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Behavioral Medicine: Less Need for Rx Drugs
Behavioral Medicine: Less Need for Rx Drugs
New treatments based on human behaviour could reduce drug prescribing
February 24, 2006
[u]Behavioural medicine: Changing our behaviour</u>; BMJ Volume 332, pp 437-438
New psychological treatments-behavioural medicine-could significantly reduce the need for drug treatments for some conditions, cutting health system costs says an editorial in this week's British Medical Journal.
Behavioural medicine-using treatments borrowed from psychology such as cognitive behavioural therapy-has the potential to reduce pain, argue the authors. Treating a patient with a system of behavioural instructions before surgery, for instance, can lower the amount of anaesthetic required during the operation, and cut the time they need to stay in hospital.
This style of medicine could also replace prescribed drugs for some conditions, say the authors. In one study diabetes rates were cut by 58% in a high risk group of patients, by intensively promoting exercise and weight loss-a higher success rate than achieved using conventional medicine.
Using behavioural techniques to reorganise clinical teams has also been shown to result in lower blood pressure in hypertensive patients-sometimes more effectively than prescribed drug treatments.
Introducing the approach more widely has been slow, however. Doctors are used to using drugs and surgery to control disease rather than behavioural techniques, say the authors.
The pharmaceutical industry also exerts a strong influence, being the chief source of funding by far for research on new treatments. "The major imbalance between investments in pharmaceutical development and in understanding and supporting health related behaviours must be of concern," say the authors.
Things are changing however. The UK has now established a Society of Behavioural Medicine, and research on these therapies is to be included on the Cochrane Database-the 'central bank' doctors use for the latest evidence-based treatments.
Behavioural medicine could make significant cost savings for health services, as well as empower patients in managing their conditions, the authors conclude.
Thanks for the article. Here I go again...
ADD is a completely unproven and highly questionable diagnosis, yet it is the basis for putting tens of thousands of American children on dangerous stimulant drugs. ADD and its popular sub-type Attention Deficit Hyperactivity Disorder (ADHD) were invented and not discovered, and efforts to popularize these diagnoses are based on politics and economics and have little to do with medicine.
In 21st-century America, when a child habitually "misbehaves" he/she is said to have a "disease." There are absolutely no organic or physiological findings to substantiate the existence of any "disease." "Symptoms" of this "disease" include such things as standing when told to sit, fidgeting, and not being happy about doing chores or homework. Since when did these childhood behaviors, ranging from normal to non-compliant, become a disease?
Anyone with a modicum of common sense can read the diagnostic criteria for ADD or ADHD and see the absurdity of this invented "disease." When the medical community and the pharmaceutical companiesÃ¢Â€Â”the chief proponents of this disease modelÃ¢Â€Â”admit that they do not know what "causes" this strange disease and cannot even prove it exists, the chuckles evoked from reading the diagnostic criteria change to gasps of disbelief. When we learn that tens of thousands of American children are being drugged with powerful and dangerous drugs based on this invented "disease," the gasps turn to cries of outrage.
There are vast implications in labeling children as "diseased" for behavior considered undesirable and then drugging them into compliance. Do we want children growing up believing that the answer to their problems lies in taking drugs? Do we want children learning that they are not responsible for their own behaviors and can instead blame a mysterious "disease?" Do we want to allow organized psychiatry, which as recently as 25 years ago told us that homosexuality is a "disease", to label childhood misbehavior as a "disease" in the absence of any proof? Do we want a society that pathologizes non-compliance and values conformity over individuality, creativity and free expression?
The physical safety and emotional well-being of AmericaÃ¢Â€Â™s children are being threatened by the ADHD/ADD diagnosis and the accompanying proliferation of stimulant drug prescriptions. A comprehensive inquiry must go beyond the self-protective jargon of the medical/pharmaceutical community and ensure, at the very least, that parents and children are exposed to all sides of this controversy and given an opportunity for meaningful informed consent before accepting this diagnosis and filling their prescriptions.
It is indeed curious that ADD is still by and large an American phenomenon, despite the recent proliferation of Ã¢Â€ÂœdiagnosesÃ¢Â€Â in Western Europe and Asia. H-m-m-m-mÃ¢Â€Â¦
Here in Australia the adverse effects of ADHD/ADD drugs are getting great coverage in the main stream media.
Trust all is well with you!
Is the diagnosis becoming more frequent in Australia as well? From some recent research I have read, it appears that American drug companies have extended their venomous marketing strategies into parts of Asia and Eastern Europe, regions of the world where citizens have never heard of ADD/ADHD.
I'm doing well, how about you?
The ADHD/ADD market has definitely expanded here. Aderall has become the new party drug. People just look up the symptoms of ADHD/ADD on the Internet then make an appointment with a psychiatrist and "hey presto" they've got themselves a speed dealer. They say 30 to 60 mg feels like a cross between Ecstasy and Cocaine and you can go all night.
It's just another part of what we call American 3-M contribution to the world. Mc DonaldÃ¢Â€Â™s, Microsoft and Mental Illness.
There is a lot of main stream media coverage on ADHD/ADD drugs causing psychosis, strokes and heart attacks. The TGA, Australia's equivalent to the FDA is a toothless lab dog of the pharmaceutical industry just like the FDA.
It seems like a large class action by parents and victims of ADHD/ADD drugs is being organised.
Take Care Miles.
Fred A. Baughman Jr., MD has been an adult & child neurologist, in private practice, for 35 years. Making "disease" (real diseases--epilepsy, brain tumor, multiple sclerosis, etc.) or "no disease" (emotional, psychological, psychiatric) diagnoses daily, he has discovered and described real, bona fide diseases.
It is this particular medical and scientific background that has led him to view the "epidemic" of one particular "disease"--Attention Deficit Hyperactivity Disorder (ADHD)--with increasing alarm. Dr. Baughman describes this himself. Referring to psychiatry, he says:
"They made a list of the most common symptoms of emotional discomfiture of children; those which bother teachers and parents most, and in a stroke that could not be more devoid of science or Hippocratic motive--termed them a 'disease.' Twenty five years of research, not deserving of the term 'research.,' has failed to validate ADD/ADHD as a disease. Tragically--the "epidemic" having grown from 500 thousand in 1985 to between 5 and 7 million today--this remains the state of the 'science' of ADHD."
In addition to scientific articles that have appeared in leading national and international medical journals, Dr. Baughman has testified for victimized parents and children in ADHD/Ritalin legal cases, writes for the print media and appears on talk radio shows, always making the point that ADHD is fraudulent--a creation of the psychiatric-pharmaceutical cartel, without which they would have nothing to prescribe their dangerous, addictive, Schedule II, stimulants for--namely, Ritalin (methylphenindate), Dexedrine (dextro-amphetamine), Adderall (mixed dextro- and levo-amphetamine) and, Gradumet, and Desoxyn (both of which are methamphetamine, 'speed,' 'ice').
The entire country, including all 5-7 million with the ADHD diagnosis today, have been deceived and victimized; deprived of their informed consent rights and drugged--for profit! It must be stopped. Now.
Try to be correct!But not always successful!
Stimulant Drugs for ADHD and ADD
The prescription of stimulant drugs for ADHD and ADD is an increasingly controversial area of treatment. Stimulants are worrisome alternative for many reasons.
Since 1991 prescriptions for all drugs to treat ADHD have quintupled. This year about six million children, roughly one child out of every eight, will take Ritalin or other forms of methylphenidate. The number of stimulants prescribed for children 2 to 4 has increased 200% to 300% between 1991 and 1995. Studies show that stimulants cause especially severe reactions in young children. Since there are no good studies, no one knows what it does to the development of the very young child's brain.
First it is important to realize that all of the stimulant drugs prescribed for ADHD/ADD are closely related to some illegal street drugs. These include dextroamphetamine (dexedrine) (street name: "dexies"), methamphetamine (street name: "crystal meth"), and, of course, cocaine. We imprison people for making drugs very similar to the drugs we prescribe to our ADHD children.
A research report in the Archives of General Psychiatry states, "Cocaine, which is one of the most reinforcing and addicting of the abused drugs, has pharmacological actions that are very similar to those of methylphenidate (Ritalin, Concerta), which is now the most commonly prescribed psychotropic medicine for children in the U.S."
The long term outcome for children is another story that has often been overlooked.
Try to be correct!But not always successful!
An Out of Control Profession_NewScientist / Infant Mental Health Now Targeted by Psychiatry_MSNBC
Monday, 03 April 2006
A report in The New Scientist, "Prescribing of Hyperactivity Drugs is Out of Control," shows just how deviant U.S. prescribing of psychostimulants for
children is compared to the rest of the world.
A graph from the World Health Organization quantifies America's bizarre prescribing pattern: "The figures are mind-boggling. Nearly 4 million Americans, most of them children and young adults, are being prescribed amphetamine-like stimulants to treat attention deficit hyperactivity disorder (ADHD). Up to a million more may be taking the drugs illegally."
Specialists in addiction, including the head of the National Institute of Drug Abuse (NIDA) worry about these drugs leading to drug dependency: Dr.
Nora Volkow argues "There has to be a re-evaluation and reassessment of the extent to which there is proper prescription."
Scientists have known that as with chronic use of Cocaine, ADHD drugs cause profound long-term changes in cognitive and other mental functions. Indeed, in 1996, Dr. Steve Hyman, the former director of the National Institute of Mental Health (now Harvard Provost) wrote: These drugs cause "molecular and cellular changes in neural function that are produced as adaptations to chronic administration of addictive drugs such as psychostimulants." Chronic exposure to psychotropic drugs, he wrote, "creates perturbations in neurotransmitter function that likely exceed the strength or time course of almost any natural stimulus."
In other words, the drugs induce a disease process by interfering with normal brain function. They produce profound neural damage and drug
addiction--a disease. See: Hyman, SE. and Nestler, EJ. 1996. Initiation and adaptation: a paradigm for understanding psychoactive drug action. American
Journal of Psychiatry, 153:151-162.
And in 2001, Dr. Nora Volkow and a team of researchers at Brookhaven Laboratories, found evidence using photo imaging techniques that contradicted the claims made by those who advocate the use of psychostimulants: "A typical dose [of Ritalin] given to children, 0.5 mg/kg, blocked 70% of dopamine transporters" --more than cocaine. "The data clearly show that the notion that Ritalin is a weak stimulant is completely incorrect." [See, JAMA http://jama.ama-assn.org/issues/v286...jmn0822-1.html ]
William Carlezon of Harvard Medical School, has studied the drugs' effects in animals and believes that they do have some lasting effect on the brain,even if its exact nature is not yet known. "Stimulant drugs leave molecular signatures on the brain, and we have to be very careful."
The New Scientist reviews some of the documented drug hazards for children reported at an FDA advisory committee (March 22): the adverse psychiatric side effects include disturbing hallucinations often involving worms, snakes or insects, experienced by up to 5 per cent of children taking the drugs.
Stimulants are not the only drugs prescribed for children without reliable or credible diagnostic criteria: antipsychotics, the most toxic of all psychotropic drugs which are linked to life-threatening hazards are prescribed for children with ADHD: A Vanderbilt report last month revealed that in 2002 two and a half million children were prescribed antipsychotic drugs. These toxic drugs have not been approved for children; for adults they are approved for schizophrenia and short-term treatment of bipolar disorder. The atypical antipsychotics are linked to cardiac arrest, hyperthermia, acute weight gain-over 100 lbs in children-dangerous levels of cholesterol, and the most severe form of diabetes.
MSNBC reports what is surely reckless irresponsible professional hucksterism: psychiatry's latest expansion is an intrusion into the neurodevelopmental life of infants: "a hot topic at major universities, and last year the American Academy of Pediatrics launched a task force with at least part of its purpose to push more infant/toddler mental health intervention." Some are already calling themselves expert "infant psychiatrists."
We challenge these newly proclaimed "experts" to show empirical evidence demonstrating that their intrusion into the life of an infant will be beneficial to that infant. Given the uncertainty at best-this constitutes an uncontrolled (hence scientifically useless) human experiment. The record demonstrates that tinkering with children's neurodevelopment is fraught with unintended harmful consequences. It is, therefore, not acceptable for those who want to intervene in infants and toddlers' lives, to be given license on the basis of an unbinding statement: "With the right therapy and care, many of these conditions can be helped significantly and often swiftly." Standards and rules of evidence must be established and met before anyone should be
given >>>>> blanche to alter infants' behavior patterns.
Who has the authority to intervene with a child's birthright to be? Or to be allowed to develop naturally and idiosyncratically at his/ her own individual pace? Who has the moral authority to say that some children should be delivered for experimental human engineering?
"the signs and symptoms of mental disorders are often also the characteristics of normal development." [See:Surgeon General Report, 1999]
As acknowledged by the chief NIMH child psychiatrist, Dr. Benedetto Vitiello: "diagnostic uncertainty surround[s] most manifestations of
psychopathology in early childhood" [See: Psychopharmacology for Young Children, Pediatrics, 2001, 108:983-989]
What evidence do these self-anointed "experts" provide to substantiate their claim of diagnosing infants?
What evidence is there to support the claim that a therapy is "right" for a young child or infant? What empirical evidence do "infant psychiatrists" provide for the claim "these conditions can be helped significantly?"
At the very least, shouldn't we as a society require of every professional seeking to render mental health services to children, to show empirical evidence that all but guarantees that no harm will result to the child who is exposed to the services being offered?
Dr. Joan Luby who is "diagnosing" toddlers with manic-depression (bipolar)--one of the most severe mental disorders that hitherto has never been unheard of in children-is quoted stating: "Treatment for mood disorders really depends on the disorder but, in general, behavioral and psychotherapeutic modalities are still the first line." But she is quick to add: "The more severe the impairment, the more likely the child will eventually need psychotherapy and medication."
What evil Pied Piper has mesmerized American adults into suspending their own judgment and common sense to the detriment of their children
Why are intelligent parents blindly following medically unsound directives whereas parents in other parts of the world do not succumb to the lure of "quick fixes?" How can the "experts" who have knowingly recommended harm-producing drugs for children be trusted?
Prescribing of hyperactivity drugs is out of control
. 31 March 2006
. NewScientist.com news service
. Peter Aldhous
Rise in ADHD?
THE figures are mind-boggling. Nearly 4 million Americans, most of them children and young adults, are being prescribed amphetamine-like stimulants to treat attention deficit hyperactivity disorder (ADHD). Up to a million more may be taking the drugs illegally.
Now, amid reports of rare but serious side effects, leading researchers and doctors are calling for a review of the way ADHD is dealt with. Many prescriptions are being written by family doctors with little expertise in diagnosing ADHD, raising doubts about how many people on these stimulants really need them. Just as worrying, large numbers of children who do have ADHD are going undiagnosed.
Both trends could lead to problems with drug dependency, argue specialists in addiction. "There has to be a re-evaluation and reassessment of the extent to which there is proper prescription," says Nora Volkow, director of the National Institute on Drug Abuse in Bethesda, Maryland. Last week, the debate intensified, following two meetings of advisers to the US Food and Drug Administration (FDA). First, the agency's Pediatric Advisory Committee suggested that parents and doctors should be warned about the risk of ADHD drugs triggering hallucinations. This followed a review of evidence of the drugs' psychiatric side effects, including disturbing hallucinations often involving worms, snakes or insects, experienced by up to 5 per cent of children taking the drugs. In February, a separate FDA
panel recommended that they should carry the most prominent type of safety warning, following 25 reports of sudden deaths from heart problems (New Scientist, 18 February, p 7).
Another FDA committee last week voted to delay an application for a drug previously used to treat sleep disorders to be marketed for ADHD. The drug, modafinil, has less potential for abuse and addiction, but the FDA's Psychopharmacologic Drugs Advisory Committee wants to see more evidence proving its safety before backing the application (see "Alternative treatments for ADHD"). Stimulants such as methylphenidate, marketed by Novartis as Ritalin, have been used to treat ADHD for decades. As well as increasing arousal and heart
rate, the drugs allow people who have difficulty concentrating to focus on tasks more effectively. Their use has exploded in recent years, especially in the US, where prescription rates are several times higher than across most of the developed world - in part because US doctors tend to use a broader definition of the condition.
Psychiatrists stress that side effects are rare, and say that the drugs have helped millions of people who would otherwise have had huge problems focusing at school and work. "These are some of the most effective treatments that we have in psychiatry," says Chris Kratochvil of the University of Nebraska Medical Center in Omaha.
To diagnose ADHD reliably, a psychiatrist would ideally observe a child for several hours, checking their behaviour against a list of symptoms relating to activity and ability to concentrate. But in many cases, family doctors are prescribing the drugs after just a few minutes of consultation, based largely on evidence of boisterousness.
Doctors are under growing pressure from children and their parents to
prescribe the drugs, as many believe that stimulants will help them get better school grades. "I have a colleague whose son was mobbed by friends wanting prescriptions," says Scott Kollins, a child psychologist at Duke University in Durham, North Carolina.
This demand is also fuelling an illegal trade. Findings published last month indicate that in 2002 more than 750,000 Americans aged 12 and over were taking the stimulants without medical supervision (Drug and Alcohol Dependence, DOI: 10.1016/j.drugalcdep.2005.12.011). Some may have been using the drugs for a traditional "high", or to keep going during all-night parties. But Larry Kroutil of RTI International in Research Triangle Park, North Carolina, who led the study, suspects that much of the illegal use is by children and young adults taking the drugs as study aids. In some cases, they are being bought by parents from illicit websites that do not ask for evidence of a prescription. "We need to look more at how people are getting
these drugs, and why," Kroutil says. Members of the FDA's Drug Safety and Risk Management Advisory Committee, which recommended the prominent safety warning on heart risks, say that they were motivated in part by concerns that many people who do not have ADHD are
taking the stimulants. "It has been clear that the drugs are overused," says Peter Gross of Hackensack University Medical Center in New Jersey, who chairs the committee.
The American Psychiatric Association argues that the picture is more
complex. "Yes, there is overprescribing," says Jason Young, the
association's communications manager. "But there is also underprescribing."
Among poorer sections of the US population, and particularly in minority groups such as African Americans and Hispanics, ADHD is believed to be widely underdiagnosed. Volkow is worried that underprescription of stimulants could lead to problems with drug abuse. Children with ADHD who are not given stimulant
drugs are more likely to develop problems with drug abuse and dependency than those who are, perhaps because they have to turn to illegal stimulants on which they can become hooked to get relief from their symptoms. So improving diagnosis and treatment among people with poor access to mental health services is important, Volkow argues.
Meanwhile, the long-term effects of giving prescription stimulants to
healthy people remain largely unknown. Kroutil's team asked illicit users whether the drugs were interfering with various aspects of their lives. On this basis, the researchers estimated that about 10 per cent were having problems with dependency. Volkow fears that problems with dependency may be more widespread. There are also hints that taking stimulants may lead to abuse of other drugs. Some studies suggest that exposing juvenile animals to stimulants makes them less likely to self-administer drugs such as cocaine when they are offered the
drugs as adults, but other studies indicate the opposite. What is needed, says Volkow, are long-term follow-up studies on people who do not have ADHD and who have taken stimulants such as methylphenidate. In the meantime, she wants medical associations to take a stronger lead in educating doctors about the proper diagnosis and treatment of ADHD.
William Carlezon of Harvard Medical School agrees. He has studied the drugs' effects in animals and believes that they do have some lasting effect on the brain, even if its exact nature is not yet known. "Stimulant drugs leave molecular signatures on the brain, and we have to be very careful," he says. "Diagnosis needs to be taken less lightly." Alternative treatments for ADHD
Despite concerns about the possible side effects of stimulant drugs such as methylphenidate, the alternative treatment options are limited. A non-stimulant called atomoxetine was approved in the US for ADHD in November 2002. Although it belongs to a different class of drugs from the more widely used stimulants, atomoxetine was implicated in some of the cases of hallucinations considered by the FDA's Pediatric Advisory Committee last week.
ADHD specialists had hoped that atomoxetine would be joined by modafinil later this year. This drug is currently used to treat excessive sleepiness, and seems to improve focus and alertness (New Scientist, 18 February, p 34). But an application to approve modafinil for treating ADHD suffered a setback on 23 March when the FDA's Psychopharmacologic Drugs Advisory Committee recommended that the drug's manufacturer, Cephalon, conduct a further study in 3000 children. Committee members were worried about a single case of a potentially fatal skin condition among the 933 patients in Cephalon's trials so far.
Though slightly less effective than methylphenidate in treating ADHD, both modafinil and atomoxetine are less likely to lead to addiction problems. That may make them particularly useful in treating patients whose social environment makes them vulnerable to drug abuse.
Apr 03 13:30:42 BST 2006
When babies see shrinks
Sometimes very young minds need special care, experts say
By Victoria Clayton
Traditionally, young children have rarely crossed paths with psychiatrists or psychologists. Not anymore. With a growing amount of research focusing on early brain development, more youngsters - even infants - are being targeted to receive the services of mental-health professionals.
There are no hard numbers available for just how many pre-kindergarten
children are being seen, but experts say infant/toddler mental health is moving into the mainstream. Psychological research on this age group is a hot topic at major universities, and last year the American Academy of Pediatrics launched a task force with at least part of its purpose to push more infant/toddler mental health intervention.
This may cause some readers to roll their eyes - especially those who
believe Americans have a tendency to pathologize and treat the slightest blip of a bad mood.
Before you pass judgment, however, it's important to understand what
infant/toddler mental health is all about, says Ngozi Onunaku, a policy analyst with Zero to Three, a Washington, D.C.-based nonprofit organization dedicated to furthering mental wellness for preschool-age children.
"When you put the words 'infant' and 'mental-health treatment' next to each other, that's really scary to some people," says Onunaku. "People think of medication and, from a more comical standpoint, they think of a baby on the couch."
Onunaku says that, in fact, a more accurate way to talk about this issue is to call it infant/toddler mental wellness. "It's more helpful to see mental health as a continuum. There are kids who need intense interventions, there are kids in the middle who are at risk for a problem and then at the other end you have your everyday, typical children who also need their caregivers to promote mental health and wellness."
While all humans can benefit from what researchers and doctors are learning about infant mental development - namely, that infants are sentient, perceptive beings whose brain development can be strongly influenced in the first weeks, months and years of life - there are certain issues that drive most parents to get help for their children.
Eating and sleep issues are primarily why mental-health professionals see infants, says Dr. Thomas Anders, an infant psychiatrist at the University of California, Davis M.I.N.D. Institute and president of the American Academy of Child and Adolescent Psychiatry. Toddlers are more often seen because of developmental delays or behavioral problems such as temper tantrums. Other reasons infants and toddlers are evaluated include abuse, adoption or other separation from a birth parent, maternal depression, premature birth and trauma such as a natural disaster or illness.
With the right therapy and care, many of these conditions can be helped significantly and often swiftly. "Sometimes one session or two sessions and a couple of phone consultations are all you need to take care of a problem,"Anders says.
Parent-infant therapy Oftentimes, it's just a matter of educating parents or teaching them some very specific parenting skills. For example, Anders, who studies infant sleep, says he may get a call because an infant appears to have a sleep disorder but sometimes it's a matter of working with parents to establish a more productive bedtime ritual.
"Most of the treatment for children under 3 or 4 is what we call
parent-infant therapy," says Anders. "Medications are very rarely used in this age group." In fact, when a young child is having any sort of problem it's always a matter of determining how the family can solve the problem.
"What we're really doing primarily with infant and toddler mental health is saying, 'What guidance can we provide to help a parent cope better?'" says Penny Glass, a developmental psychologist with Children's National Medical Center in Washington, D.C. "Sometimes it's amazing when you just counsel parents on how to establish structure."
Glass notes that having organized mealtimes and bedtimes often help families feel as if they have more control and helps eliminate toddler behavioral problems. "Even if you just help a child get a decent amount of sleep many of the problems don't seem so big," says Glass.
In some cases, parents may mistake one issue for another. Glass recently saw a boy, age 3 and a half, who was referred to her for behavior problems. But when Glass did the full evaluation she found out that the child was actually developmentally delayed and operating more at a 2-year-old level. He didn't understand some of the words or thoughts and ideas that people were trying to convey to him because they were speaking to him at the level of a 3- or 4-year-old. Once this was understood Glass could recommend therapy to help get him up to speed but she could also counsel the parents, teachers and
caregivers in how to speak and treat him appropriately.
Just knowing the problem and what they were dealing with, Glass says, helped the parents feel better, understand the child better and treat him in a more health-promoting way.
Some conditions are being detected at much earlier ages than ever. Dr. Joan Luby, a child psychiatrist at Washington University in St. Louis, says thanks to the attention being focused on infant mental health, professionals are now more likely to diagnose certain problems such as autism spectrum disorders as early as 18 months.
Research in the past several years by Luby and colleagues, published in the Journal of the American Academy of Child and Adolescent Psychiatry and elsewhere, has helped scientifically validate that children as young as preschool age can suffer from depression, anxiety and other mood disorders. Even with these disorders, though, doctors tend to be wary about medicating the pre-kindergarten set because most of the drugs used to treat the disorders haven't been properly studied in children.
"Treatment for mood disorders really depends on the disorder but, in
general, behavioral and psychotherapeutic modalities are still the first line," says Luby. The more severe the impairment, she adds, the more likely the child will eventually need psychotherapy and medication.
"It sometimes helps to think about [mental illness] in terms of diabetes," says Anders. "If a child was diabetic you wouldn't like it but you'd get treatment. If it's true that your child has a problem, you need to treat it."
Teen problems can have early roots
Experts say that while many of us haven't realized it, our children have often paid steep prices for not having their mental health taken into consideration. Dropout rates, drug abuse, suicide and eating disorders are all adolescent problems that could have roots in treatable early childhood mental health issues.
Zero to Three's Onunaku points out that we don't even have to wait until adolescence to see the impact of ignoring early childhood mental wellness.
A Yale study last year looked at the problem of pre-kindergarten children being expelled. Led by Yale Child Study Center researcher Walter S. Gilliam, the study found that in classrooms where the teacher had no access to a psychologist or psychiatrist, preschool students were expelled about twice as frequently.
"We know for certain that kids this young can have significant problems. By catching the problems early and working with them we have a chance to positively influence how their lives progress," says Onunaku.
Researchers point out that more than just influencing whether a child gets kicked out of a school or not, by identifying and treating certain mental and emotional problems extremely early there is a chance that the brain could even be altered positively.
"If we intervene early there is the issue of plasticity of the brain," says Glass. The ability of the brain to change with learning is called
neuroplasticity, or plasticity. "There are no absolutes and we know we can't just fix everything that isn't right."
But, she says, there is reason to believe that if we help early on we may beable to help more and perhaps in a more permanent way.
There's even hope, says Glass, that with early intervention we'll have fewer teens and adults "on the couch" in the future.
Victoria Clayton is a freelance writer based in California and co-author of "Fearless Pregnancy: Wisdom and Reassurance from a Doctor, a Midwife and a Mom," published by Fair Winds Press.
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