|Basic InformationMore InformationQuestions and AnswersLinksBook Reviews|100 Things Guys Need to Know3 NBS of Julian DrewA Guide to Asperger SyndromeA Tribe ApartA User Guide to the GF/CF Diet for Autism, Asperger Syndrome and AD/HDA Walk in the Rain With a BrainAdolescence and Body ImageAdolescent DepressionAfterAggression and Antisocial Behavior in Children and AdolescentsAll Alone in the UniverseAmelia RulesAmericaAnother PlanetAntisocial Behavior in Children and AdolescentsArtemis FowlAssessment and Treatment of Childhood Problems, Second EditionAutistic Spectrum DisordersBad GirlBetween Two WorldsBeyond AppearanceBeyond Diversity DayBig Mouth & Ugly GirlBill HensonBipolar DisordersBody Image, Eating Disorders, and ObesityBody Image, Eating Disorders, and Obesity in YouthBoyBoysBrandedBreaking PointBreathing UnderwaterBringing Up ParentsBullying and TeasingCan't Eat, Won't EatCatalystChild and Adolescent Psychological DisordersChildren Changed by TraumaChildren with Emerald EyesChildren’s Dreaming and the Development of Consciousness City of OneConcise Guide to Child and Adolescent PsychiatryConquering the Beast WithinContentious IssuesCrackedCutDancing in My NuddypantsDemystifying the Autistic ExperienceDescartes' BabyDilemmas of DesireDirtyDoing ItDoing SchoolDying to Be ThinEating an ArtichokeEducating Children With AutismElijah's CupEllison the ElephantEmerald City BluesEmotional and Behavioral Problems of Young ChildrenEvery Girl Tells a StoryFast GirlsFeather BoyFiregirlForever YoungFreaks, Geeks and Asperger SyndromeFreewillGeography ClubGeorgia Under WaterGirl in the MirrorGirlfightingGirlsourceGirlWiseGLBTQGood GirlsGoodbye RuneGranny Torrelli Makes SoupGrowing Up GirlHandbook for BoysHealing ADDHeartbeatHelping Children Cope With Disasters and TerrorismHelping Parents, Youth, and Teachers Understand Medications for Behavioral and Emotional ProblemsHollow KidsHow Children Learn the Meanings of WordsHow to Keep Your Teenager Out of Trouble and What to Do If You Can'tHug MeIntrusive ParentingIt's Me!It's Perfectly NormalJake RileyJoey Pigza Swallowed the KeyJuvenile-Onset SchizophreniaKeeping the MoonKilling MonstersKim: Empty InsideKnocked Out by My Nunga-NungasLaura Numeroff's 10-Step Guide to Living with Your MonsterLearning About School ViolenceLeo the Lightning BugLet Kids Be KidsLiberation's ChildrenLife As We Know ItLisa, Bright and DarkLittle ChicagoLord of the FliesLoserLove and SexLove That DogManicMastering Anger and AggressionMind FieldsMiss American PieMom, Dad, I'm Gay.MonsterMore Than a LabelMyths of ChildhoodNew Hope for Children and Teens with Bipolar DisorderNo Two AlikeNot Much Just Chillin'Odd Girl OutOdd Girl Speaks OutOn the Frontier of AdulthoodOne Hot SecondOne in ThirteenOphelia SpeaksOphelia's MomOur Journey Through High Functioning Autism and Asperger SyndromeOut of the DustOvercoming School AnxietyParenting and the Child's WorldParenting Your Out-Of-Control TeenagerPediatric PsychopharmacologyPeriod PiecesPhobic and Anxiety Disorders in Children and AdolescentsPINSPraising Boys WellPraising Girls WellPretty in PunkPrincess in the SpotlightProblem Child or Quirky Kid?Psychotherapy As PraxisPsychotherapy for Children and AdolescentsRaising a Self-StarterRaising BlazeRaising Resilient ChildrenReclaiming Our ChildrenRedressing the EmperorReducing Adolescent RiskRethinking ADHDReweaving the Autistic TapestryRineke DijkstraRitalin is Not the Answer Action GuideRunning on RitalinSay YesSexual Teens, Sexual MediaSexuality in AdolescenceShooterShort PeopleShould I Medicate My Child?Skin GameSmackSmashedStaying Connected to Your TeenagerStick FigureStoner & SpazStop Arguing with Your KidsStraight Talk about Your Child's Mental HealthStrong, Smart, & BoldStudent DepressionSurvival Strategies for Parenting Children with Bipolar DisorderSurviving OpheliaTaking Charge of ADHD, Revised EditionTaming the Troublesome ChildTargeting AutismTeaching Problems and the Problems of TeachingTeen Angst? NaaahThat SummerThe American Psychiatric Publishing Textbook Of Child And Adolescent PsychiatryThe Arctic IncidentThe Bipolar ChildThe Buffalo TreeThe Bully, the Bullied, and the BystanderThe Carnivorous CarnivalThe Depressed ChildThe Developing MindThe Dragons of AutismThe Dream BearerThe Dulcimer Boy The Einstein SyndromeThe EpidemicThe Eternity CubeThe Explosive ChildThe Field of the DogsThe First IdeaThe Identity TrapThe Inside Story on Teen GirlsThe Little TernThe Mean Girl MotiveThe Men They Will BecomeThe Myth of LazinessThe New Gay TeenagerThe Notebook GirlsThe Nurture AssumptionThe Opposite of InvisibleThe Order of the Poison OakThe Other ParentThe Present Moment in Psychotherapy and Everyday LifeThe Real Truth About Teens and SexThe Rise and Fall of the American TeenagerThe Secret Lives of GirlsThe Sex Lives of TeenagersThe Shared HeartThe Spider and the BeeThe StepsThe Thought that CountsThe Unhappy ChildThe Vile VillageThe Whole ChildThen Again, Maybe I Won'tTherapy with ChildrenThings I Have to Tell YouTouching Spirit BearTrauma in the Lives of ChildrenTreacherous LoveTrue BelieverTwistedUnhappy TeenagersWay to Be!We're Not MonstersWhat about the KidsWhat Would Joey Do?What's Happening to My Body? Book for BoysWhat's Happening to My Body? Book for GirlsWhen Nothing Matters AnymoreWhen Sex Goes to SchoolWhen Your Child Has an Eating DisorderWhere The Kissing Never StopsWhose America?Why Are You So Sad?WinnicottWorried All the TimeYes, Your Teen Is Crazy!You Hear MeYoung People and Mental HealthYour Child, Bully or Victim?
by Lawrence H. Diller
Basic Books, 2002
Review by Christian Perring, Ph.D. on May 14th 2002
Lawrence Diller's new book Should
I Medicate My Child? presents straightforward advice for parents about
their options when their children face emotional and behavioral problems and
diagnoses such as ADHD, depression, oppositional defiant disorder, conduct
disorder, and bipolar mood disorder. It
is relatively short, at 243 pages, and it is full of discussions of real life
cases based on Diller's clinical experience.
His main message is that there are many approaches to treating children,
and medication can be a reasonable choice, it is certainly not the only one
available. Many psychiatric medications
used on children have not been comprehensively tested for their safety or
efficacy when used with children, and of those that have been tested, a good
number have been shown to be of little help.
It is often safer and more effective to deal with mental health problems
in children by changing the parenting style or using very specific techniques
of rewards, warnings, and punishments.
view is that medication should not necessarily be the first resort in treating
children, and he is very concerned by the trends of escalating prescriptions of
stimulants, antidepressants, anti-anxiety pills, mood stabilizers, and
antipsychotics for children and adolescents.
Roughly 5 million children in the US are currently on psychiatric
medication; 4 million of those are taking stimulants such as Ritalin, and many
are taking two or more drugs. According
to the DEA, production of Ritalin increased by over 700% between 1990 and
1998. About 15,000 two-year-olds were
prescribed Ritalin in 1995.
study showed that roughly 1-2% of children and adolescents are taking
antidepressants, but figure rises to about 4% for 15-19 year olds. Only about 13% of children and adolescents
diagnosed with depression received a prescription for antidepressants. Another
32% received psychotherapy alone, 36% received both, and 20% received
neither. In 1997-8, about 0.4% children
under 5 received medication for emotional or behavioral problems. Estimates for the rate of major depressive
disorder (MDD) in children vary, but one recent article in a respected journal
gave figures of 1% of preschoolers, 2% of school-aged children, and 5-8% of
adolescents. The number of children
with mood and anxiety disorders seems to be increasing with each generation,
and the age of onset seems to be decreasing.
psychiatric prescriptions are written not by child psychiatrists but by general
practitioners and pediatricians. One
study showed that just 8% of its sample of non-specialist physicians felt that
they had adequate training to treat childhood depression. HMOs and health insurance pressure doctors
to see more patients, spending less time with each child, and it is not
surprising that more parents are leaving doctors' offices with a prescription
rather than a recommendation for family therapy and many follow-up visits.
discussed many of these trends in his earlier book Running on
Ritalin; that book focused particularly on Attention Deficit
Hyperactivity Disorder, and was more scholarly, being considerably longer, with
footnotes, and discussing in depth our society, psychological theories, and our
treatment of children. Should I
Medicate My Child? is a simpler book aimed at a wider readership. Although it discusses a wider range of
psychiatric conditions, it is more focused on the treatment options available
for children and their families. It
guides parents who are unsure how to proceed when dealing with their children's
emotional problems, explaining what to look when searching for a clinician, and
it emphasizes the alternatives to medication that are safe and effective.
Diller's ideas seem sensible and helpful, although some of his claims may be
controversial. He says that spanking
can be part of a reasonable parental reaction when dealing with a troublesome
child, although it should not be used excessively. He argues that it can less painful than physically restraining a
struggling child, and it can be effective in communicating disapproval of a
child's behavior. He also makes clear
that parents should not use physical punishment when children are strong enough
to fight back, because this can become dangerous.
Medicate My Child? is written clearly and is structured logically. While it may not answer all parents'
questions, it should be very helpful for the many who worry about medicating
their children and want to know what the best approach is to dealing with their
children's problems. Recommended.
© 2002 Christian Perring. First Serial Rights.
Perring, Ph.D., is Chair of the Philosophy Department at Dowling College,
Long Island. He is editor of Metapsychology Online Review. His main
research is on philosophical issues in psychiatry. He is especially interested
in exploring how philosophers can play a greater role in public life, and he is
keen to help foster communication between philosophers, mental health
professionals, and the general public.