Should kids be labelled with a psychiatric diagnosis?

Should kids be labelled with a psychiatric diagnosis (like ADHD) and should they be treated with medication (like Ritalin)?

Most people have extremely strong feelings about this topic, particularly those who have been affected in some way by their child (or themselves) having being given a psychiatric diagnostic label or prescribed medication.

There are conflicting views about what how to help troubled children, particularly hyperactive ones. From an informal survey I did recently with colleagues from all over the world, a range of strong opinions emerged about medicating young children with Attention Deficit Hyperactivity Disorder (ADHD). Most clinicians felt that medication – such as Ritalin and Concerta – should be the absolute last resort and that it is over-prescribed. My own clinical experience is that ADHD is over-diagnosed and that medication is often offered too quickly, too early. The problem with this is that sometimes ADHD really is the most accurate way to describe the child’s difficulties and that a child may actually be helped significantly by being on medication. But many parents have lost faith in the medical and psychiatric professions because it has become clear that too many children are labeled as having ADHD and treated with Ritalin. Sadly, this has led parents to have become mistrustful of the clinicians to whom they take their children for an ‘expert’ opinion.

You will no doubt have heard strong arguments about how changes in lifestyle can improve the symptoms of ADHD. Examples of these are dietary measures such as cutting out additives, sugar and preservatives, reducing computer time, screen games and TV, getting more physical exercise and more outdoor time. These common sense, constructive measures are likely to benefit your child whether or not she has symptoms of ADHD. But, although useful and important, for many kids with full-blown ADHD, these measures probably will not be enough. In addition to lifestyle changes, children with severe, debilitating ADHD may actually be helped by medication. But the reality is that there are side-effects and possible dangers of stimulant medication. It’s essential to weigh up the pros and cons of medication and also to weigh these up against the severity of your child’s condition, her quality of life and ability to learn and concentrate at school. There are children who have been transformed by being on medication, but it is not without it’s dangers so it needs careful consideration. The benefits of the medication have to outweigh its risks and side-effects. Most importantly, find a child psychiatrist whose judgement you trust. Keep talking to him or her about the right treatment options for your child. Have the necessary psychometric testing done so that you and your professional team are sure about the diagnosis and the management plan. Monitor your child’s progress and change the management plan when things are not working.