Makes Sense of Whether To Give Kids Psychiatric Medication.
Marlowe: Avalon, dist. by Publishers Group West. May 2006. c.288p. index. ISBN 1-56924-333-6. pap. $15.95. PSYCH
"What kind of information do parents want when deciding whether to give their child psychiatric medicine? Presumably, they are looking for timely, accessible advice from experts, which is just what these books provide (Kalikow and Roberts are both experienced child psychiatrists). In addition, they want information that is specific to their situation. Someone struggling with a hyperactive or aggressive child probably doesn't have the patience or the energy to read about the symptoms and treatments of depression. Roberts's book is better on this count, as it is arranged into chapters devoted to particular disorders and medications. Much of the same material is covered in Kalikow's guide, but it is scattered throughout the narrative. Indeed, Kalikow states that his goal is to illuminate the thought processes of a doctor as he makes choices about medication, not to list the uses and side effects of drugs. Yet it's nice to have something interesting to read, and Kalikow's book is definitely the livelier of the two, containing numerous anecdotes and a more in-depth look at the parents of one patient, 'Rosie,' as they struggle to decide how to help their anxious daughter. Neither book is a crucial purchase, though even the smallest libraries should have a few more specialized titles-at the minimum, one on childhood depression, one on anxiety disorders, and one on ADHD. For larger public libraries needing more material, these current titles are good supplementary works, with the Roberts book more likely to be checked out regularly."
Mary Ann Hughes
Neill P.L., Pullman, WA

"This is an outstanding resource for parents from one of America's most important child psychiatrists. If you are a parent with a child who is taking psychiatric medications, or you are thinking about starting your child on these medications, this is a must read." Tobias Desjardins, LCSW, family mediator, creator of the Divorce Survivor workshop series
"A carefully thought out, down-to-earth analysis of a sensitive problem many parents face. It should be reassuring to lots of moms and dads."
Thomas W. Phelan, PhD
Author of 1-2-3 Magic: Effective Discipline for Children

"Any parent who is considering placing their child on psychiatric medications should first read this book. Dr. Roberts takes an extremely complicated issue and, using common sense and solid medical knowledge, distills it down to no-nonsense advice that is enjoyable and informative to read."
Bryan D. Yates, MD
Psychiatrist

From the Foreword:
"What you need is not propaganda from either side in the war. What you need is the truth, which is almost certainly in the middle. Thankfully, Dr. Elizabeth Roberts has written this book, a practical, hands-on, no nonsense guide to making one of the most difficult decisions in parentdom. She's laid out the issues, the confusions, the problems and the solutions without getting into partisanship in the war. Her allegiance is to you and your child, to helping you to neither give your child medications he may not need nor to avoid them when they might help. In this book, your child gets to be your child rather than a poster kid for either side of the war going on in psychiatry."
Drew Ross, M.D.
Psychiatrist

Should You Medicate Your Child's Mind?
A Child Psychiatrist Makes Sense of Whether or Not to Give Kids Meds
Excerpt:
"My inspiration for this book came from my clinical experience. After repeated encounters with children as young as three years old who had been diagnosed by their previous doctor multiple times, with simultaneous psychiatric illnesses and medicated with several different psychiatric medications, I knew something was wrong. As I sorted out each situation with each individual family they would ask me, 'Where could I have found this information before the mistakes were made in my child's treatment?' Parents asked me to write a book to help them navigate the sea of mixed, often contradictory advice offered by well-meaning teachers, neighbors and hurried pediatricians. They complained that most authors generally take an all or nothing approach. Authors usually present the extremes. They will either vilify or glorify psychiatric medication. Finding a book that approaches the subject in reasonable way is not easy."
Elizabeth Roberts, M.D.
Child & Adolescent Psychiatrist
Author

When children, who are spoiled, are diagnosed with Bipolar Disorder, a great injustice is done to the child. Though other people may benefit when a child is diagnosed with Bipolar, the one individual who really loses is the child. Merely for the want of decent parenting, it is the child who must be burdened unnecessarily with the label of a mental illness. Simply because weak parents want to avoid guilty feelings, it is the child who has to endure the side effects of the powerful psychotropics that treat Bipolar Disorder. Medicating an ordinary, bratty kid, based on a misdiagnosis of Bipolar Disorder is a tragedy. Sadly, a child's only advocate is the parent who lacked the courage to apply appropriate discipline.

Parents must put the needs of their children before their own when they seek a psychiatric diagnosis for their misbehaving child. A parent's efforts to avoid an uncomfortable confrontation with their belligerent child may spare themselves a headache but they hurt their child. When it comes to providing guidance and discipline to a child, the sooner, the better. The longer a parent waits to address their misbehaving youngster, the harder the job becomes. Rushing to a psychiatrist for absolution from their parental guilt, will not always correct a child's behavior problems and puts a child at medical risk. Unfortunately, families have no idea what risks they take when stepping into a child psychiatrist's office seeking medications for their misbehaving kid.

There was a time in the profession of child psychiatry when doctors insisted on hours of evaluation of a child before making a diagnosis or prescribing a medication. Today many of my colleagues in psychiatry make an initial assessment of a child and write a prescription in less than 20 minutes. Parents have reported to me that their pediatrician took only five minutes to assess and medicate. Who's the winner in this race? Parents eager to fix their child's problems, pressure doctors to provide fast relief. Unfortunately, most doctors usually reach for the one and only tool they are familiar with: medication. Medicine is what they know best, and often what the parent comes to expect from a child psychiatrist.

Doctors under the pressure of practicing in the managed care environment, will spend less and less time with each patient, and rush to a quick diagnosis, with little if any explanation to the family regarding the risks of the psychiatric drugs they prescribe. Well-intentioned but hurried doctors play the biggest role and carry the greatest responsibility in this complex system that drives the current practice of overmedicating children based on a misdiagnosis of Bipolar Disorder.


Doctors need to take the time to understand their pediatric patients better, and have the courage to deliver the bad news that sometimes a child's disruptive, aggressive and defiant behavior is due to poor parenting, not to a chemical imbalance such as Bipolar Disorder.

What I hope to impart to you is the importance of a careful, honest, and thorough evaluation prior to medicating a child. Don't be overly hasty to find the solution for a troubled child in the convenience of a pill. Psychiatrists need to have the courage to withstand the pressures placed on them by guilty parents or frazzled teachers. Doctors need to put the welfare and safety of their pediatric patients ahead of the push by their managed-care contract to get the assessments done quickly. Every psychotherapeutic intervention needs to be explored and implemented before a doctor reaches for his prescription pad. If a child must be prescribed medications, proceed with caution. Correctly prescribed, for a legitimate mental illness, a psychiatric medication can enable a child to function more normally. Properly prescribed, medications have the potential to save a child's life. Casually prescribed, they can destroy it.
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1/1/2020

Bipolar Children

Bipolar Children: Cutting Edge Controversy, Insight, and Research
Chapters Authored by:
Elizabeth Roberts, M.D. Child & Adolescent Psychiatrist
Lawrence Diller, M.D. Developmental Pediatrician
David Healy, M.D. Psychiatrist
Philip J. Landrigan, M.D. Pediatrician
Daniel Burston, Ph.D. Psychologist
Joanna Le Noury, Ph.D. Psychologist
William J. Purcell, Ph.D. Psychologist
Toni Vaughn Heineman, MHD Psychologist
Robert Whitaker Journalist

DESCRIPTION
Over the past decade and a half, there has been a dramatic increase in the number of children being diagnosed with Bipolar Disorder, an illness that was once considered rare prior to adolescence.

This book examines:
* Why the incidence of pediatric Bipolar Disorder has risen so dramatically
* New treatment guidelines published by the American Academy of Child and Adolescent Psychiatry for early onset Bipolar Disorder which advocate the use of mood stabilizers in combination with atypical antipsychotics
* The impact on children's health of a 'polypharmacy' treatment approach
* Cultural trends at home and school that contribute to children's emotional immaturity
* The greater likelihood in the current cultural climate that 'difficult' children will be labeled as psychiatrically disturbed
* Marketing pediatric Bipolar Disorder by pharmaceutical companies
* The value and limitations of the medical model as a framework for understanding early onset bipolar disorder

Excerpt
"Bipolar Disorder has become the diagnosis de jour for children who display any symptoms of irritation, anger, frustration, insomnia, sadness, or aggression. Regardless of the child’s circumstances, home environment, academic problems or social struggles, child psychiatrists and pediatricians are quick to diagnose Bipolar Disorder. Frightened children, bullied kids, abused children, grieving children, even kids making adjustments to new situations such as divorce, may share these symptoms of irritation, insomnia or sadness. Yet, clinicians from all disciplines of mental health are jumping to the conclusion that these kids must have Bipolar Disorder.

Of course, some children actually do have Bipolar Disorder. Other children, misdiagnosed with this disorder, also have a legitimate mental illness—just not Bipolar Disorder. Unfortunately, children whose symptoms more closely meet the criteria for other disorders such as Adjustment Disorder, Major Depressive Disorder, Anxiety Disorder, Post Traumatic Stress Disorder, Intermittent Explosive Disorder or Oppositional Defiant Disorder, nonetheless get tagged as Bipolar anyway. Due to the understanding that Bipolar Disorder is purely the result of a chemical imbalance, many clinicians believe that Bipolar children require nothing more than medications. Consequently, medicine is often the only treatment provided. Tragically, once the label of Bipolar Disorder has been incorrectly applied, the appropriate interventions and therapies for the actual diagnosis, may never be delivered.

Perhaps the most reprehensible misuse of this popular psychiatric diagnosis is its application to ordinary, belligerent children. Parents, teachers and clinicians now characterize the typical defiance, misbehavior and temper tantrums, of bratty children as Bipolar Disorder. Using the diagnosis of Bipolar Disorder, doctors are now justifying the sedation of these difficult children with powerful psychiatric drugs—drugs which have serious, permanent and sometimes even lethal side effects.

Unfortunately, when a normal but bratty child is misdiagnosed with Bipolar Disorder, almost everyone benefits. The schools get more federal funding for the education of their mentally or emotionally handicapped student. Once the child is medicated, the teacher has a more subdued student in their already busy classroom. Parents may benefit financially too, by getting an SSDI check for their child. Finally, the parents of bratty kids are not forced to examine their poor parenting practices. A diagnosis of Bipolar Disorder provides a parent the perfect excuse for their child's misbehavior: he has a chemical imbalance. Parents believe that a psychiatric condition absolves them of any responsibility for the child's problem behaviors. After all, parents understand that they have no control over chemical imbalances. Neurotransmitters, as parents understand them, are the responsibility of the doctors, they fall under the scope of a psychiatrist's influence.

When children, who are spoiled, are diagnosed with Bipolar Disorder, a great injustice is done to the child. Though other people may benefit when a child is diagnosed with Bipolar, the one individual who really loses is the child. Merely for the want of decent parenting, it is the child who must be burdened unnecessarily with the label of a mental illness. Simply because weak parents want to avoid guilty feelings, it is the child who has to endure the side effects of the powerful psychotropics that treat Bipolar Disorder. Medicating an ordinary, bratty kid, based on a misdiagnosis of Bipolar Disorder is a tragedy. Sadly, a child's only advocate is the parent who lacked the courage to apply appropriate discipline.

Parents must put the needs of their children before their own when they seek a psychiatric diagnosis for their misbehaving child. A parent's efforts to avoid an uncomfortable confrontation with their belligerent child may spare themselves a headache but they hurt their child. When it comes to providing guidance and discipline to a child, the sooner, the better. The longer a parent waits to address their misbehaving youngster, the harder the job becomes. Rushing to a psychiatrist for absolution from their parental guilt, will not always correct a child's behavior problems and puts a child at medical risk. Unfortunately, families have no idea what risks they take when stepping into a child psychiatrist's office seeking medications for their misbehaving kid.

There was a time in the profession of child psychiatry when doctors insisted on hours of evaluation of a child before making a diagnosis or prescribing a medication. Today many of my colleagues in psychiatry make an initial assessment of a child and write a prescription in less than 20 minutes. Parents have reported to me that their pediatrician took only five minutes to assess and medicate. Who's the winner in this race? Parents eager to fix their child's problems, pressure doctors to provide fast relief. Unfortunately, most doctors usually reach for the one and only tool they are familiar with: medication. Medicine is what they know best, and often what the parent comes to expect from a child psychiatrist.

Doctors under the pressure of practicing in the managed care environment, will spend less and less time with each patient, and rush to a quick diagnosis, with little if any explanation to the family regarding the risks of the psychiatric drugs they prescribe. Well-intentioned but hurried doctors play the biggest role and carry the greatest responsibility in this complex system that drives the current practice of overmedicating children based on a misdiagnosis of Bipolar Disorder.

Doctors need to take the time to understand their pediatric patients better, and have the courage to deliver the bad news that sometimes a child's disruptive, aggressive and defiant behavior is due to poor parenting, not to a chemical imbalance such as Bipolar Disorder.

What I hope to impart to you is the importance of a careful, honest, and thorough evaluation prior to medicating a child. Don't be overly hasty to find the solution for a troubled child in the convenience of a pill. Psychiatrists need to have the courage to withstand the pressures placed on them by guilty parents or frazzled teachers. Doctors need to put the welfare and safety of their pediatric patients ahead of the push by their managed-care contract to get the assessments done quickly. Every psychotherapeutic intervention needs to be explored and implemented before a doctor reaches for his prescription pad. If a child must be prescribed medications, proceed with caution. Correctly prescribed, for a legitimate mental illness, a psychiatric medication can enable a child to function more normally. Properly prescribed, medications have the potential to save a child's life. Casually prescribed, they can destroy it."

Elizabet J. Roberts, M.D.
Psychiatrist
Author
Order on Amazon