Q: Some parents I know seem in a rush to have their children go on medication for things like depression and hyperactivity. What should parents do before making the jump to medication?
A: For psychological disorders, a thoughtful and accurate diagnosis is key to developing an effective treatment plan. What elementary child does not have occasional concentration problems in class? Does this mean that he/she has Attention Deficit Hyperactivity Disorder (ADHD)? Similarly what adolescent isn’t moody from time to time? Do we diagnosis him/her with Bipolar Disorder? Many mental health professionals would agree that these two disorders are highly over diagnosed in children and adolescents. This is a significant concern because both ADHD and Bipolar Disorder are typically treated with strong psychoactive drugs. Once diagnosed, patients may be on these drugs for the rest of their lives.
The accuracy of a diagnosis is a function of gathering information from multiple sources and thoughtfully ruling out other variables that may better explain the symptoms. For example poor concentration is also a symptom of depression. Some would argue that mood swings are a normal function of hormonal changes in adolescence. While it can be costly, considering formal testing by a trained psychologist can dramatically increase our objective data and thus increase the accuracy of our diagnosis. There are specific psychometric tests that can assess attention impairment (e.g. the TOVA), mood disorders (the MMPI), and other psychological conditions. A comprehensive psychological evaluation would include a battery of tests; an analysis of the child’s medical, family, educational, and social history; as well as surveying parents, teachers and children, in order to get a convergence of multiple data points as to the source(s) of the presenting problem. In the end the cost of a thorough psychological evaluation may be far less than the impact of an incorrect diagnosis.
When accurately diagnosed and treated, medications can prove to be a great blessing in treating conditions like ADHD and Bipolar Disorder. We just want to do everything we can to be sure of the root cause, which allows us a much better chance of developing a treatment plan to address it.