The Bottom Line
By Kevin T. Kalikow, M.D.; 276 pages. Subtitle: An Insider's Guide for Parents to the Psychiatric Medicine Dilemma
Looking for a hard and fast answer to the question of whether psychiatric medications will be safe, effective, and necessary for your child? Too bad, you won't find it here. You will find an evenhanded look at the pros and cons, from a psychiatrist who is cautiously pro-medication but entirely mindful of its pitfalls. Whichever side of the fence you're on, or even if you're straddling it, you'll find some validation for your point of view here. Some food for thought, too.
Pros
- Writing is jargon-free and accessible to parents
- Short chapters make for quick reading
- Vignettes are also mostly mercifully short
- Forthright about the lack of scientific knowledge of how the brain and meds work
- Gives good representation and respect to all sides of the argument
Cons
- Vignettes are short, but there are an awful lot of them
- The sort of therapy and supervision recommended can be hard to come by these days
- Lack of hard conclusions may be frustrating for those who are seeking them
- Tone is sometimes condescending toward parents, though probably not purposely
- Final chapter, an extended family story, is excessively lengthy
Description
- Introduction: The "Can Do" Age of Psychiatry
- Chapter 1: The Challenge of Change
Chapter 2: The Elusive Criteria for Changing Your Body - Chapter 3: Bring on the Brain
Chapter 4: Psychiatry Welcomes the Brain - Chapter 5: A Duty to Treat
Chapter 6: The Challenge of Children
Chapter 7: The Evolving Diagnoses of Children - Chapter 8: The Burden of Proof
Chapter 9: The Benefits of Medicine
Chapter 10: Let's Be Practical - Chapter 11: The Risks of Medicine
Chapter 12: Subtle Psychological Side Effects
Chapter 13: Concealed Consequences - Chapter 14: Medicine's Competition
Chapter 15: Oh, to Be a Parent! - Chapter 16: The Pressures on the Prescriber
Chapter 17: Too Many Prescriptons? - Chapter 18: Rosie
Chapter 19: The Time Is Now - Appendices:
Are You Wise If You Try an SSRI?
Recommended Reading
Guide Review - Book Review: Your Child in the Balance
When I first picked this book up, I was pretty sure it was going to be strongly in favor of psychiatric medications for children. Flipping through and reading isolated pages, I saw vignettes that seemed to be making parents and other concerned individuals seem foolish for worrying overmuch about side effects. I expected it to be the pro-med response to a book like 101 Reasons to Avoid Ritalin Like the Plague, with a strong message for parents to be aware that living with a mental health problem and no pharmacological help can do more damage than any medicinal side effects. And as someone who has worried perhaps a little obsessively about side effects, I expected to be defensive as heck reading it.
I was surprised, then, to find in the actual reading of the book that it was entirely more evenhanded than I expected, giving good and respectful consideration to concerns about side effects both specific and societal, and advising a cautious approach involving risk and benefit assessment, regular therapy and supervision, and reduction of dosage and weaning off of meds when possible. I wish the author was a little less condescending to the parents in his little family-tale vignettes -- I don't think he even means to be, it's a doctor thing -- but I deeply appreciate the degree to which he admits that doctors don't know everything, and are going on their informed instincts just as much as parents are. The study of brain chemistry and the way it's affected by pharmaceuticals is still in its early stages, and while professionals have good guesses about what might work, prescribing is still something of a crapshoot; determining whether the odds are better than doing nothing is where the challenge lies. There, and in finding a doctor like Kalikow who will really think through these issues for your own specific child and family.
