Thoughts on Medication

It's such a scary thing to be told a doctor recommends giving your child a mood or behavior altering drug. As a teacher I've seen so many parents struggle with a diagnosis of ADHD and the recommendation of meds. I've also seen first hand in my own family, having a younger brother who struggled with severe ADHD, and with my students the amazing difference the right medication can make in a child. With those experiences in my head, I always swore to myself that as I mom, I would never let my own fears get in the way and refuse a recommendation to medicate if the situation warranted it. 

Oh the naive things we think before we are actually parents.

(Granted, GAD and SAD are not ADHD and the preferred medical treatments are a different class of drugs, so maybe that's where some of my hesitation originated. But also, it's just dang hard to hear that about your own baby!)

This August 2020 diagnosis and recommendation is not the first time that medication has been suggested to us for Ella's anxiety. It was first brought up when we were desperately seeking answers and help after "The Big Meltdown" of 2019 (that I'll write about at a later date). It was brought up again by her play therapist about 4-5 months into her treatment in spring/summer 2019. Both times Brandon and I felt that medication at that point would be a bandaid and a cover up for an issue we still didn't even know enough about. It was a no go at that time.

Fast forward to 2020. I thank God for our wonderful new pediatrician who pointed us to a neuropsychologist for an extensive evaluation. Not once, in all of our searching for help, had this ever been brought up and our questions about seeking further evaluations had always fallen on deaf ears. It was our neuropsych's recommendation after getting, what I feel, was the first real, full picture of what Ella and our family have gone through in the last 6 years, that intensive in-home Cognitive Behavioral Therapy PLUS medication would be the best way to help.

The CBT therapist and pediatric psychiatrist we were referred to also came to the same conclusion after their own evaluations. 

I am going to attempt to explain why we actually agreed to medication this time around with a few things I know to be true from the many trauma-informed teaching and de-escalation trainings I've had over the years coupled with the conversations I've had with the multiple experts who are now helping us.

• It has been proven that being in a constant state of stress or anxiety - always in fight or flight mode - has dramatic negative effects on a child's developing brain. The brain scans of children coming from trauma vs the scans of children in healthy environments with low levels of stress show stark and scary differences. While Ella's issues do not stem from any trauma that we know of, her brain for whatever reason is in that same fight or flight mode almost constantly (or can get there very quickly!). As our therapist says, "stress is stress" regardless of the cause and its results are the same.
• The good news is that is has also been proven that those negative effects CAN be reversed!
• Knowing this, Brandon and I had to weigh our fears of what side effects Prozac could have on her developing brain and body (the side effects that are known are very minimal and rare!) versus the side effects that letting her continue in her current state would have on her beautiful creative brain.
• To expand on an analogy used by our therapist and psychiatrist, imagine a kid who can't swim in the deep end of a pool. The kid is desperately trying to keep his head above water. What do you do? Yell instructions for how to kick your feet and use your hands to swim? No! You dive in after him and give him a float to hold onto! This is where Ella is right now. She can't even begin to learn how to swim and navigate/manage her anxiety and the anger that comes with it until she can rest and catch her breath. Giving her medication to reduce her level of anxiety is the floaty she needs right now. The hope is that it can give her enough of a break to be able to learn and practice "swimming" with skills from her therapist. Eventually the goal is to let air out of the floaty little by little so that she gradually starts to depend more on her new found coping skills and less on the medication to the point that one day she may not need any and can "swim" on her own.

Medicating my baby girl is a scary decision to have made and it's one that I still question multiple times a day if I let myself dwell on it. The good news is that at this point (1 wk and 6 days in) we have not seen any real side effects. On the other hand, we also have not noticed any difference in her behavior or level of stress. We were cautioned that this would be likely because we are starting on such a tiny dose that it's considered "non-therapeutic". I am anticipating that our psychiatrist will increase her dose from 5mg to 10mg at our next visit on Sept 10.

I am still hopeful that we are finally on the right track to knowing and understanding what Ella deals with on a daily basis and I'm hopeful that the help we have found will make a difference. Meanwhile, we're still struggling trying to find our calm and keep the peace in our house. The waiting game is hard!