Challenging Or Pathological?
(Column appeared on December 13, 2007, in The Montclair Times)
Molly is (some of the time) an exuberant, charming, 6-year-old girl. Every new experience seems to excite her, perhaps a little too much. She dances, she claps and pirouettes - sometimes for no rea son at all except that it is a sunny day with white fluffy clouds in the sky, or it is a rainy day with large round raindrops that fall on her bedroom window with interesting "plops".
However, it doesn't take much - perhaps a fraction of a second - for Molly to display a fearsome temper because of ... practically nothing. Someone might have looked at her the wrong way, or said "no" to something she wanted, or told her that she could not wear her red dress because it was in the laundry.
Then she crunches up her face and cries heartrending loud sobs or uses her small fists to punch the nearest wall (or person) around.
Yet five minutes later she once again seems perfectly happy.
Molly is ... very moody or suffering from bipolar disorder?
Kenneth is a very unusual nine year-old. The breath of his knowledge - especially about things that interest him - is quite astonishing for someone his age. Perhaps because of the kinds of books and on-line articles he likes to read, or because it is just his personality, he does not talk like a nine-year-old. When he discusses global warming or the Civil War or the Beatles, he takes on a professorial air and tends to lecture rather than talk. His creative writing is ... well ... creative. Perhaps too creative for some of his teachers.
Kenneth is not particularly interested in sports or any other kind of group activities. He doesn't have a best friend and he can be quite socially awkward with kids his own age, frequently not picking up on normal social cues.
Kenneth is . . . interestingly quirky or suffering from Asperger's Syndrome?
Jessica, who is seven years old, is quite timid. Large groups of people and/or people she doesn't know can make her anxious and tongue tied. It is hard for her to talk with anyone outside her immediate family; she will tend to turn away and avoid eye contact. But while she might not say much, she is keenly observant of others and has a rich, creative life at home where she loves to draw and play the piano. However, as soon as a new person enters the house - a friend of her parents, a repairman or perhaps the new parish priest - she will run and hide.
Jessica is ... very shy or suffering from social phobias?
Peter, six years old, is an active, loving young boy who can never seem to sit still or concentrate for very long. He shakes his head, he waves his arms, he wiggles his feet; he is always in motion. His idea of exercise is to bounce up and down on the living room couch - some times when people are already sitting on it! He never walks into a room; he prefers to run or skip. He loves to help others - even when they do not necessarily wish to be helped. He is ever eager to ask a question or venture an opinion and usually does not observe the niceties of waiting his turn.
When he began first grade and was expected to sit quietly at his desk and observe classroom rules, problems ensued.
Peter is ... energetic and rambunctious, or suffering from ADHD?
There is now an explosion of children whose behavior is being diagnosed as "pathological" and who are subsequently being prescribed medication whose long-term effects are not fully known. Many caring adults are questioning - and should question - why this is occurring. Are children today genuinely more pathological than they were two or three generations ago? Or is annoying, disruptive or baffling behavior too easily - and hastily - being given psychiatric diagnoses?
First of all, let me make clear that there most certainly are children who have genuine, serious psychological and/or psycho/biological problems. In these cases, an accurate psychiatric diagnosis - and possible medication - is crucial and can result in providing important and often life-altering help.
But many parents and mental health professionals are becoming deeply concerned that the process of giving children with odd or troublesome behavior psychiatric diagnosis and medication has become a worrisome, slippery slope.
Worrisome because of how such labels affect children's view of themselves and how others view and deal with them.
And certainly worrisome because of the known (and unknown) side effects of medications that have not yet been thoroughly tested on children.
What can be done? There are several effective strategies that parents and other caring adults can try with regard to children's behavior before considering medication.
- Evaluate children's diets
How much sugar, preservatives, artificial dyes and chemicals are children ingesting? Studies have shown that these food additives can affect children's mood and behavior.
- Pay attention to what children are watching on television and on the lntemet
What is the content of the television programs, video games and internet sites that children watch, are engaged, in or are exposed to? How do the characters treat one another and solve problems? Studies have shown that the degree of violence and incivility children are exposed to via the media can affect their mood, their behavior and how they view the world around them.
- Do whatever possible to ensure that children get adequate sleep
When children and adults are sleep deprived, they tend to get cranky and moody, and their ability to concentrate and make good decisions is significantly impaired.
- When children's behavior is moody, difficult and/or "hyper" try the following:
Experiment with physical, meditative and visualization exercises from ancient disciplines such as yoga and tai chi to help them focus and "de-stress".
Adjust children's physical environment (such as their bedrooms) using some basic principle of the art of feng shui to help promote a peaceful, calming atmosphere.
No matter how children behave, try to give every child a daily period of what I call "special time" (perhaps only 10-15 minutes). When a child receives uninterrupted individual attention, it can be extraordinarily therapeutic (I'll write about this concept in more detail in future columns.)
- Give children "special time"
Lastly, remember that while medicating children can be helpful in controlling certain symptoms, it does not help children solve problems, does not sensitize them to the needs and feelings of others, and does not alter difficult family dynamics.
Only caring people can do that.
Janice Cohn is a psychotherapist with offices in Montclair and Manhattan.