Mental Disorders in Children and the Importance of Early Detection

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Newspapers such as New York Times or the Wall Street Journal, have been presenting articles that write about some alarming statistics about the use of medications with children, or the use of medications for things like Attention Deficit Hyper Activity disorder. And I think reading some of those articles puts parents and even doctors in the situation that they are very scared to prescribe, because of the hysteria behind alot of the information presented.

There's a high percentage of mental illness, and the reality is less than 50% of those get the actual treatment or help they need. And if we could identify things earlier and sooner, we could help people have more of a normal life. I think few and other fields of medicine would argue not to treat something.

For example, if I was a neurologist and you came to see me, you had a seizure disorder, of course I will give you medication to treat that. I'm not sure why that cannot apply to psychiatry as well but if we see something, and you identify it early, then we should get treatment early.

We have the psychiatric disorders that actually start in childhood and they tend to be ones that occur with children because of probably developmental, and they involve things like either processing or control, so you have Attention Deficit Hyperactivity Disorder, you have Autism, you have Ticks and Turrets, and you have a whole host of sort of learning disabilities that could also present with emotional difficulties.

And then after that I think as children mature and become adolescents and adults, one also has to be concerned and be on the look out for things like anxiety disorder and depression. They each require their sort of specific therapies, they may not always require medications. You know it's more than here's the medication and everything is better.

And depending on the severity of the symptoms or how impairing they are, a lot of children can get better and families can get better with non-medication therapies that might include either behavorial therapies, confidence behavioral therapies, it might invlove coordinating treatment with school, and school personnel so it may not always require medications.

I think the deciding rule or deciding factor that goes into that, is how is, what's the level of impairment. You know how much are the symptoms getting in the way and how much are they impairing. We have much better identification and because of that we have much earlier identification.

And I think as anything else in medicine if we are going to use that as a analogy and parallel is that it clearly the earlier we can identify, the sooner we can get treatment and the sort of the better the outcome. But question I always tell parents if they come in and they are worried about the side effects of medication, I would throw it back and say, what are the side effects of not treating something.

And you know there are now some sophisticated brain studies and brain imaging work in which children are followed on medications. The brain scanning showing that a year into the medication treatment or more, the brain is starting to look like sort of what we would consider normal brains.

So again earlier treatment, you could reverse the course sometimes of a particular illness to help a child develop more normally and have a normal life. A big part of the treatment for the children is actually working with their parents, and a lot of times parents don't know what to do, or parents may also be quite exhausted from trying to do what they are doing to help the child.

So a lot of the treatment is also supporting the parents, giving them the strategies and the skills and also the understanding of what to sort of expect over the years. Things do get better, we can help them make changes, the child can get better, and the family gets better.