Children and the Mental Health Epidemic

Kids and Mental Health:

This week, there were two tragic stories in the news here in New England. A 24 year old Math teacher was killed by a 14 year old student in Danvers, MA and in another incident, a teenager from NH tried to kill his mother, after she withheld his ADHD medicine because she was concerned it was making him violent. (Sounds like she was right.)

I'm a member of an ADHD parents support group on Facebook and I have to say, after hearing stories like the above and seeing posts by other parents, I'm starting to be really afraid. I'm afraid that serious mental health issues in kids is on the rise yet resources and treatment options are not.

According to the Center for Disease Control, there are currently 5.2 million children diagnosed with ADHD. This number has risen dramatically. The number of parent-reported cases of ADHD increased 22% from 2003-2007, the last year for which I could find data.

That means that there is an increase of 22% of kids requiring medical care, additional school resources  and overall special care from caregivers who have not been trained to deal with the symptoms that these kids exhibit. Meanwhile, budgets are tighter than ever so schools are doing more with less and healthcare costs as always continue to skyrocket. Medical providers are overwhelmed, which I know about all too well. It took us eight months to get an appointment at Children's Hospital and literally, all they did was give us a prescription and ask me to check in again in three months. Seriously, I waited eight months for that?

Also, the best treatments for a child are often not covered by health insurance providers so kids are given medication that doesn't best address their issues. This means there could be serious side effects that as I mentioned above, could have serious results. My son is covered by MassHealth so I'm lucky in that respect. But other parents in the Facebook support group have private insurance and say that their prescriptions cost $150 a month and that's for Ritalin. They can't even get Metadate (my son's medication) because their insurance doesn't cover it. 

Last but not least is the lack of funding for mental health research on children. Kids brains are still developing until they are seven years old. Then of course they continue to grow and hormonal fluctuations kick in which could also affect their mental health. The current diagnosis for ADHD consists of two different people checking off boxes on a checklist (the Vanderbilt Diagnostic Parent Rating Scale). If those two different people pretty much say the same thing, then a diagnosis of ADHD is given.

Unfortunately the symptoms of Bipolar Disorder mimic the symptoms of ADHD so it's difficult to determine which illness the child has without a trial and error approach. This means that the doctor prescribes a stimulant to the child and if it works, the kid has ADHD. If it doesn't work, the child probably has something else. As you can imagine, the number of ADHD mis-diagnoses is really high. This could have tragic results.

Earlier this week I was reading posts on the Facebook ADHD page and there was a mom out of her mind, not knowing what to do because her 10-year-old daughter was threatening to kill herself. No one else on this page knew what to do for her but I finally chimed in and told this complete stranger to call her daughter's doctor's after hours emergency number immediately. Thank God she listened and now her daughter has been hospitalized. Holy cow, the last thing I want to read on Facebook is that some woman's child has killed herself but what if I hadn't said anything? What would she have done? I can imagine she's overwhelmed but this could have had a very tragic ending if I, a total stranger, didn't tell her what to do. I don't want that kind of responsibility!

A coworker told me this week that her sister in law has a son that's bipolar and that she has had a knife to her throat on more than one occasion because bipolar kids can be violent, thanks to medication and its terrible side effects. Another parent on the Facebook page wrote one day to say her son woke her and her husband up in the middle of the night, standing at the side of the bed with a knife hovering over her husband. WHAT THE HELL!

When kids are young, you are stronger than they are but what about when they get older and they become stronger than you? That's when you end up with the case of the woman from NH who was stabbed by her son. And that is when you end up with a case like Sandy Hook in Newtown, CT. Terrible, terrible.

I'm not kidding when I say I think our mental health epidemic is going to get worse before it gets better. Until we as a nation decide to spend more money on research and treatment of mental health disorders in children, we are going to have more news stories like the above. Considering I have a school age child, it pretty much scares the daylights out of me knowing so many of these tragedies are happening at school. 

So how do we make change? I really have no idea. I wish I did.

To Medicate or Not to Medicate

We finally got our diagnosis from Children's Hospital and no surprise, it was ADHD. The doctor also noted that Christopher seems to have trouble identifying letters and is well below Kindergarten level there so she's concerned that there's dyslexia as well.

I agree with the ADHD but not so much with the dyslexia. Christopher's been learning some things more slowly than other kids his age--potty training was a challenge for example. And I'm still battling with him to use a fork at the dinner table. So I think it's a learning delay, as opposed to dyslexia.

I've seen his school work and he seems to get a lot of "happy faces". He is writing and the letters look normal (for a 5 year old that is). Plus he loves school and doesn't appear to be frustrated at all. So I think maybe he just needs a little extra attention for reading and writing. I will ask the school to provide testing though and we'll get to the bottom of that.

However I totally agree with the ADHD diagnosis. Plus, I'd also throw in SPD and ODD for good measure as well. The doctor gave us a prescription for Metadate CD and suggested I try that out with Christopher. A low dosage to start: just 10 mg per day.

I did some research on ADHD medications and there are definite side effects which scared the bejesus out of me. I'm like I'm supposed to do this to my child??? No way!

Then I started asking around and I joined an ADHD parents' group on Facebook and learned that there are a lot of parents going through what I'm going through now. And everyone says that the medication is fine. I liked how they said if it doesn't work out for your child, you could just stop. Truth told, I hadn't thought about that--I felt like once we started I was locked in--so I appreciated that as an option.

I looked into holistic options as well (since I realized diet makes a huge difference, why not consider herbal supplements?) But the thing about herbal supplements is that nothing is regulated by the FDA and these supplements could have some strong components to them as well. I went onto the Amazon.com site and looked up Brightspark, for example because I had heard about that as an option. I started reading the reviews and saw that one woman reported that her child was experiencing something called Micropsia, and it was because a form of Arsenic is one of the top ingredients and it was affecting her daughter's brain chemistry. I'm sorry but...Arsenic??? In a children's medicine???

I just don't know how I feel about going to the Internet and buying powerful psychotropic supplements that are not regulated by the FDA and that are being administered to young children. Do we have any idea their safety protocols? Do we understand how they will affect little kids? And are they really putting Arsenic in them??

Long story short, I decided to start Christopher today on the Metadate and we'll see how it goes. He mentioned today while we were at the dog park that he was super thirsty but aside from that, so far so good. No negative side affects. Yet. I did notice that he played with his friend Salvi for an entire hour without shoving him as well, so that's equally good. Hopefully this was the right decision for us. I guess we'll see.

We FINALLY Got Our Eval From Children's Hospital

Children's Hospital, Boston

After an almost unbearable eight-month wait, Christopher finally had his neuro-eval at Children's Hospital. Yay! Hopefully we're moving in the right direction for a long-term solution now. I hope so at least.

The appointment went well. Christopher met with the therapist for about two hours and I met with the behavioral pediatrician. I told the doctor all about Christopher's history as well as the issues that have brought me to Children's.

Once the discussion ended, the doctor told me that she recognizes that Christopher's behaviors are probably not typical ADHD simply because of his trauma background but that he may have more of a ADHD *like* scenario going on. I agreed that his background plays a huge role in Christopher's life today. He won't sleep in his own bed, he has irrational fears and he worries that I will give him away when I get mad at him. But that's not the behavior stuff I want addressed. I can manage those things myself. I want to address the ADHD-like stuff because that's what's keeping him from integrating well into society. I hope that came through in our conversation.

I think it's possible to have an ADHD diagnosis in addition to all the trauma stuff he has had to work through. It's tough to unravel everything going on with my little guy, I'm sure. But we need to try to see each piece on its own, as much as we can.

A Revelation

In going through the questionnaire that I completed, we discussed the concept of "food hoarding". I said that Christopher has been known to hide food ]behind pillows and to sneak into the refrigerator when I'm asleep or taking a shower. He will also pick up random food and drinks off the street and try to eat or drink them, with me running after him, yelling for him to drop it. It's gotten to the point where I lock some treats in my car to keep him from sneaking them (or else I just don't buy them).

I never really thought about these actions in the context of his history but apparently they stem from the fact that early in life, Christopher never felt certain that he would get fed. A child who is chronically hungry develops a primal fear that he or she will never have enough food. They learn to eat whatever they can, wherever they can find it or they stash it away...just in cse. Thus his actions are the sad result of early abuse, neglect or deprivation. Well that just kind of breaks my heart. I can assure you though...this little guy wants for nothing now. He just needs to be able to accept that.

Next Steps

I go back on September 26th to discuss Christopher's diagnosis with the behavioral pediatrician and therapist. I'm looking forward to hearing what she has to say and to figuring out how we could best treat my awesome little guy so that he's a happy, healthy, well-adjusted kiddo.

This Was Random...

When we were leaving the hospital, all the sudden I heard from behind me, "Christopher?" I turned around and there in front of us were Christopher's last foster parents. They live three and a half hours away so the idea of running into them at Children's Hospital in Boston is completely shocking to me and obviously even more so to Christopher. (They were there getting some treatment for their grandson.)

He didn't recognize them at first and when they reminded him who they were, I could tell he didn't know how to take that. He started acting out. Running around the lobby. He climbed on top of the Information Desk and just acted a bit out of control. He wouldn't speak to the former fosters. I decided I needed to get him out of there because hey, it had been a long day (3 hours of evaluation) and now he was going to deal with the emotions of his last placement. It was too much. So we left. I asked Christopher if he wanted to hug the former fosters before he left and he said no. That's pretty telling because this kid hugs everybody. I didn't push it though and left it up to him. At that, I said goodbye to the fosters and we left. Christopher calmed down as soon as we got outside and has been calm ever since. I haven't brought up the former fosters and won't unless he does. 

And with that now we wait for the next step. So stay tuned. More to come!