First off, I have thus far written in a stream-of-consciousness style, brainstorming and sharing various ideas. I am going to write in a manner that is more clear.
Secondly, I know my opinion is not typical of mental health professionals specially psychiatrists, and I am not saying what to do with your sister or not to do. Frankly I don't know either you or your sister and I'm not qualified to give an opinion even if I knew her. As I said to another poster, this is a discussion and since you mentioned your sister, I have used her as an example. She may need meds, she may not. I mention this so you can step back and look at this from a theoretical perspective as well. You obviously care a lot about your sister and would do much for her--which you may not do for others. So if we speak of child X, we can discuss him in a more detached manner.
Third, this is going to be my last comprehensive reply here. I am involved with a few psychiatric research projects so I can't spend as much time interacting here for the next little while. I'll do the best I can. I've spent several hours on the forum today....
Lastly, I appreciate you engaging me. I am also impressed by how much you care about your sister and I hope you, your family, and specially your sister, all the best. I am sorry if my opinions have hurt your feelings or have brought out all the pain associated with a loved one who is struggling in life. The nature of life is so that we are never certain of what it is we need to do to take care of people we love. My intention here is to emphasize and elaborate on an approach--to suffering and life difficulties--that does not involve drugs. I really think that a few decades from now, we'll look back and shudder at how often and how needlessly we medicated little kids. History is full of examples like that. So I'm doing my part. As long as a few people read this thread and consider asking a few more questions and looking at other options, questioning undue influence of pharmaceutical companies on research, on government, then I've made a small difference.
I do not expect anything from my sister...it's a concern for her possibly missing an opportunity to be a carefree child like her siblings close in age...concern for her missing her opportunities to take from her early education as much as she can, to prepare her for her later life...How will this play out when she gets older? Isn’t it a bit risky to just wait it out? Especially when research has shown that this is not the typical behavior of one her age? We never thought of her as someone that needed to be “fixed”… And I’m a little troubled that this was even mentioned.
Why? If you're not trying to fix what is wrong with her, then what exactly are you trying to do? Your whole family is very concerned but obviously you are not accepting that she is simply different from many of the kids her age, right? You're looking at other kids and you mention research and age-expected behavior, the idea that she needs to get all the education she can...you are looking for a solution to make her behave differently and more like kids her age and so on. If you prefer, we can say you're trying to find solution for her maladaptive behavior (as opposed to fixing what is wrong with her).
And what is wrong with social norms? There is a huge benefit to standards and normalcy, and its very definition is being tweaked day by day as we discover and learn more and more. If there were no standards, no norms, there would be much chaos and nothing stable that anyone could hold on to or reference to.
I don't think there is anything inherently wrong with social norms. Philosophically, there is potentially something wrong with defining mental illness based on social norms and and prescribing drugs to bring child X's behavior closer to the social norm. Imagine a school in a very poor neighborhood. Significant number of kids skip school, don't pay attention, scream and fight. Social norm here is different from that of a very prestigious school where most kids are intelligent and very well behaved. So social norms change, depending on time and place, etc. Again, there is nothing inherently wrong with wanting to fit in or relying on others for clues to what is perceived as proper behavior or thinking. However, I better not marry a girl (or divorce her), for example, solely because 80% of people marry. It's not reason enough.
We’ve even talked to her after her treatment was started. She is much happier. She doesn’t panic, cry, and roll around on the floor when we don’t give her chocolate milk.
I'm glad she's happier and less anxious and sad.
She plays with dolls and toys and people more, and more importantly, her academic scores are improving. Before, she had no focus to learn how to read. All of a sudden, she’s spelling out words and reading entire children’s books all on her own! Unfortunately, I do not live in a perfect world where society smiles upon those who cannot read, those who have poor grades, those who do not focus, and those who are too afraid to socialize.
It's so great that her school performance has improved as well. And yes, it is sad that some people in our society can be cruel to those who are different or do not measure up in one way or another. That's partly why people do plastic surgery, wear clothes they can't afford, lie and deceive, etc etc. That's also partly why parents can be so concerned about their children when they do not fit. It's a tough world out there, even for "normal" people. Competition is tough. If you are developmentally delayed or have a disability, you may have difficulty making money, making friends, etc.
what about anxiety in the absence of any threat whatsoever, big or small? Is that natural?
Let's stay clear of the word "natural" unless you define it specifically. Regardless, threat can be subjective. It doesn't have to be a tiger in the room. But I do see what you're saying. Sometimes we can be hypervigilant. Some people who've survived trauma, get anxious for no obvious reason.
Too much anxiety causes stress; it causes many lost opportunities at socializing, achieving goals, and much more. Should we just take the risk, chalk it up to her mind trying to be its natural self and let it go? That hasn’t played out very well in past experience and in research.
Again, I don't know. I don't know her diagnosis, what meds she's tried and what she's on, what kinds of psychological therapies she has tried, what sort of physicians she's seen, her behavior at school and at home, family members' style of interaction, mental illness in family, genetic history, birth complications, environmental stressors, past medical/psychiatric history, etc etc. But I do agree with you that severe anxiety can interfere with her behavior and thinking.
Blood flow in the amygdala - which is thought to deal in anxiety - increases when an unpleasant stimulus is presented, and if this causes anxiety, what does it mean when blood flow increases and one gets anxiety even when there isn’t any unpleasant stimulus presented? That can’t be normal. It’s not functioning as it should be. It’s not functioning, just as a kidney wouldn’t function. And so you give it medication. You give it therapy.
Okay, so let's use the example of amygdala, a structure that is often mentioned when speaking of anxiety. It is particularly known for its role in processing of emotional memories. That there is increased blood flow in amygdala is not quite the same as dysfunction in a kidney. We know so little about the brain and amygdala. Seeing a change in blood flow in amygdala does not tell us that much. We can already see that child X is anxious, very anxious. That anxiety shows up in the body in different ways, from sweating to change in blood pressure, to changes in brain signals and blood flow. The actual problem is finding the source. Sources in the environment can affect brain as well and change the blood flow, etc. If it is coming from the inside, perhaps based on something genetic, can we change it from the inside (meds, surgery) or from the outside (relaxation, behavioral therapy)?
I have an untreated friend with ADD...he has broken-heartedly given up on these passions and wants to become a voice actor. And if therapy alone doesn’t work, what next? Is he doomed to live in this vicious cycle? Is it JUST society and the environment? Does he just need to wait until his environment and society and the schools and every other aspect is straightened out? How long will that be?
Your friend is who he is. Not everybody can become a psychologist. Why should everybody be able to do that? We can all wish. I wanted to be a neurosurgeon, but I don't have the manual dexterity. So I went into psychology. You may not be aware of this, but some people who do not "need" meds, take it to enhance their memory or concentration. It's like the performance-enhancing drugs in sports. Perhaps I could have tried them and maybe they would have helped. Who knows!?
Imagine a society where anybody could make a living. That means even if you had no arms or legs, you could do something. You could be a therapist in fact. Or if, instead, you have hands and legs but have difficulty sustaining your attention, you could do something more active. In fact, there are those with ADHD who do not take meds and try to find a niche for themselves. That happens in our society but that is not to say it's easy. Definitely not! My dad needed a bachelor's degree to get a decent job. I need a PhD. Times have changed. But I do like to take a stand. And I'm not the only one. We have changed. Our society is becoming more open to those with disabilities, to people from other cultures, religions, etc. We take a stand against racism, sexism, and ageism. We have a long long way to go, of course.
Often this is what I see: a family does its best to make the "ill" member "well." Be it drugs, therapy, or even hide them from the world. They dedicate themselves to helping the person. When it becomes clear that none of those work, or can't be a long-term thing, they have to make a difficult decision. They have to accept that their child, brother or sister, or parent is simply different and not what they hoped they could be. Are they "doomed"? Depends on how you define that. We all have a particular biological makeup. That's a fact. We're mortal. That's also a fact. Are we doomed? We may try to overcome our biology, by exercise, drugs, surgery, therapy. Nothing wrong with wanting to improve, but at what cost? It's hard when a family member has a serious illness, like cancer, that seriously reduces their quality of life. Of course some may refuse chemotherapy but often enough the family gives it a chance. Cancer is biological enough I suppose. Mental illnesses are more complicated. We want the anxious child, the angry child, the slow child, to do better. We want them to have a great future. It may not be possible, at least not based on how we define success. He may not have a luxury car, but he may be a role model to many. He may not become a surgeon, but he might mend broken hearts.
Maybe our research will one day be successful in figuring out the mind and soul, but for now, as the brain is a very, very, very complicated thing, we only have neurological information to go by. And even that is limited.
We have more info, not just neurological and psychiatric. Heck, we have several thousand years of human knowledge to consider. Of course none are "scientific" enough for us. It's only the big studies with the big money behind it that we consider. And that's from the last few decades and the ones sponsored by pharmaceutical companies.
I don’t know why you assume that drugs inhibit creativity and enthusiasm. A common misconception with psychiatric drugs is that they morph you into something you’re not, turn you to a zombie, and suck the life and soul out of you.
That was one example and the example of antipsychotics. Like I said earlier you did not mention your sister's issues nor her meds, so obviously it's not every case. However, antipsychotics are used in so many cases when the behavior is not manageable.
I’ve been taking medication for about ten years (I’m 20), and I’m in the best mental condition of my life, because my medication (which balances Serotonin levels) has brought me to a normalcy that I can grasp... Medication has turned my life around enormously.
As I said before, maybe we should focus less on how bad medication is and more on educating ourselves on the how much they can benefit from the correct usage.
Again, I disagree. We should focus on how bad medication are for most people. If one in a thousand cases actually are disturbed enough to require drugs, then so be it. People have self-medicated for thousands of years in fact. But to give drugs under the name of "medication" and under the authority of medicine, to pretend that we know what a mental illness really is and pretend it's some kind of "chemical imbalance", to put a whole nation on drugs, is dangerous and unethical. Who says that psychiatrists are the ones who are experts at treating mental illness? Why not spiritual or religious leaders? Why not the drug dealer next door? Some of my friends did marijuana. It certainly made them feel better and they felt more creative and energized after. A glass of red wine seems to help others. Is it that we are in search of a rationale and not a drug dealer then?
Psychiatric medication can be very safe, and can change a child’s life around, just as any other medicine can. But of course, just as any other medicine, it can be dangerous if improperly prescribed, diagnosed, and used.
Drugs can be safe or be dangerous. That's fine if you want to use some to relax, I suppose. But it's not a cure. Nor does the word "psychiatric" mean that the drugs are safe or appropriate. Look at psychiatric treatments that were deemed safe some decades ago but turned out to have more serious side effects than previously had been assumed.
I just don't understand why we should swear off something we know little about? If it has had beneficial effects, why shun it? Why not look into it more, see what maybe we're doing wrong, and go from there?
Sure, do more research. We have already tested all kinds of psychiatric drugs on millions of rats, not to mention a large number of dogs, cats, and monkeys. We have terrorized them, angered them, removed parts of their brains, taken them away from their family, done all kinds of ungodly things to them all so that human beings can have better lives and drug companies make billions more in profits. We have done research on humans too and some desperate people have volunteered to be lab rats though we have treated them with more respect. Despite my issues with animal and human experimentation, I am not fully against it. We are improving with respect to ethics and animals are being treated better. But if I had an ill family member, I would want the researchers to continue researching. Find out why meds work. However, that line of research is limited. If we knew a hundred times more than we know about the brain, we would still be faced with the philosophical question of where to intervene. And when. Changes in societal structure, values, and economic forces can influence the presentation and frequency of mental illness. Changes in psychiatric training, values, emphasis, societal power, and so forth can influence the diagnosis of the illness. We need to look everywhere and study it all.
