Yesterday I shared the story of getting one of my kids diagnosed with Post Traumatic Stress Disorder. His teachers thought he had Attention Deficit Hyperactivity Disorder, but wise medical professionals were able to identify the more accurate diagnosis. In both the mental health and foster care arenas, there is a lot of controversy over psychotropic drugs being used to treat children. Most studies that I have read conclude that there are way too many kids in care getting medicated for conditions that may not necessarily warrant that extreme intervention. I agree that medication is an extreme intervention. Foster parents who want their kids on medicine for the ease of parenting or the higher board rate check are out there and are wrong. I was going to parent this child right. I was going to put in the time because love heals all wounds.
We tried therapy and TONS of reflective listening and positive reinforcement. We identified the child's need for information and ownership of his story.
"You are growling and throwing your toys against the wall. It looks like you are angry."
"You thought I said you could buy ice cream at school today, but I didn't say that, so you had no money. That was why you ran around the cafeteria when Mr. Miller called your class to their tables?"
"I see white on your nails!! You didn't bite them! Let's cut them outside and then you can play with your soccer ball. Great Job!!"
"The medicine that the Doctor gives you is picked out to make you better. If you took your sister's medicine, it would make you sick because it's not yours. When people take medicine that the Doctor didn't tell them too, it makes them unhealthy. Every kid needs a healthy parent to take care of them and keep them safe."
"Do you remember the first time you slept in your room here? What did your tummy feel like that day?"
I will say that the behaviors we saw in the way of tantrums and defiance did gradually get better. I had to constantly stop myself from comparing day to day or even week to week. Month to month, though- we were getting somewhere.
The questions started almost immediately from friends, family, teachers, caseworkers:
"Is he on something?"
"Has anyone mentioned medicine?"
"My [nephew, neighbor, whatever] started Ritalin and is an honor student now."
I was viscerally opposed to medicating a BABY with drugs that alter his mood and personality. I made it very clear that I would NOT give up on my child. I would work with him. I would hold him accountable. I would not medicate him.
Then someone who I don't even like all that much looked me in the eye and said, "At what point does you protecting him turn into keeping him from the last thing that could help him?" I don't speak to that person anymore, but they were right.
I started to ask questions to other parents who had children like mine. I found out that the people who started using medications for their kids had struggled with the same objections I had. They had neutral to positive feedback about using these meds. What I found REALLY helpful was a friend who shared their own journey with medication for themselves. They said that it helped without changing who they are. I knew that if that was true, I wanted it for my struggling child.
After a particularly unbearable 2 weeks for everyone in our house. I called the caseworker and said that we needed to start pursuing medication "to preserve the placement". Those are fighting words around here. I meant every single one of them at that moment. I joked with Brandon that the medicine we pursued didn't even have to be for the child. If I could get some horse tranquilizers, I wouldn't care about the daily calls home from school.
We met with the Doctor who prescribed an extended release stimulant medicine that is typically used for focus. We gave it in the morning with breakfast and it worked throughout the day. The school LOVED it. He was listening and focused. His papers were getting completed and he stayed in line in the hallway. At home, though- he never stopped talking from 3pm to 3am- not even to breathe. He wasn't sleeping at all. He was ripping his skin off his fingers. Pulling his baby teeth out that weren't even loose. Not eating. We were all going bonkers. He has allergy meds that we keep around for seasonal allergies and itching skin when he picks. They both have an anti-anxiety effect. We started giving that regularly to calm him down. When that did nothing, we started melatonin to help him sleep. He started complaining of stomach aches and headaches everyday to the school nurse. She started to check on him daily to ask how he was feeling, and he started responding, "sad.". We went into the Dr again. There we found out he had lost 3 lbs in just 2 weeks. That medication was discontinued.
We then took a different approach and placed him on an anti-anxiety med. In just 3 days, all the negative side effects had cleared up and we were seeing a much less angry kid. He stopped that constant talking, and there was much rejoicing. I loved what I was seeing at home. He was still himself, but he seemed more aware of his surroundings and less wrapped up in himself. It was nice. Until the notes from school started rolling in. He was not staying with the class, telling crazy stories to get out of work, trying to get the other children to play with him instead of doing what the teacher instructed. He was using baby talk to make the kids laugh, and trying to sneak toys into class at the bottom of his backpack or packed in his pockets. When he was caught he said he gets bored at school.
I asked him what he needed to get out of the cycle of bringing home negative reports everyday. He said, "You can just give me my pink pill. I promise I won't be sad and I will eat my lunch." Even this small child could tell the difference. He wanted to do better. He knew he needed help.
After a month of desperate pleas from the teachers, the Dr agreed to try a fast acting stimulant at school. In the morning when he gets to school, the nurse gives him the pill. It lasts about 4 hours and during that time he has great focus. By the time he gets home, it is out of his system and is ready to eat, sleep, play- all without the aggression that the anxiety caused before. He doesn't have perfect days like with the other med, but he has the chance to make good choices with a little assistance.
We were able to take down the allergy med to just as needed, and he no longer needed melatonin.
We continued with therapy, positive reinforcement, hold him accountable for poor choices. We understand that behavior choices are harder for him than other children, and we are teaching him that means he has to try harder. Right and wrong don't change because you have had a raw deal in life. I wish it was different for him, but it wasn't. Excusing poor choices doesn't help anyone.
I never thought I would be one of those foster parents who dope up their kid to make them behave. I always knew that I would do anything for my children, though. When those two ideals contradicted each other, it took me a while but I chose my child over my stereotypes of bad parenting. When I did, we both found peace.
That being said, medication is a big deal with bug side effects, as we saw. It should not be entered into lightly and should be monitored closely by a medical professional who knows the child and all about traumatized kids in care. Our kids are different and need to be treated specially for their condition. If I could do it all over, I would still have turned over every stone for years before trying medication. Even now that we have a good regimen that is working, all of the non- medication stuff is still as important as it was before.