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Everyone wants to be heard. Everyone wants to have their truth acknowledged. Maybe this is why one of the biggest frustrations we deal with growing up is the sense of not being heard – or even having a voice. Sometimes when children are referred for psychiatric medication, they resist. They don’t want to be seen as different or to be labeled. So parents are put into a difficult position. As I wrote earlier this year,
Deciding whether to medicate a child is a big decision. It can give a child the chance to experience life with less anxiety and social conflict. Sometimes, medication is absolutely necessary. But often, there’s an unfortunate side effect: parents drop the skills-training and other support they were providing their child. And their child gets the message loud and clear: When you’re struggling, use medicine. No need to keep practicing your friendship skills or learning tools for attention and how to self-regulate. Put all your faith in the pills.
This issue was at the front of my mind while reading Dosed, a new book that exists to recognize the experiences of what its subtitle names “The Medication Generation.” Drug-driven treatment, says author Kaitlin Bell Barnett, “has shaped who they are, who they seem to be, or who they declare themselves to be.”
Indeed, issues of selfhood are often front-and-center as Barnett examines the life stories of a representative sample of young adults, as well as her own experience. For as she notes, youth is a time of self-discovery. The sense of self is developing, evolving, maturing. Add meds, and “Who am I?” can become a kind of Gordian knot: Am I me or the medication? Do the pills make me Me? Or is the real me the one who has problems that the drugs cover up?
“I don’t really feel the medicine anymore,” a fourteen-year-old girl told researcher Tally Moses in her study of teenagers’ commitment to continuing their medication. “I’m sure it’s helping me in some way…. Like I started taking medication for ADHD when I was five years old so it’s not like it’s new. I’ve pretty much lived with it for as long as I can remember.” Nevertheless, for many kids at this age, the drugs contribute to a sense of constantly grasping and questing after one’s identity, of being involved in a very immediate and intense process of self-discovery that leads to more introspection and questioning, even in the case of long-lasting treatment. In addition to asking what purpose the medication is serving and how well it is achieving that purpose, teenagers can quite legitimately ask another question: “Am I still the same person who needed medication back then?”
As Barnett and her subjects reveal, it’s not just the nature of the drugs or the act of medicating that raises these questions. Adults’ actions matter, too. Perhaps the most common example is when a child is having a bad or problem-riddled day, and a parent, or other adult asks if they’ve remembered to take their medication. Or consider the well-intentioned explanation that a child’s problems are due to a “chemical imbalance,” which, as Barnett notes, effectively “[separates] the child from the problem.”
With this kind of messaging, it’s relatively easy to become disconnected from one’s feelings. Barnett cites psychiatrist David Mintz:
“A healthier person thinks, ‘Well what does this mean and what should I do with this,’” he explains. “’Does my guilt mean I shouldn’t ever do this thing again? Does my anger mean I have to confront somebody?’” But some young people who have spent their formative years taking medication, he has observed, “end up thinking of their feelings not as guides, but simply as symptoms.” Debra Emmite, a child and adolescent psychiatrist in Houston, also thinks that medication, and the symptom-based model of biological psychiatry that goes along with it, can cause kids to doubt the authenticity of their emotions.
And if “self” is tied to symptoms, what happens when symptoms change? Barnett describes her own experience of tapering off Prozac at her doctor’s suggestion and struggling to understand her “deterioration” when new symptoms arose.
It’s striking to me now that I was so blithely confident that it was the same old problem – and that Prozac would work as it had before – despite the unfamiliar symptoms. To my recollection, no one suggested, and I didn’t consider, the possibility that what looked like a relapse might be withdrawal, my brain adjusting to functioning without the drug…. Instead, I took the represcription as confirmation that I did, in fact, have a fundamental, lasting “chemical imbalance” that needed righting. I refused to conceive of this chemical imbalance shifting over time, which is one reason I had considered it absurd of my pediatrician to suggest my depression might no longer require medication treatment. But in assuming so resolutely that I required continuing pharmaceutical treatment, I ended up missing the ways in which my problems – or at least my problems as they manifested themselves – had in fact changed….
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With only one way of understanding my problems, I forced my new symptoms to fit into the same conceptual framework. To do otherwise would have been to dismantle the coherent sense of self I’d worked so hard to construct.
There can be a similar grasping for identity in the refusal to take meds, as well:
What may see like a simple act of frustration or a developmentally normal assertion of independence, however, can also reflect a deeper, fundamental anxiety about what taking medication signifies, or about the ways in which it makes you “not yourself.” At a time when the search for one’s identity is already a fraught, challenging, and muddled process, rejecting drugs that change emotions and behavior can be not only a rebellion against authority figures, but an attempt to preserve the aspects of self kids hold dear.
Dosed really underscores why it is so crucial that we teach and nurture mindfulness in the children in our classrooms, clinics, studios and lives, especially when medication is deemed necessary to help them cope. The kinds of social-emotional games and processes we do in Yoga Calm support this task, just as the physical yoga helps them be in tune to what their bodies are saying. Kids gain tools and strategies for making sense of their treatment and developing a stable sense of self. It’s why more and more psychiatric clinics and treatment centers dedicated to the well-being of children are turning to Yoga Calm as an adjunct treatment. Bottom line: It improves outcomes.
You can learn more about Dosed at rxdosed.com and the author’s blog.
This week, we’re pleased to feature a guest post by Donna Freeman, yoga instructor, author and founder of Yogainmyschool.com.
With the new school year already underway for some and on the verge of beginning for others, Donna offers some terrific tips for making a positive return to school, which older kids can follow on their own and parents can teach to younger children.
The first day of school is an eventful day. Many children are excited, but there may also be some anxiety and nervousness. Here are some hints on how to avoid chaos and head back to school filled with confidence and enthusiasm. These 7 tips will help you start the school year positively and energetically. By setting yourself up for success emotionally, physically and intellectually, each day will offer new adventures and opportunities for learning and growth.
- Rehearse
Before the first day of school arrives, take the time to do four things. First, locate the bus stop and know what time your bus will pick you up and drop you off. Alternatively, trace your path if you walk or drive to school. Second, do a run-through of your morning routine. Know what time you have to get up and the tasks that need to be done to get out of the door on time. Third, visit the school in order to find your classroom and say hello to your teacher. Fourth, visualize your success. See yourself succeeding at school, developing good work habits, making new friends. - Be Prepared
Pack all your supplies into your backpack. Set out your clothes (maybe a favorite shirt, new shoes or special piece of jewellery) the night before. Have contact numbers for parents and a trusted family friend accessible. Tuck in some money for the cafeteria. Get enough sleep. - Create a Homework Plan
Designate a specific place at home where you will do homework. Make sure you have all the necessary supplies (pens, paper, ruler, glue, markers, etc.) at hand. Set personal homework rules and times such as “Homework is done before watching TV.” Make a homework plan and set goals for the coming year. - Share
Talk to someone about your fears. Your parents, teachers, siblings and friends are there to support you. Ask for help, even with the little things. That way they don’t become major obstacles preventing your growth and development. - Plan Meals
Good nutrition is important. Be sure to stock up on healthy options for breakfasts, lunches and snacks. Include fresh fruits and vegetables, fiber-rich grains, lean proteins, and a re-usable water bottle. - Try Your Best
Put your best foot forward and smile. Inhale and exhale slowly if you feel anxious. Say hello to the new kids. Be calm and positive knowing that within you are all the talents and resources needed to meet any challenge. Remember your sense of humor and that school is fun. - Reward Yourself
Plan a small incentive for the end of the first day. Maybe it is a play-date with your best friend or a special activity with the family. Change can be daunting and you’ve achieved another milestone, so reward yourself for a job well done and celebrate life’s special moments with those close to you.
Donna Freeman, founder of Yogainmyschool.com and author of Once Upon a Pose, believes in living life with an open heart and a upbeat attitude. She encourages all individuals to embrace lasting positive change and connect with who they are and their infinite potential.
Photo courtesy of Avalore
leah pritchard/Flickr
Physical exercise has more than just physical benefits. For instance, as we wrote a while back, when kids exercise more, they also tend to achieve more academically. In Spark, John Ratey provides ample support for this as well as the many other benefits of exercise for children and adults. For example, exercise also has a positive effect on mood, emotions and psychological well-being – so much so that exercise is now prescribed for conditions such as depression. (And some say it should be prescribed even more.)
For a long time, when people talked about the psychological effects of exercise, they usually focused on endorphins – opiate-like compounds released by the pituitary gland and hypothalamus during exercise or when we’re excited or in pain. More recently, research has looked at the possibility that changes in dopamine or serotonin levels during exercise might be involved.
The truth of the matter is that we don’t yet completely know why exercise makes us feel good mentally as well as physically, but some intriguing research out of Princeton may bring us one step closer to understanding this important phenomenon.
According to a report on the study published late last year in the New York Times, there appears to be a difference in neuron response between active and sedentary rats.
Scientists have known for some time that exercise stimulates the creation of new brain cells (neurons) but not how, precisely, these neurons might be functionally different from other brain cells.
In the experiment, preliminary results of which were presented [in October 2009] at the annual meeting of the Society for Neuroscience in Chicago, scientists allowed one group of rats to run. Another set of rodents was not allowed to exercise. Then all of the rats swam in cold water, which they don’t like to do. Afterward, the scientists examined the animals’ brains. They found that the stress of the swimming activated neurons in all of the brains. (The researchers could tell which neurons were activated because the cells expressed specific genes in response to the stress.) But the youngest brain cells in the running rats, the cells that the scientists assumed were created by running, were less likely to express the genes. They generally remained quiet. The “cells born from running,” the researchers concluded, appeared to have been “specifically buffered from exposure to a stressful experience.” The rats had created, through running, a brain that seemed biochemically, molecularly, calm.
In short, exercise was shown to reduce anxiety.
Notably, the changes don’t happen overnight but, as other research cited in the article has shown, emerge over a period of weeks. Nor is it entirely clear yet how these findings translate to human activity – although one of the reasons rats are so commonly used in studies such as this is that their metabolisms and other bodily functions are so similar to those of humans.
However, we do see – both in research on physical education and in our own work with students – much lower anxiety levels after some weeks of regular physical movement relative to anxiety at the beginning of the course. In fact, a good number of kids whose parents enroll them in Yoga Calm courses are there precisely because of anxiety and related mood disorders, the parents looking for ways of helping their children cope.
Similar results are reported by teachers, nurses, counselors and other school workers who have brought Yoga Calm to the classroom. The blend of breath work, physical activity and social-emotional games not only helps ease anxiety but also gives children tools for coping with anxiety and big emotions when they do arise – and they will, invariably. They are a part of life, after all. But by giving children – and ourselves – the means to handle them when they arise, we allow them – and ourselves – a way to thrive in spite of such difficult feelings.
Since the onset of the current economic crisis, much has been discussed and written about how its effects are not just financial but psychological, as well. And as a recent New York Times article reminds us, they affect children just as much as adults.
Children, especially, have become hidden casualties, often absorbing more than their parents are fully aware of. Several academic studies have linked parental job loss — especially that of fathers — to adverse impacts in areas like school performance and self-esteem.
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A recent study at the University of California, Davis, found that children in families where the head of the household had lost a job were 15 percent more likely to repeat a grade. Ariel Kalil, a University of Chicago professor of public policy, and Kathleen M. Ziol-Guest, of the Institute for Children and Poverty in New York, found in an earlier study that adolescent children of low-income single mothers who endured unemployment had an increased chance of dropping out of school and showed declines in emotional well-being.
We are not born knowing how to deal with stress, especially the psychological kind. Rather, this is a skill we learn, most commonly by observing others. Thus, it is not surprising that children pick up on stress cues demonstrated by parents.
lanuiop/Flickr
As we discuss in Yoga Calm for Children, some stress, of course, can be positive – a kind of motivating factor. But if the stress goes on too long, the stage is set for physical illness. As Robert Sapolsky shows in his book Why Zebras Don’t Get Ulcers, although stressors – even massive or chronic ones – don’t automatically lead to illness, they do increase the risk of disease. Health risks include compromised immune system function, inhibited growth and even death of brain cells in the hippocampus; osteoporosis; cardiovascular disease; neck, shoulder, and back pain; rheumatoid arthritis; asthma; depression; and diabetes.
In children, emotional and physical development may be impaired. And unhealthy ways of reacting to and interacting with the world may become entrenched. Some examples of such maladaptive behaviors and other coping devices are described in the Times article:
Paul Bachmuth’s 9-year-old daughter, Rebecca, began pulling out strands of her hair over the summer. His older child, Hannah, 12, has become noticeably angrier, more prone to throwing tantrums.
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When Rebecca began pulling her hair out in late summer in what was diagnosed as a stress-induced disorder, she insisted it was because she was bored. But her parents and her therapist — the same one seeing her parents — believed it was clearly related to the job situation.
The hair pulling has since stopped, but she continues to fidget with her brown locks.
The other day, she suddenly asked her mother whether she thought she would be able to find a “good job” when she grew up.
Hannah said her father’s unemployment had made it harder for her to focus on schoolwork. She also conceded she had been more easily annoyed with her parents and her sister.
At night, she said, she has taken to stowing her worries away in an imaginary box.
“I take all the stress and bad things that happen over the day, and I lock them in a box,” she said.
Then, she tries to sleep.
How stress affects an individual depends upon the person’s genetic makeup, experience with stress, and how he or she has learned to cope with it. Children under acute or chronic stress may exhibit any of a wide variety of symptoms, many of which are readily observable by parents, teachers, counselors, physicians, and others who regularly interact with children. Obviously, any symptoms of chronic stress should prompt inquiry and possible action to alleviate their causes. If left unattended, they can become impediments to learning, create additional challenges in classroom management and set the stage for long-term health problems.
However, no matter what the source, all children will benefit from learning how to handle their stress in positive, proactive ways – to become stress-hardy, as illustrated in the graphic below.
From its roots in a therapeutic context, Yoga Calm’s tools were developed to directly and comprehensively address the threats to children’s health by teaching lifelong stress management and social/emotional skills. The approach is effective with a wide range of children, and adults too – further expanding yoga’s definition of “union” – and is now playing a catalytic role in the continuing evolution of school-based yoga interventions.
Learn more at yogacalm.org.
For further reading:
- “Stress-Proofing Kids Through Yoga” (PDF), Natural Awakening, August 2008
- “Secrets of Healthy Kids” and related yoga activities, Natural Solutions, September 2009
