This blog is my place to vent and share resources with other parents of children of trauma. I try to be open and honest about my feelings in order to help others know they are not alone. Therapeutic parenting of adopted teenagers with RAD and other severe mental illnesses and issues (plus "neurotypical" teens) , is not easy, and there are time when I say what I feel... at the moment. We're all human!

Monday, January 25, 2010

More on Medication

Hubby grew up in a 'don't take meds or see a doctor unless you're dying' household. He rarely even takes a Tylenol for a headache, and will only take an allergy med if he's completely miserable (for those of you who don't know, if you don't have allergies when you come to TX, TX will give them to you). Hubby cannot imagine taking meds for the rest of your life.

I grew up with a mom who was a doctor's daughter and in a military family (meaning we were human guinea pigs, but seeing a doctor was always free).  So I'm more likely to go to the doctor.  I take medication for a headache only if someone forces me to (luckily I rarely get headaches), or if a fever is at least over 103, if I'm so stuffed up I'm drowning, or if I have an infection... but I've been willing to take meds for my bipolar disorder when needed (which was usually when I'm under uber stress - like raising 2 kids with RAD and teens in general, but now that I'm in a stable place I'm trying again to see if it helps with stress and anxiety.)

I have 2 kids with major trauma and mental illnesses. They take meds for their bipolar disorder, and the one with severe ADHD takes meds for that too.  Hubby doesn't have a lot of problems with these (although he hates the sheer number of meds they take and the thought that they have to take them for the rest of their lives), but most of their major issues cannot be "fixed" by medication (C-PTSD, RAD...), and are trauma based not biologically based.

Experts say some symptoms (like insomnia, anxiety, restlessness, irritability...) can be alleviated, even though it doesn't cure or effect the actual diagnoses (like trauma based issues).  I'm all for medicating those too, because in my opinion you can't work on healing trauma if you can't sleep, focus, sit still, react normally to external stimuli (like someone saying, "you dropped jelly on the counter," which, in my opinion, should not trigger a screaming rage but has)...

So in the past Hubby's opinion was that I have allowed the kids to be over-medicated. I disagree. They are on lots of meds, but it took time to find the right meds and good combinations that worked for their individual body chemistry. They are already taking fewer meds than they did 2 years ago. I think a lot of this is due to the fact that they could focus on internal healing when their outside world didn't feel totally chaotic. (I hope it goes without saying that we are not addressing anyone's needs and issues with ONLY medications).

I think it's like surgically inserting a pin in the leg of someone with a shattered bone and giving them a crutch, a cast and major pain meds. The cast keeps things stable while the body works on mending and healing. The crutch helps them be able to do the things they would normally be able to do if they hadn't broken the leg (like walk and go to school). The pin is necessary to give the remaining bones something to heal around. There is scientific evidence that the body heals better when it is not in pain so you need the pain meds.

Some drugs are casts and crutches and will not be needed down the road. Other drugs are like the pin and the body wouldn't work without them. I will not allow my children to be drugged into zombies, and when the child is stable I will start looking at lessening or removing their meds (or amping up therapy treatment) - for as long as they continue to make progress healing.

Hubby obviously sees meds differently - maybe more like an engineer?
He feels it is possible to heal most things without medication. If you're "strong enough." You could use alternate methods to mend a broken leg that weren't as invasive or long term as a pin. You don't have to get up and move around so a crutch isn't totally necessary. Legs don't have to be straight to work so a cast isn't required either. We've all heard of "that guy" who was able to drag himself off a mountain and survive with 2 broken legs, 2 broken arms and nothing but a toothpick and a breath mint...

Hubby has probably been clinically depressed more than once in his life (although he'd never see a therapist or a doctor), but he survives without meds. He was diagnosed with GIRD and Allergic Rhinitis (not as bad as it sounds and has nothing to do with rhinoceroses although he coughs like one), but he ignores them and lives without meds (except for the occasional Tums). I don't know if it's a good thing that he's been depressed and know how it feels or a bad thing because he handles it without meds.

Most importantly, mental illness, especially non-biologically based illnesses like C-PTSD and RAD, in addition to not responding well to meds, are not like strep, diabetes, pneumonia or something where you see the results of taking or not taking meds.

Meds don't work the same for everyone. I tried Lexapro (recently mentioned in a comment by someone it works well for) and it was HORRIBLE for me! True, I was not feeling the overwhelming stress anymore, but I also didn't feel ANYthing! I was like a robot (and robots do not "cuddle" if you know what I mean). Plus, I started having horrible side effects that got even worse as I went off the med (which apparently is common - this is one scary drug). Bear tried Vyvanse which caused a horrible reaction for him (gastro-intestinal issues, tics, nausea, dizziness...).  Abilify worked like a miracle drug for Kitty, and didn't do diddly squat for me.

In recent news there've been lots of articles about children being over medicated in foster care.  Here's what I think:

Higher Likelihood of Serious Issues
I think one reason we see a high rate of prescription drugs for our kids is there is such a prevalence of mental illness in foster kids. I've seen a lot of "like attracting like" among my kids and other kids in the foster care/ mental health care system (can you say Kleenex girls?). 2 parents with bipolar disordered (or alcoholic or emotionally disturbed or whatever) often means scary genetics for the child. Plus, being raised by a mentally ill parent, frequently leads to abuse as well.  All leading back to children ending up in foster care.

Not only is my children's birth mother mentally ill, which was passed on to my children (bipolar disorder, ADD/ ADHD, GAD, Borderline Personality Disorder, insomnia...),
but they also have brain injuries (from unknown or multiple causes - genetic, FASD, injury during abuse...),
were most likely "pickled" in the "toxic soup" of anxiety hormones, drugs and alcohol in utero,
and then there's the trauma stuff causing PTSD, RAD, and night terrors,.
add in the genetics of their respective biodads (Like Attracts Like - )
... you get the idea.

Alleviating Symptoms
I know a lot of times there is a huge resistance to giving children meds, and while I agree that there are times some foster children are over medicated, I also believe that it often means kids are struggling and they can't heal if they feel like they are existing as though they are in the middle of a war zone or they are struggling with basic coping skills, unable to function.

In my opinion, you can't work on healing trauma if you can't sleep, focus, sit still, react normally to external stimuli (like someone saying, "you dropped jelly on the counter," which, in my opinion, should not trigger a screaming rage but has)...

Medication Cocktails
The article makes a big deal about kids taking more than one of the same type of medication. I know that for bipolar people, taking two or more different mood stabilizers is frequently recommended to stabilize the person. Especially when there are multiple diagnoses, it can take a med cocktail to help the child stabilize, and unfortunately our body chemistries are unique, and with growth and puberty added in... well one can necessarily feel like a human guinea pig.

Finding the right "cocktail" took years of experimenting as everyone's body is different and changes over time (especially as they enter puberty). Sometimes a new diagnoses was recognized or started (many mental illnesses have adolescent onset). Sometimes meds stopped working. Sometimes better ones came on the market. Sometimes that issue healed and they didn't need a particular med any more.

Sleep Meds
My kids suffer from PTSD (like most kids of trauma) and sleep is HARD! If you don't get enough sleep, then you can't learn in school and it's harder to control your emotions - sleep deprivation is a common form of torture! If you're living in a war zone in your head (PTSD), or you can't focus (due to ADHD), then you aren't learning (my kids have HUGE gaps in their education). If you're struggling with depression or anger (bipolar, RAD, mood disorder NOS, ODD...) then you're so busy fighting or coping that you can't learn the developmental lessons or how to get along in a family.

I'm not recommending we drug our kids into zombies (although we did have to do that once for a short period of time to keep our son and family safe while we waited for a bed to open up in an RTC), and yes, there are some nasty side effects from medications that aren't tested on children... but without meds, my children would have been virtually unadoptable and my son would have ended up dead (self-medicating with drugs, gang life, suicide...) or in juvie many years ago.

Years of the right medications gave my son time to mature, learn, and attain coping skills... When he decided to stop taking his medications at 18, he learned very quickly that he needed them, but I also believe that the consequences of his actions off the meds were much less severe because of that time of growing/ healing.

Proper Diagnosis and Medication
When our kids came to us, they weren't properly diagnosed or medicated.  Bear was diagnosed with PTSD, mood disorder NOS and possible conduct disorder.  Kitty was diagnosed with ADHD (unmedicated for some unknown reason - possibly because it killed her appetite and she was underweight already), ODD and "attachment issues" (which the caseworker claimed couldn't be true, because she was such a loving child who always hugged the caseworker - typical RAD), and learning disabilities.

After we'd known them for long enough to get an accurate psych eval, they were diagnosed with:

Bipolar Disorder (which apparently they'd been diagnosed with before entering foster care and had been removed for some reason - possibly because many doctors don't believe in child-onset bipolar, or maybe because it made them seem less adoptable, but if the latter was the case then they sure left a LOT of other stuff in!),
Reactive Attachment Disorder (I asked their therapist from foster care why this wasn't seen before and she claimed not to have seen it - it's possible that in previous foster homes no one had tried to bond with them),
ADD/ADHD - Kitty was already diagnosed with this, but now Bear is as well.
Brain injuries (cerebral dysrhythmia - strongly effecting memory and processing), which is probably tied into Kitty's learning disabilities, but for Kitty also effects her emotions.
Complex Post Traumatic Stress Disorder,
Emerging personality disorders.

The discrepancy was huge, their medications were all wrong, the kids were raging and miserable, and their "misbehavior" had made a mess of their lives.  I won't say medications fixed all their problems, but... without it I know we couldn't have adopted Bear - he wasn't safe, and Kitty has come SOOOO far with her healing that she couldn't have done without alleviating some of her symptoms through medication.


To help with finding the right Medication Cocktail (since what each person needs is specific to their body chemistry, diagnoses, trauma, current situation - under unusual stress?, and even personality) each individual can often feel like a human guinea pig. We preferred the kids to be in a psychiatric hospital or residential treatment center during this process, because it can be quite scary.

My kids are bio half sibs with identical diagnoses and they still needed different meds. Some meds stop working after a time. Some work best in combination with others (Abilify is a good example of this). Kids/peoples needs can also change as they hit puberty or have a growth spurt, experience new trauma or begin healing, are under great stress (ex. exams and major life changes like divorce, moves, new siblings, relationship issues...)

GeneSight is a genetic testing company which for a cheek swab and a maximum of $200 (It's sliding scale) will report which meds are unlikely to be metabolized well, which are not likely to work, and which are likely to cause problems.  I have not personally tried it (I found out about it after we found the right meds for my kids), but it's been highly recommended to me.   


Anonymous said...

You said: "Alternately he's argued that I've always been under a lot of stress and had issues like hating my job and insecurities about what other people think about me, and that meds are not helping these and are not designed to help those so why bother."

But some meds *do* help with how you handle stress and anxiety. (Not that any of them are "designed" for anything). I was really suprised at how my social anxiety went down when I started Tegretol. A med can't change the crap your boss hands you, but it can change whether it sucks you down for the whole day vs a brief "bummer".

So ask him, "Gee, honey, would you rather, after a bad day, I sit down to eat dinner w/ you and tell you about the stupid people I dealt with, or I scream at you, kick the dog and tell you to get your own @$% dinner?"

Yeah, not necessary, really. I just wanted to say that.

Mama Drama Times Two said...

Loved you analogy of the crutch cast and pin...I'm guessing Hubby has never had to pass a kidney stone - otherwise I think he might have a whole new perspective on the merits of taking medication. The Other Mother has to practically be bleeding from the ears before she'll take a pill. I, on the other hand, will gladly take one...or two.

blog said...

bipolar depression

Jules said...

Yeah but the thing is, some mental illnesses like depression are caused by an actual, measurable chemical imbalance in the brain and cannot be "healed". It's an illness that needs to be treated with a drug every day to correct it and keep a person from being completely miserable. With respect, I don't get why he doesn't understand this. There is hard, scientific evidence of such imbalances. Does he think such people should just suck it up and deal?

SSRI's aren't an abusable drug either. Meaning, you don't get "high" when you take them. I really am having such a hard time understanding his logic in this situation. You obviously need medication and your kids certainly do as well. What is the advantage to letting mental illness go untreated to avoid taking meds?