To medicate or not to medicate, that is the question. I have been in the field of Autism as a professional for over 30 years. During that time, I have seen children on a variety of medications at a variety of ages. As a parent, I have chosen not to take that path. Well, not just me, both my husband and I have chosen not to medicate. As a behavior analyst, I felt well-equipped to help my son by teaching FERBs (functionally equivalent replacement behaviors) - essentially, teaching him more appropriate and efficient ways to have his needs met without aggression, property destruction, or any other maladaptive behavior. I guess I thought I could program his sadness away. I say sadness, because we have been struggling for the past year to help him accept our family’s move to a new home. His emotions ran from extreme anger with aggression and property destruction, to extreme sadness with excessive tears and sullenness. Over the period of a year, I can count on one hand the number of times that I have seen him smile, and still have fingers left over. His daily disposition was a frown on his face and anger in his voice. It has been truly heartbreaking. I have been reading about the connection between autism and social deficits leading to social ostercization and increase suicide ideation (e.g. thoughts of suicide, suicide attempts - both successful and unsuccessful). Reading this really got me to look at my son’s symptoms outside of autism. What I saw was someone who was grieving the loss of his childhood home, someone who was socially isolated and without friends, someone who preferred to sleep all day rather than be in the world and finding things to enjoy. Even before the move, I noticed a change in his disposition with the onset of puberty and teenage years. I also recall once him saying that he did not like being in his ‘big’ body. Everything was changing, his voice, his facial hair, his hands, legs, arms, his height, everything was growing and he did NOT like it! HE asked if there was anything I could do. HE did not like how he was feeling. This to me, was a cry for help and I listened.
For the sake of transparency, I must admit that I suffer from clinical depression. It is a diagnosis that I received while grieving the death of my first husband and father of my two daughters. Without going into too much detail (maybe in a later blog), this is when I first began to take medication for my emotional well-being. When stating to my doctor that I wanted to be free from medication all together, she asked if I took any other medications. I explained that yes, I had hypertension, and took medication to control my blood pressure. She stated that mental health is a medical condition the same as physical health. A chemical or hormonal imbalance in the brain is similar to a physical imbalance in the body. The only difference is the stigma associated with one over the other. If it is ok to take blood pressure medication, then it should also be ok to take medication for mental health. This gave me a new perspective. One that allowed me to see the benefit of medication for my son. Not as a cure for autism (because there is no such thing - nor would I want to), but as a means to help his depression and/or anxiety. My husband understood this analogy and he agreed.
I found a psychiatrist specializing in autism and medication management. He talked to my son and asked him three very important questions: 1) How are you feeling? 2) Do you want to feel better? 3) Do you want to take medication to help you? His answers were basically, I feel like crap, I don’t like it and I want to be better. I spoke with the doctor at length to talk about the several medications available. Because of my history of medication use for depression, I was familiar with several and how I felt when using them. I also recognized that it takes trying out dosages and brands until you find the right one. His psychiatrist gave me clinical information about each medication option before offering his recommendation. As a researcher, this was very comforting for me. We started him off with a very low dosage to see how it goes.
Week 1: I was not expecting results so quickly, but he was out of his room and sat on the sofa with us. His face was relaxed and he was smiling!! He was talking to his family without yelling angrily. He played games with me! He gave me kisses on the cheek. Once, I asked him to play a game with me (e.g. dominoes, board game, etc.) He said no at first. I said, “Please” and he replied while smiling, “You are such a child!” I cracked up laughing! I felt like I had my son back. Seeing him smile, seeing him come out of his room to interact with us means EVERYTHING! I recently asked him how he was feeling. He said, “I feel better. I slept really good last night.” HIS WORDS!
As always, I must add that these are MY experiences. This is what MY family is going through. I share as a way to help others see our path and how we are navigating through. If you are considering medication for your child with autism, if you can, find someone who has experience with children on the spectrum and medication. Talk to your child, if you can, and ask them what they want. My son is now 17years old. Your child might be younger or older. Whatever the case, make your decision with love. Not to take away the autism, but to help your child and your family find what works for you. Ultimately, this is YOUR journey and you have to walk in a way that only YOU can walk. Take comfort in knowing that you will and can make the best choice for you.
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