Sunny With No Chance Of Angst; Medication Dilemmas: 11-20-11

Sunny With No Chance of Angst: We hope. The young ladies seem to have passed their first domestic crisis and spent Saturday attending a matinée of The Wiz at our local High School. Last heard from, our daughter was coming back to their apartment for a chicken dinner.

Medications in The Special Needs World: Given the propensity for negativity during “menses” we will revisit options including medication to circumvent a recurrence. We will also address the Seasonal Affective Disorder (one cousin recommended vitamin D) conundrum and anxiety. Our daughter’s history with medications for moods, anger, anxiety, and attention challenges is typical of the special needs community. Many of the students at her boarding school, Riverview, were on a pill potpourri ranging from seizure drugs to anxiety, depression and attention medications. Other health issues including diabetes and childhood arthritis were heard of through the grapevine. The health care center was the busiest place on the campus.

Medication History: As early as first grade, Attention Deficit Disorder medications were utilized periodically but they muted down our daughter’s already delayed speech development and her frolicsome personality and she would crash so badly that they were discontinued. In middle school her anxiety was treated with Wellbutrin and then Depacote was called in to moderate the frequent aggressive and defiant outbursts that were undoing us all. Those medications also inhibited her personality and eventually were disbanded but they did facilitate her learning tremendously. She entered high school sans medications but ended her challenging freshman on birth control pills to treat premenstrual and menstrual mood strife. (Her menses began at age 11 1/2, how ironic that the only area of development on the early end of normal was one of the most challenging for a young girl to handle.) They worked beautifully for years but when she gained weight we decided to give her a break when she graduated high school. Since then she has been medication free.

The Challenge: In addition, we did many trials of natural remedies and I worked for a long time with a naturopath who lived in a far away place and was a disembodied voice coaxing us along. To expedite this long-range treatment I was asked to provide a video of our daughter’s temper tantrums, which I later showed our daughter. She was pretty mortified and apologized. We did the full series of Auditory Sensitivity Training and of course the hallmark of sensory integration treatment in those years, brushing. Our daughter received occupational therapy, physical and speech therapy, naturally, throughout elementary school and continued speech and O.T. in middle school.

A Costly Effort: All parents of special needs of any kind, whether their child be cognitively or emotionally challenged, put hours and dollars into consulting, dosing and ruminating about what works, what makes worse, what burns out, what side effects, seen and unseen, might bring down the whole house of cards.

Talk About Complicated: This is one of the more complicated issues facing folks today in all areas of life. In my field, patients are constantly debating the usefulness of anti-anxiety and anti-depression medications along side fears of life long dependency, often labeling themselves as “weak” for choosing a medication manner for dealing with difficulties. Side effects like dry mouth, weight gain and loss of libido further complicate the process. For special needs parents, the medication issue casts prickly pangs of guilt as we the parents are often the deciders, which presents its own emotional burden. Seeing our children suffer uncomfortable side effects, lose their particular swagger and spirit, or feel somehow punished for behaviors they cannot control is agonizing and terribly sad.

The Proof Should Be In The Pudding, Really? Most psychiatrists today, also known as psychopharmacologists, mix cocktails of medications, customized for the particular medley of symptoms the patient exhibits. This is an art as my husband has educated me to understand over the decades, and requires careful monitoring of side effects, meticulous coordination with medical conditions, and most important, specific feedback well-listened to from the patient. This is no walk in the park for anyone and I have serious trepidation as we now revisit that can of worms with our daughter. Riverview teachers, staff at Ability Beyond Disability: everyone would love to see her on anti-anxiety medications, or medications that enhance focus and attention. Easier said then done. We have been there before and it can be a hellish ride. The answers rest with the young lady and we will approach putting any kind of pudding together very carefully, consulting with experts and for me, relying on my gut. I know her second best. She knows herself best.

The Proof Should Reside In The Pudding but the process of finding just the right ingredients for that pudding can rain havoc and misery upon our gal. The whole process has to have those bright plastic caution ribbons wrapped around it. This is no simple pudding.

©Jill Edelman, M.S.W., L.C.S.W. 2011

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