Hello,

Here is an article from the Australian which illustrates the problems 
some boys face at school.

Cheers,

Vincent Patrick



----------------------------------------


http://www.theaustralian.news.com.au/common/story_page/0,5744,12078781%255E23289,00.html


The Australian

Unhappy pills
Clara Pirani
January 29, 2005

CAROLE-ANN was stunned when teachers said her seven-year-old son had 
attention deficit hyperactivity disorder.

"They recommended that we have him assessed for a possible learning 
disorder, which involved an IQ test. He produced outstanding results in 
puzzle-solving, well above average, but performed badly in tests that 
involved reading.

"The motor skills assessment showed he had trouble standing and hopping 
on one foot. So they said he had ADHD."

Carole-Ann was horrified that nobody bothered to ask if there were any 
problems in her son's life at the time that might be causing the changes 
to his behaviour, or if he had any physical problems.

"They didn't know that he was born with club feet that required surgery 
– and they were asking him to stand on one foot and balance, which was 
impossible."


Carole-Ann had also just separated from her husband and was suffering 
depression after the death of her brother and mother. She was 
incorrectly diagnosed with bipolar disorder and ADHD, and admitted to 
hospital.

She fought the diagnosis, and was released after a magistrate ruled she 
had probably suffered a drug-induced psychosis from the range of 
medications she had been prescribed, which included Prozac and 
dexamphetamine.

Carole-Ann has no doubt Stephen was reacting in part to the turmoil at home.

A week after teachers demanded to know why Stephen was not taking 
Ritalin, she moved him to another school.

Two years later, neither Carole-Ann nor her son takes any form of 
medication.

"He has had no problems at his new school and is very happy and doing well."

Experiences like Carole-Ann's are not uncommon.

Doctors are increasingly prescribing drugs to treat an ever-widening 
array of conditions, from ADHD to depression.

Last month a British Medical Journal article (2004;329:1394-6) warned 
that unhappiness among children seemed to be rising, but labelling it as 
depression and prescribing antidepressants was ineffective and possibly 
harmful.

Author Sami Timimi, a UK-based consultant child and adolescent 
psychiatrist, wrote that the boundaries between adulthood and childhood 
have become blurred and children were being viewed as miniature adults.

"One effect of these changing expectations of childhood and parenting is 
that more childhood behaviours previously considered normal are now seen 
as problematic, and problematic behaviours are more likely to be 
medicalised.

"These days we are as likely to use medicalised terminology to describe 
children's feelings (such as depressed) as we are less pathological 
descriptions (such as unhappy)," Timimi wrote.

Federal government figures released in April 2004 revealed 250,000 
antidepressant scripts were issued to Australian children and 
adolescents in 2003, 30,000 more than in 2002.

The head of psychological medicine at the Adelaide Women and Children's 
Hospital, Jon Jureidini, says doctors are increasingly looking for 
medical explanations for childhood and adolescent problems.

"We're more likely to conceptualise suffering as being something that 
needs to be treated, or medicalised, than we used to be. So stress is 
more likely to be construed as an illness," Jureidini says.

"There is this notion that unhappiness needs to be treated. And it can 
be dangerous both from the point of view that the drugs can sometimes be 
dangerous, but also because sometimes significant, bad things in kids' 
lives get missed because it's seen as a medical problem, rather than 
recognising that they are just responding to bad things happening in 
their lives."

Jureidini believes doctors are not spending enough time investigating 
the reasons why children are depressed. He says the situation is 
compounded by other problems including patients' desire for a quick-fix, 
and a lack of mental health services.

"A lot of people think medication is quick and easy and any doctor can 
give it, whereas therapy is very complicated and difficult, and you have 
to go to a specialised mental health service. And there aren't many of 
those around."

In 2002 a NSW parliamentary inquiry into the use of prescription and 
over-the-counter medication by children and teenagers found some parents 
actively seek out doctors who will prescribe drugs.

It revealed a Commonwealth Department of Health and Aged Care report 
found 16 per cent of mothers surveyed admitted to shopping around until 
they found a GP willing to prescribe medication, even when their own GP 
had refused.

Jureidini believes parents feel enormous pressure to make sure their 
child is "normal". "Parents are unsure when their child is showing 
typical teenager angst or whether they are experiencing a more serious 
mental illness that may require treatment.

"What makes that worse is the idea that is pushed around that if your 
kid's depressed, they might kill themselves. A lot of parents are very 
frightened by that. But antidepressants haven't been shown to be helpful 
in those instances."

Louise Newman, chairwoman of the faculty of adolescent and child 
psychiatry at the Royal Australian and New Zealand College of 
Psychiatrists, disagrees and says a better understanding of mental 
illnesses, combined with prescription medication, may be responsible for 
the fall in teen suicides.

"The adolescent suicide rate has plateaued and is now going down, so 
we're obviously doing something right. Maybe GPs are getting better at 
picking up severe depression in adolescents and are treating it early."

Newman argues medication should rarely be used for mild or moderate 
depression, and only when other treatments had failed. "Our position is 
that for the majority of mild to moderate depression cases in children 
and early adolescents, antidepressants and drugs are not the first-line 
treatment. We need to keep advocating for a broad range of treatments 
for young people. And part of the problem for GPs is that there is not 
easy access to alternatives."

However Newman says it's difficult to assess the problem because the 
prescription of antidepressants is not properly monitored. "We'd like to 
know what else was tried, for how long, what was the response, whether 
antidepressants were prescribed as initial or second-line treatment and 
what sort of response is there to anti-depressants.

"And we don't know that."

Newman says the college has been meeting the Therapeutic Goods 
Administration and other medical bodies to improve the monitoring of 
children and teens who are taking medication, especially antidepressants.

However both Newman and Jureidini believe doctors need to be more 
proactive at finding alternatives to medication.

"We have to put the child's concerns into some kind of family, school 
and social context. Instead of saying 'what illness do these symptoms 
represent', we should say, 'what do these symptoms mean, and what does 
this tell us about the predicament this child is in and what can we do 
to alter that predicament'," Jureidini says.

It's perhaps not surprising that the diagnosis and treatment of mental 
illnesses, particularly depression, is often controversial.

Unlike a broken arm or leg, the physical signs are difficult to identify 
and symptoms are open to interpretation.

Despite ongoing education campaigns and research into ADHD, debate about 
the prevalence and treatment of the condition continues.

In November a bi-partisan report of a lower house West Australian 
parliamentary committee estimated 11,500 children in that state – some 
as young as two – were prescribed psychostimulant drugs, mainly 
dexamphetamines, for ADHD.

It called for an urgent overhaul of the state's model for treating the 
condition and recommended the federal Government investigate and address 
the dispro portionate use of dexamphetamines across the states and 
territories.

In 2000 a federal Government report, the National Survey of Mental 
Health and Wellbeing, surveyed 4000 people in Australia and found 11 per 
cent of parents thought their child was suffering symptoms of ADHD.

Prescriptions for dexamphetamine – the top-selling drug to treat ADHD – 
have skyrocketed during the past decade. In 1994 about 46,000 
prescriptions were issued for dexamphetamine, compared to 246,000 in 2004.









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