Wondering if medication is the answer to your kid’s mental health challenge?
I recently reached out to the board of psychiatry to express my concern about the 13 psychiatric medications prescribed to an 8-year-old child. Although this is not typical, it is increasingly common to see children as young as 6 on multiple medications. While medication can be game-changing in certain cases, recent scientific research supports behavioral and lifestyle interventions as the first course of action to address a wide variety of mental health symptoms.
6 important questions to consider before choosing meds
If you are currently considering putting your child on psychiatric medication, consider the following to help inform your decision.
1. Has your child been accurately diagnosed?
A comprehensive diagnostic assessment by a licensed clinician is a critical first step before considering psychiatric medication. Self-diagnosis via internet searches or discussing your child’s symptoms with someone who has a child with a mental health diagnosis may feel helpful but is no substitute for a comprehensive diagnostic assessment. Physical imbalances, such as a sluggish thyroid (hypothyroidism) and/or nutritional deficiencies from gastrointestinal weaknesses, can often masquerade as mental illness. Getting an accurate diagnosis helps ensure the treatment recommendations are appropriately targeted and avoids further stressing a child’s compromised system with medications that don’t address the root cause of their symptoms.
2. Are there imminent safety concerns?
Sometimes the decision to medicate is a no-brainer. In situations where a child or youth is at high risk for suicide or is having hallucinations commanding them to self-harm or seriously harm someone else, medication may be the quickest way to safety. In cases like this, screening for toxins to rule out substance-induced symptoms is a prudent first step before pursuing medication.
3. Is there a family history of the diagnosis you are looking to medicate?
A family history of certain diagnoses should not necessarily give you the green light to medicate your child, but it is a serious factor to consider. Even though epigenetics researchers find genetics has only about a 20 percent influence on health and mental health outcomes, biological markers for certain mental health diagnoses, such as bipolar disorder, can be much higher. When such markers are present on both sides of the family, the impact of a pharmaceutical intervention may be the most effective way to disrupt brain patterns enough to make counseling and other behavioral interventions more effective. Having close relatives who are successfully treated for the same diagnosis can give your child’s physician a starting point when considering which types of medications to try first.
4. Have you exhausted all recommended behavioral and lifestyle interventions?
Environmental influences can impact health and mental health outcomes by up to 80 percent. These include things like a consistent sleep schedule, regular exercise, time in nature (away from electronics), strong social support, and quality nutrition, to name a few. Given the potential for such positive effects, maximizing the impact of these health levers may eliminate the need to pursue medications at all. That said, for children with significant or severe symptoms, such as extreme lethargy, medication may be the help they need to make behavioral interventions more accessible.
5. Are complementary or natural options cost-prohibitive?
Acupuncture, herbal remedies, yoga classes, and even fitness trackers are just some of the complementary interventions that can be extremely helpful in improving mental health. Unfortunately, many of these are either not covered or only partially recovered by insurance companies, which can disproportionately disadvantage people with limited resources. Increased consumer demand for non-pharmaceutical treatments will hopefully increase equitable access to more comprehensive mental health care for all.
6. Are you mindful of how social and systemic factors may influence your decision?
Social stigma, special interest groups, systemic limitations, and/or popular trends can all impact your decision. For example, social stigma could steer you away from a medication your child really needs. On the other hand, practices such as financial incentives to psychiatrists and direct marketing to consumers keep pharmaceutical companies well-positioned to heavily weight doctor-patient conversations toward medication. Systemic structures, such as the 15-minute med check appointments that are now standard practice among many psychiatrists, leave little time to discuss complementary treatment options. It is important to be mindful of how these variables may influence you.
reaching a decision
For those of you who are on the fence about medication, it is important to remember that a medication trial is not a lifelong commitment. You can always change course. For those of you who are still unsure about medication and have access to financial resources, reaching out to an integrative mental health clinician or functional medicine psychiatrist may provide you with the alternatives you seek. Either way, consultation with a trusted, collaboratively-oriented clinician is an important part of the decision-making process. Lifestyle changes that include science-based behavioral tools should be incorporated into any treatment plan. Such tools not only create opportunities for youth to tap into their body’s abundant capacity to heal but can also provide them with the skills to develop lifelong resilience.
Statements in this blog are not a substitute for medical advice. Please consult with a licensed health care provider.