December 6, 2010

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Bob-

I saw a sixteen-year old girl for a sports physical today. She plays softball for the local high school and also is on the volleyball team. She gets good grades, takes honors classes, and serves in the student government. She presented with her mother, whom I assumed was her biological mother due to a fairly striking physical resemblance. I was surprised to learn that this young woman had actually been adopted at age twelve by the mother, into a very loving and stable home. Previous to her adoption, she had spent six years in over eleven different foster homes, after she had been taken from her alcoholic, neglectful, and abusive biological mother at age six.

What happened to her after entering the foster care system is an all-too-common tragedy, which luckily has a happy ending in this case. She was diagnosed with ADHD at age six and started on stimulants. She saw psychiatry and counselors regularly and was diagnosed with multiple psychiatric diseases: ADHD, PTSD, oppositional-defiant, and RAD (Reactive attachment disorder? Never heard of this one . . .) She was put on multiple stimulants and “some other medicines” for these “diseases,” and according to her was never given a drug holiday from age six to twelve, not even over summer breaks or holidays. I’m not sure of all of the details, but finally she came into the custody of the family who would eventually adopt her, and the adoptive mother was astute enough to recognize the iatrogenic and environmental nature of her symptoms: the aggression, the paranoia, the rapid cycling mood states, the low weight, the headaches. Before adoption, the new mother went to the psychiatrist asking if they could decrease the medications, only to be told flat out that the girl was diseased and would never get off the meds.

The mother proceeded with the adoption, and when she had legal custody, she took her off the meds over a summer. When the psychiatrist found out about this, he angrily discharged the patient and her mother from his practice, saying he couldn’t care for her if she wasn’t compliant. She had some initial behavioral swings and adjustments, but overall there was a dramatic improvement, and by the time the next school year started three months later, she went from a C and D student to an A and B student in one year. That was three years ago, and now she is thriving in high school.

Today, prior to me divulging any bias against psychotropics, I asked her how she feels about her whole experience of being on meds, and she fairly burst out saying, “I hated those medicines. They made me feel horrible.” I asked how she felt now, and she said, “Like a new person, with a whole new life in front of me.” Interestingly, at the time of her adoption, she asked to literally change her first name, from Vanessa to Charity, as she wanted to have an entirely new identity from her chaotic childhood years.

Imagine all of the variables in her case: the in-utero drug and alcohol exposure, the physical and verbal abuse as an infant and toddler, the abrupt separation from the biological mother, the chaotic bouncing around in the foster care system. Throw in the multiple psychotropics, the constant negative reinforcement from doctors and counselors that she was broken and needed a pill to be fixed, the lack of continuity at every transition. How could anybody mature in that milieu and find a way to psychologically survive? In her case, she was rescued by one loving, discerning adult who took a chance on her and provided a new paradigm of self, a launching pad for life, free from prescription drugs. Instead of more meds, the cure was in stopping them all and providing a stable home. Today, she certainly seems like a young woman with a bright future.

One alarming message of this story is the self-serving, destructive psychiatric care in the foster care system that places these defenseless children on chemical restraints in order to moderate normal acting-out behaviors that are, more than anything else, sequelae of their unstable environments. But the other aspect is the incredible resilience of the human brain and spirit. Give a seed good soil, adequate sunlight and water and room to grow, remove from it toxic influences and chemicals, and it is amazing what beautiful flowers can bloom.

Mark

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Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.

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