In which I tackle Something Serious

Well, this is terrifying.

I can’t imagine what it must be like to be a parent at 22, having just passed that agemarker myself. I would probably be a total wreck, and you certainly wouldn’t be reading this blog. But the above story of the woman and her child really is indicative of something very, very wrong with our medical system.

Everyone knows we’re living with a broken system, one that sees medical costs eating up 17 percent of our GDP and inflating at a rate three times that of the Consumer Price Index. The blame doesn’t just lie at the feet of insurance companies, though. (They’re certainly not helping, but they actually have a much slimmer profit margin than you might think.) Americans are starting to (starting to) fall into two categories: Those who don’t give a shit about their health or can’t afford to give a shit (which sucks so very badly), thus not receiving the treatment they need; and those who overreact and seek treatment for every little problem they encounter.

Don’t want to wait to see your general practitioner? Go to the ER. Feeling a bit under the weather? Better go to a doctor straightaway to get some antibiotics. (Not long ago, I was sick every couple weeks for a period of four months. Ear infection, cold, flu–you name it, I had it. My boss at the time harangued me, during each of these illnesses, to go to the doctor immediately, and was offended when I told him, other than the ear infection, that it really wasn’t necessary; I’m young, have a high-functioning immune system, and most of the time the doctor isn’t even sure what you have. They look at you for five minutes and send you on your way with a prescription for an antibiotic.)

Is your toddler acting up? Get thee to a child psychiatrist or neurologist, so he can be diagnosed with bipolar disorder, a condition that is incredibly difficult to diagnose in adults and encompasses a wide array of subconditions, and is really more of a spectrum than a discrete label. Finding the right medicine (hell, the right doctor) to treat the disorder is a long, grueling process that often doesn’t even have an endpoint. When you’re not the patient, you can’t possibly know what’s going on inside his head; you’re limited to interpreting external signals, which can be indicative of a huge number of mental states–even ones that fall within sociological norms. What makes this a hundred times more difficult is when the patient is just learning to speak and interact with other people in a meaningful way.

Now, again: I don’t have kids. But I was one once, and I helped my siblings grow into the surly teens they are today. (I’m 5 1/2 years older than my brother and 7 years older than my sister, so I have a pretty decent memory as far as their upbringing is concerned.) As my mother so helpfully reminds me every few weeks or so, I was an absolute monster from about the ages of six months to 3 years–in private. I yelled and screamed and beat my head with my fists and kicked the floor. But then I grew out of it (or was disciplined out of it, maybe). At gymnastics class at age 3, I was the kid who sat quietly while everyone else in the class gamboled about, driving the teacher nuts. I was the minority.

Kids are active, flighty little buggers; their brains are trying to figure out how to filter and process the overwhelming amount of information they receive every second, and they have an astonishing amount of energy. Sometimes that energy gets funneled into some pretty negative activities: My brother would frequently do something mean to me (either as retaliation against something I did to him–I’d be penalized too, in this case–or just because he felt like it, because he’s a boy, and that’s what little boys do), and would be sent to his room as punishment. Naturally, he did not approve of this punishment (purely, I suspect, because it was framed as a punishment; it’s not like his room was a broom closet or an iron maiden). How did he express his displeasure? Why, by lying on the floor in front of the door and just kicking the shit out of it. While screaming bloody murder, of course. He would do this for 20 minutes or more, sometimes kicking so hard, the locked-from-the-outside door would be jarred open. My parents did not medicate him into submission. They simply ignored his attention-seeking behavior when it was negative, and rewarded him when it was positive. When he did something bad, he was punished, and so learned that his actions have consequences. My brother is almost 18 now, and he’s just fine, aside from being obnoxiously arrogant; he is, after all, a 17-year-old boy.

My siblings and I were fortunate in that our parents were very intelligent people who knew the cognitive and behavioral milestones that children pass, and though their own were ahead of the curve, they understood that every child is different, and, just as some are a little faster, others develop at a slower pace. It’s when you have (metaphorically) poor young parents who are in way over their heads that you get problems. Of course there are fantastic young parents out there; they educate themselves and try to make as few mistakes as possible, like every other parent, and they tread carefully when it comes to medical treatment. But that can’t happen all the time. They’re busy, they’re stressed, they’re scraping by and/or going it alone, and when their kid starts acting like a total maniac or won’t talk even though the same-aged baby down the block is talking, they assume something is terribly wrong, when really it’s the kid being a kid. Maybe he’s acting out for more attention, maybe he’s just a little slower than the baby down the block or doesn’t feel the need to communicate. You can’t know this with any certainty, but what you can know is that drugs like Seroquel and Risperidal have a pretty serious side effect profile, and their impact on childhood development remains to be seen.

This is different from those horrible, awful people spreading the lie that vaccines cause autism. Vaccinations are necessary for disease control, and have a proven, demonstrable positive effect. Loading children up with antipsychotics (especially when they’re being prescribed off-label) brings us to the very fine line between “Better Living Through Chemistry” and “Just Being a Kid.”

Some children absolutely need medication. Obvious cases of ADD and ADHD, autism, etc. should be treated; it would be irresponsible not to. But cases like the one first mentioned are increasing at an unprecedented rate–shouldn’t we be exercising a little more caution here? Bringing down the number of overdiagnoses will bring down medical costs and save who knows how many kids from missing out on their childhood.

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