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!

Wednesday, February 16, 2011

Labeling

Recently saw this article and others like it and thought I'd respond:

Why Psychiatric “Labels” are the Problem
Increasing numbers of people realize that just because a child fidgets, or loses pencils or toys—criteria for an “ADHD” diagnoses, this doesn’t mean a child is mentally ill. In fact many now claim that children diagnosed “ADHD” are really suffering from lead toxicity, or allergies, or poor diet, or lack of reading skills, and not a mental “illness.” The problem is that they continue to use the psychiatric label, such as “ADHD”, which stigmatizes a child as “mentally ill.” If in fact a child suffers from lead toxicity, then why not call it lead toxicity? If he hasn’t been taught to read, why don’t we just say he hasn’t been taught to read?
The same is true of all psychiatric diagnoses—every single psychiatric label stigmatizes the person being labeled and as long as we continue to use psychiatric labels (contained within the DSM) to describe behaviors—psychiatry will continue to profit while the public suffers.
Psychiatric diagnoses are simply lists of behaviors that psychiatrists have compiled into little lists, given a name, added “disorder” on the end—then voted them into their billing bible, the Diagnostic and Statistical Manual of Mental Disorders (DSM) as “legitimate.” This is big, big business, but it isn’t even close to legitimate diagnoses. Not in any medical or scientific context. But in a profit making context? Yes—coming up with new lists of behaviors and new “disorders” is the bedrock of the multi-billion dollar psychiatric/pharmaceutical industry. Its how they get paid. Remember, no psychiatric label, no billing insurance. No psychiatric label, no drug prescribed. So until we stop using these psychiatric labels, which mean nothing other than what some psychiatrists decided was a mental “illness,” we will never stop the “stigma.” The psychiatric labels are backed by corporate interests—not medicine, and not science.
Is Free Thinking a Mental Illness?

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My response (to an article that is no longer available, so forgive me if parts of it sound out of place):

Yea, nice. Unless your kid needs those labels to get services, proper medication, support, and therapeutic help. My kids have most of those “labels” and they NEED them.

Not labeling Bipolar Disorder does not make my son an artist, it makes him a tortured psychotic.

Not labeling or medicating my daughter’s ADHD does not make her a “normal kid,” it makes her unable to participate in school, learn, or make friends.

Not labeling someone with Oppositional Defiant Disorder means that that child does not get any help, which means yes, he might become a revolutionary, but more likely he’ll be unemployed (you can’t hold a job if you constantly talk back to your boss), homeless (no money, no one who can tolerate being around you willing to support you), dead (mouth off to the wrong person), or in jail (mouth off to an authority figure or do something stupid just to spite someone).

Wanna know where to find those unlabeled teens in 5 years? They’re homeless, dead or in jail. And their parents are being told that it’s all their fault.

Some articles state that all mental illnesses are subjective and therefore don't exist. I have QEEG reports that show my kids' brains are hardwired differently than the average person.  




So Why Label?

Lots of reasons!

To get them access to services and medications so they can:
  • heal if they're able to heal 
  • get the right treatment - therapeutic parenting, attachment therapy, physical therapy, trauma therapy... instead of wasting time on treatments that aren't effective for their type of issues.
  • have a break from their symptoms so they can mature and gain coping skills without having to feel like they're in a war zone 24/7
  • help them remain calm, stable, and generally happy, so they can focus on living their life and attaching and developing relationships
  • help them sleep, focus, and learn
  • access needed programs at school and other organizations 
  • keep them from being constantly suicidal, homicidal, and/or psychotic
  • keep others from believing they're just bad kids, manipulative, deliberately defiant, need punishment, deserve/ want to be in juvie or worse... 
  • keep them from internalizing the negative effects of their diagnoses as their fault, personality or identity shortcomings/ flaws, or blaming others
  • ... 


Medication

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 will have to take many of 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 with medication, even though it doesn't cure or effect the actual diagnoses (like trauma-based issues).  I'm all for medicating those symptoms, because in my opinion, you can't work on healing trauma if you can't sleep, focus, sit still, stop crying or raging, 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 - we also do therapy, therapeutic parenting, and many other tools).

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 bone pieces 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 like 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 would never 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.



Do Kids Need to "Buy Into" These Labels?

Bear thinks he's normal.

When kids are little, they call it Magical Thinking. Could be positive thinking I guess.  All I know is that whenever we discuss a diagnosis, medication or issue, Bear gets mad - at us.

We've talked to him about this repeatedly. We are not labeling him to be mean and put him down. We are not doing this to him. We are trying to identify triggers, symptoms and issues so we can help him deal with them.

Did you know, that there is even a mental illness called Anosognosia that prevents people from being able to recognize their own bipolar disorder?

Someone asked me if it was really necessary for Bear to "buy into" his labels and understand them. I think his reaction highlights that yes, he must understand. If Bear thinks he's "normal," then he has no motivation to do anything to deal with his issues. In fact, all of his energy is devoted to getting away from the mean people who think he's not normal and that he should be doing stuff he doesn't want to do. (By the way, the "mean people" is mostly me in case you hadn't guessed).

Also, when he has behaviors that we know to be symptoms of his mental health disorders (depression, anxiety, night terrors, rages...), and he doesn't believe in his "labels," then he is very likely to attribute the behaviors to something else and/ or blame himself and his faults. Just more proof that he is unlovable and unworthy of love, or that people are out to get him, or that if he's feeling depressed then there must be something causing it. He starts looking around him for what is causing these feeling and of course he finds "it."

Because of his RAD, "it" is usually me. I want him to be in special ed (it's not because his brain injuries and ADD severely effect his academics). I just want to control him by not letting him go somewhere or do whatever, because I enjoy being his warden and torturing him. Because I'm "holding a grudge." This is all worsened by the fact that he really doesn't remember the past very well. He has magical thinking, distorted reality, poor memory, and dissociates.

He needs his world to be within his control. This is a life or death feeling. It's always someone else's fault, because that's safer - he's terrified we will discover that he's not perfect and leave him. Therefore, someone else did or said something to make him mad - his raging therefore has a reason that makes sense to him, and is not caused by his Bipolar Disorder. Instead of being caused by his PTSD, his night terrors must be because the devil is mad at him or he has special powers (because he is Native American) - and they must be predicting that someone close to him will die.

People either don't understand mental illness, or just can't believe how severe the issues and behaviors are that they cause in Bear, or how these illness and trauma interact.

Everyone around him (school, friends, girlfriends...), is telling him he's fine. They think telling him the truth will damage his self-esteem and cause him to feel bad about himself, or they really don't understand it. The special program he’s in for emotionally disturbed kids sees that he is no longer physically aggressive, and do not consider him severe enough to need to be there anymore. They don't see that the structure they provide is the reason he's doing well.

It doesn't help that my kids have what I call "Charming RAD" (Disinhibited RAD). Kitty's caseworker denied that she had RAD, because "she gives me big hugs every time she sees me." (That's actually a huge red flag. It means she indiscriminately tries to please others so they will take care of her). It is easy for Bear to "fool" people who are not around him much. Truthfully, he fools some people who are around him all the time too. It is a survival instinct leftover from when he had to make people like him or they'd hurt or abandon him.

How does that saying go?

You can fool some of the people all of the time, and all of the people some of the time, but you can not fool all of the people all of the time.
Abraham Lincoln, (attributed)16th president of US (1809 - 1865)

When it comes to people outside the family, I'm not so sure about this. None of these people have a relationship with him, he's not actually capable of them, but they don't see that. There is no give and take, and they really know nothing about him. He can and does function in public, and that is a huge step forward. However, he will eventually have to have relationships with people that lasts longer than 6 months.

Even those who know him well enough to understand that he has serious issues, cannot agree on how best to help him. Unfortunately, Hubby and I often fall into this last category, and it is not helping our relationship at all.



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