Today the good folks at WaPo had a curious article. The headline “Most antipsychotic drugs prescribed to teens without mental health diagnosis, study says“. The study published in JAMA Psychiatry noted that of the youth taking these drugs
“60 percent of those ages 1-6,
56.7 percent of those ages 7-12,
62 percent of those ages 13-18, and
67.1 percent of young adults, ages 19-24,
..had no outpatient or inpatient claim indicating a mental disorder diagnosis” (layout and bold mine for easier reading).
Does this strike you as curious?
It does me. Of course, if you read this blog you know I question the rampant use of psychotropics (the same article says that in 2010, 2.8 million prescriptions for psychotropic drugs were written for teens!).
So here’s a trauma-responsive and perhaps somewhat blistering take on the issue of children without mental health diagnoses, and therefore without professional relationships focused on deliberate skill-building and better functioning in the world.
Let’s start with the chances that some of these children, if they mirror the rest of US culture, grew up with at least one ACE. The ACE study tells us clearly of the consequences of exposure to adversity in childhood on physical and mental health, and my goodness, it only addresses nine common childhood experiences. There are so many more events that can overwhelm children! And their parents and caregivers, too.
And thanks to recent research, we know that epigenetics–the impact of the trauma of the generations before them–is encoded in RNA for generations. Search for “epigenetics of trauma” or “inherited trauma.” So parents with combat histories, or grandparents who survived the holocaust or the Great Depression, or who had experiences that were traumatic pass on the genetic impact to their children.
Perhaps children grow up in situations where media provides consistent, appealing relationships. With things. Not people. And the impact of exposure to violence in media (TV, computers, games, music) is known.
Childhood is when, where, and how we learn to be human beings. Social, relational, connected. Our “connectome” develops, the neural map in our brains unique to us. This wiring diagram is influenced by
- Brain development, which may be delayed or changed if a baby is premature, if the mother was stressed pre-natally, or ingested certain drugs
- The initial contact between parents / caregivers
- How well and often parents / caregivers recognize and respond to the child’s distress cries in a soothing, calm, positive way
- The types of “input” in a child’s life–how much they are read do, talked with, observed and addressed in specific ways during play, how many hours a day they spend in conversation with adults and others, hours spent watching TV, playing games online, on the computer..
- The opportunities they are given to correct their errors in non-shaming ways that help develop a map for restoration and healing instead of revenge.
- The modeling of the world around them: how adults behave in their presence, the feelings they emit, and the limits they run into.
In addition to all of that, you want to give kids antipsychotics when they don’t even have any diagnosis. They’re misbehaving loudly, and at least one parent has had enough. The child is labeled, prescribed drugs to control their “symptoms” of aggression and discontent, and what happens to their brain at that point is that the mapmaking is changed, dramatically.
My worst fear is the impact across generations is strengthening rather than weakening. Young parents may be overwhelmed. Their child may be left with others who are not so invested in him or her. Perhaps their parents didn’t have the same set of skills we now value. The children-now-parents learned what they developed from parents, caregivers and classmates; from the growing or full-blown technology dependence. The negative impact of ACEs, trauma, media, and every other deficiency is increasing as it is passed to the next generation, who now learns less and substitutes more of the things that are easy, quick, and not challenging.
If the impact is strengthening across time, as the baton is passed from parent to child, then we need less media, less time staring at screens, more time in each other’s lives in relationships, practicing and demonstrating the things we wish we could have had as children. We can enact this with one another, and with youth. We can be the relationships they need to help reduce the risk of inappropriate medication and the risks it brings.
No one doubts the need of a parent, a teacher and a community to have youth that behave in less frightening ways. Psychotropic meds are a quick, easy addition to tamp down problematic behavior but they make it really hard to learn new ways of being.
In most cases, giving a person a drug for something they haven’t been diagnosed with is considered really poor (I mean really poor) medicine. Yet in the case of behavior that can be called out of control, pills trump relationship when relationship is the missing ingredient.
We push pills in each other’s directions when often we need catch up time to help our brain development sort out, practice with the skills we missed to test them and see how they work, realize we can survive using them. We need more time with each other practicing the good things. Having decent fun with each other. Youth need people who can help them in the moment as they struggle with what has happened in their lives instead of what’s wrong with them.
But anti-psychotics for kids? Not in those developing brains, please.
Four things you can do now:
- Have a look at the tools used by Walla Walla WA ‘s Lincoln High School staff to reduce and nearly eliminate suspensions (85% drop).
- Read “The Whole-Brain Child,” and use the 12 strategies it teaches.
- Start relating to youth instead of judging, labeling, and drugging them.
- Recognize the deficit may also be yours–your child didn’t get that way in a vacuum.
Help his or her generation lift up one little bit from the ills they experienced and those they inherited. It takes, it is said, seven generations to heal. That could be lots of pills, or lots of experiences that reshape the brain in good ways. We may never see the outcome, and it’s up to us to plant the seed.