I concluded the last paragraphs of Part I, stating that the average depression is in many cases a natural part of life, even if unpleasant. We have instead been sold the idea that periods of depressed mood are abnormal. The DSMIV diagnoses a Major Depressive Episode after only two weeks of depressed mood and one or two episodes can be sufficient for the diagnosis of Major Depressive Disorder (MDD). It is my opinion instead, as also stated in part I, that depression, in most cases, is a self-correction mechanism that we cannot do without, as it helps us to stay on target by showing us when we are not, informing us of when we have strayed from our Soul’s path or pointing to areas of inner wounding that need healing. From this perspective it is my belief that we need, whenever possible, to teach our children to confront and resolve their pain. We need to assist them in healing their issues through careful parenting and skilled counseling, rather than numbing away feelings, moods and challenges through the use of medication. The drugs at our disposal, as wonderful as they way be, only treat the symptoms, do not tackle the underlying causes and come along with a host of adverse reactions to which children seem to be particularly vulnerable. Of course there are extreme cases in which medicating might be a valid option, but I do not believe that the majority of children that are being medicated for MDD belong to this category. The mainstream, however, does not share my point of view. The rising trend of treating depressive disorders with medication has increased so much in the last ten years as to have become the dominant medical view, with therapists, psychiatrists and doctors often suggesting medication as the first solution to mood disorders.
Money makes the world go round
Recently a person I know went to the doctor to see if he could be referred to a counselor on his medical insurance plan. The doctor said that he did not need counseling but medication after less than a five minute interview. When my friend said that he did not want medication as he did not agree with chemically treating the depression he was experiencing, he was pretty much told that he did not know what he was talking about. He was shown no compassion for the problems that he was dealing with. He left the doctor’s office very distressed after a heated argument with the very person that was supposed to assist him.
This is not an isolated case. It seems that the medical profession has bought hook line and sinker the idea that psychotropic medication is the only way to go in the treatment of depression. And the reasons do not all have to do with the fact that they believe that medication is the better treatment. Some of the reasons for which some doctors now prefer to prescribe medication over counseling to adults and children alike is that it is the option preferred by the insurance companies. Effective counseling takes time and insurance companies are not all that willing to cover the costs of the many sessions it takes to explore and heal issues through the therapy approach. Most insurance companies do not cover more than twenty counseling session and some cover only as little as eight sessions. Even considering the upper scale of the number of sessions covered, twenty sessions is less than four months of weekly sessions, a time scale that is often not sufficient to bring true results. Paying for counseling sessions privately, at least in the US, is very expensive and many cannot afford to pay for this kind of treatment on their own. In this light it is not surprising that we are seeing an increase in the prescription of medication in both adults and children.
Money makes the world go around, the saying goes, a statement that has never been more appropriate than in recent times. Small businesses are gradually disappearing swallowed up by large corporations that by their very nature are more anonymous in their customer care and ultimately more concerned with their bottom line than with the well being of their costumers. Gone are the times of the small pharmacy that knew their customers intimately. Gone are the times of the nurturing family doctor. They are being substituted by an efficient medical machine that seems to run more on the principles of profits and losses than on the principles of healing. If we do not want our children to be caught up in the cogs of this machine, we need to be aware that the choices and advice given to us by mainstream medical/pharmaceutical industry do not always come from a place of care but more often than not from a chain of decisions of a financial nature.
The drug approval process
Let’s take for example the drug approval process. In the US drugs are approved by the FDA, the Food and Drug Administration. This is a body that, amongst its many tasks, is in charge of making sure that the new dugs that pharmaceutical companies create are safe before they are distributed and marketed to the public. The FDA also makes decisions as to what will appear on the drug labels. For obvious reasons, the FDA is supposed to be a neutral body where the drugs undergoing trial and testing are scrutinized thoroughly using impartial and accurate scientific procedures. However there has been growing concern that the FDA might not be as neutral as it should be. Peter Breggin M.D. states in his book Talking back to Prozac that whilst the general public mostly believes that the FDA takes tough stands towards the pharmaceutical industry, that this has never quite been so. According to Breggin, enormous amounts of money are required to finance the drug approval process and often these monies are funded by the very pharmaceutical companies whose drugs are under scrutiny. Breggin states in his book that a former FDA official told him that he estimated that Eli Lilly, the drug company that manufactures Prozac, contributed $80 million to the approval process for the revolutionary SSRI drug. If what Dr Breggin and other researchers are saying is really true i.e. that the organizations that are supposed to regulate the use of pharmaceuticals are partly paid by the businesses that produce them, questions concerning conflict of interest arise naturally.
Common sense prompts me to observe that, generally speaking, it is difficult to be neutral towards the sources of one’s funding. I remember that when I was studying Physics at university in Italy the government began motions to privatize the state university system. This meant that universities, that in Italy were a public institutions, would be taken over by private industry, which would become in charge of financing both academic matters and research. Within a week students across the country entered into a strike that lasted several months on the grounds that there could not possibly be independent research once industry was in charge of it. The motion did not pass and the state university system remained government funded. For the same reason of maintaining independence, it would make sense to see that agencies that are supposed to look after the good of the public health be funded by public moneys only. If not we risks to see the integrity of regulatory bodies deteriorate. And this may already be happening. A study conducted by Dennis Cauchon published in USA Today states that more than half of the experts hired to advise the government on drug safety and effectiveness have financial relationships with the pharmaceutical companies that will be helped or hurt by their decisions. The study states that often the same experts that are hired by pharmaceutical companies to develop these drugs are the same that are hired by the regulatory bodies whose job is to judge if they are safe enough to be approved. It sounds a bit enmeshed to me. And it makes one wonder about how scrupulous and accurate the approval process for SSRI antidepressants such as Prozax, Paxil, ect. had been. These drugs were initially approved without much ado and it is only now, after several years from the original approval, that side effects such as increased aggression and suicidal ideation are being acknowledged by the FDA. These same adverse reactions had been observed by many on the ground for years.
Mental health, kids and the New Freedom Initiative
We could continue on and on with issues within the drug approval process, as unfortunately there are many others, but for now I would like to return to the main theme of this article, touching upon other issues in mental health that are of concern for our younger generation. In particular I would like to bring to your awareness an initiative that is brewing at the level of policy in the US. And as it is common that trends that start in the US, often spread to other countries, I feel that this is an issue that parents and educators worldwide need to be aware of. I am referring to the plans announced in 2004 by President Bush as part of the New Freedom Initiative to screen the population, including preschool children, for mental illness and psychiatric disorders. This initiative emerges from the findings of the President’s New Freedom Commission on Mental Health that reported in 2002/2003 that mental health problems were not being adequately addressed and were costing lots more money than they should do. The initiative aims at readdressing problems in mental health through screening and testing as a preventive measure.
Although this might sound like a good idea on paper, we have to be aware of issues presented by screening. From what I understand from the articles I have read, and I encourage you to do your own reading and research on this subject, it seems that the plan is to introduce ‘universal screening” targeted at children as young as three years old. The thinking behind this is obvious: if mental health problems are caught early enough they can be treated early saving lots of money to society at a later time. It costs less to treat a child and nip an illness in the bud than to treat psychiatric disorders in an adult. Disorders in adults are usually more established and take much more time and effort to treat, with costs spreading across a time span of years.
If I understand correctly, the universal screening initiative seems to suggest the idea that the screening will be compulsory. And here is where the possible pitfalls start. The first is that as we have seen in part I of this article, current diagnostic criteria for psychiatric disorders are far too wide and there is already, in my opinion and that of many others, a tendency to over-diagnose kids as having disorders that they don’t have. This is particularly obvious with ADD/ADHD, but over-diagnosis of depressive disorders is also common. The second issue is, once the children have been diagnosed, what happens with regards to treatment? Do the parents or guardians get to have a say with regards to treatment or is the treatment imposed from above? There is worry as far as the new initiative is concerned that it may contain the possibility of compulsory treatment taking choice out the family’s hands and placing it in the lap of government. It is important that awareness is raised collectively with regards to this issues as to prevent any possibility that parents might loose their right to decide what they see as best mental health treatment for their child. Already historical precedents exist in which parents have been deemed unfit or charged of child abuse for refusing to medicate their child. However on the plus side, many states in the past two years have also been passing laws that state that refusing to medicate a child with psychotropic medications or stimulants does not constitute by itself grounds for charges of neglect, child abuse or prerequisite for attendance and admission to schools and state services. There is hope that with more awareness being raised amongst parents and policy makers that all states will follow suit.
It is paramount that advocacy groups succeed in making sure that the New Freedom Initiative or initiatives like it does not extend as to override pre-existing laws that protect parental right to choose treatment for their children. A part from exceptional circumstances in which the parent or guardian is already deemed unfit to make good decisions for the child in other areas of the child’s life, the choice of treatment for children needs to remain firmly within the hands of parents at all times. Lets me remind you that the state’s approach to the treatment of mental health issues of the children in its care has been heavily orientated towards psychotropic medication, as can be seen quite clearly with kids in state homes or kids in state foster care, where so many of the children are on multiple psychotropic drugs, receiving psychiatric medication instead of the nurturing that they require. Of course medication is less time consuming and more cost effective than adequate psychological care. For the sake of our kids, we need to be very aware of any initiative that might threaten to diminish parental rights to chose treatments for their children. The New Freedom Initiative is one whose future development definitely needs monitoring with a watchful eye.
Medicating children below six years of age
In closing I would just like to mention a few words on the increasing trend of medicating children below six years old, including infants, with potent SSRI antidepressant medications, such as Prozac, and psycho-stimulants, such as Ritalin. It is a well known fact in psychology that the psyche is at its most vulnerable in the first five or six years of life. We need to think very carefully before prescribing powerful mind altering drugs to such small children as psychological damage caused before the age of six is the most difficult to heal later in life. The adverse effects of these drugs administered at such a young age could have far reaching consequences and could scar them for life. No test from any drug approval process could ever tell us about the long term consequences of these drugs on the development of the still very malleable psyche of small children. Such tests would take decades of observations, following the development of a child into adulthood. In a way this kind of test is going on, but not in the lab. It is happening right here, in the real world, on our children. It saddens me to the depths of my being that this is so. If at all possible, do not medicate small children and help to spread the word that medicating a small child should always be one’s last option. I have not had time to conduct the research to back me up on this statement. But I know in my gut and my Spirit that we are treading dangerous ground. Something in me shudders when I think of an infant or a toddler on SSRI antidepressants. I feel we are playing God with the most vulnerable amongst us and it does not sit well with me. If an infant is depressed we need to cradle it and nurture it, not fill the little one with drugs. And besides, I struggle with the idea that we can make definitive psychiatric diagnosis in children of such a tender age.
Our young of the new millennium face novel challenges that are particular of the modern technological times we have built for them, and, ironically, they need to be protected by the very progress and advances that we have made. This is true in so many ways, but becomes urgent when dealing with new trends in mental health. Remember that pain and depression, to some extent, are a part of life. Teach your children to face and befriend their moments of difficulty and despair as stepping stones to wisdom. Know that quick fix solutions are not always the best path. Look for the causes of presumed psychiatric disorders and try alternative approaches to mental health. Always seek a second opinion on any diagnosis made regarding your child. And, last but not least, keep your eyes very open on current developments in mental health policy and become an advocate for children and parental rights. Many of the readers of CNE are enlightened educators and parents for which the information above is redundant. But many children of the modern world are not so lucky and they get sucked into the wormhole of mainstream policies, under the guidance of less informed guardians. Become aware of problems affecting the general population and less fortunate children and help whenever possible to raise awareness. Children are our most important resource and they deserve a fair shot at life. They deserve to develop into the best human beings they can without their mental health being threatened by a too widely spread chemical solution.
Note: None of the statement made in this article are meant to replace the advice of a trained mental health professional. The author’s opinions here expressed are offered to stimulate awareness and raise questions, not as substitute for appropriate medical advice, diagnosis and treatment. If your child is on medication, know that it is dangerous and at times life threatening to discontinue medication without the support of a licensed mental health professional. Never stop psychiatric medication without the appropriate assistance and supervision of a trained professional.
©2005 Katie Gallanti. All rights reserved. http://katiespapaers.blogspot.com. This article was first published in Children of the New Earth Magazine in February 2005.
References and further reading
Breggin P. M.D. 1995. Talking back to Prozac. St Martin’s Paperbacks.
Breggin P. M. D. 1994. Toxic Psychiatry: Why Therapy, Empathy and Love Must Replace the Drugs, Electroshock, and Biochemical Theories of the "New Psychiatry". Saint Martin’s Griffin.
Breggin P. M. D. ‘s web site. www.breggin.com
USA Today Exposes Conflicts of Interest in FDA Drug Approvals. Articles by Dennis Cauchon written in 2000 for USA Today retrieved from http://www.mercola.com/2000/oct/1/fda_drug_approvals.htm
FDA Issues Public Health Advisory on Cautions for Use of Antidepressants in Adults and Children. Retrieved from http://www.fda.gov/bbs/topics/ANSWERS/2004/ANS01283.html
The President’s New Freedom Commission on Mental Health. http://www.mentalhealthcommission.gov/
Adams. M. 2005. President Bush’s mental health screening initiative: Commentary. Retrieved from http://www.newstarget.com/001688.html
Lenzer J. 2004. Bush plans to screen whole US population for mental illness. Retrieved from World Net Daily. http://www.worldnetdaily.com/news/article.asp?ARTICLE_ID=39078
Institute for Health Freedom. 2004. President Bush proposes screening the US population for mental illness. Retrieved from http://www.forhealthfreedom.org/Publications/Privacy/MentalScreening.html
Citizens Commission for Human Rights. 2002-2004. U.S. bills and resolutions introduced or passed against coercive psychiatric labeling and drugging of children. Retrieved from http://www.fightforkids.com/bills_resolutions.htm
Thoma R. 2004. Critical look at the foster care system – medication of children. Retrieved from http://www.liftingtheveil.org/foster13.htm
Bishop M. 2004. Foster kids on mind altering drugs? Retrieved from http://www.woai.com/troubleshooters/story.aspx?content_id=168321B6-DF50-4A2F-83D1-1789D8F2A18A