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‘WHAT IF’ PALES BESIDE ‘WHAT’S NEW?’ IN TREATMENT

0 Comments | Palm Beach Post, Apr 4, 2010

I wish I had a nickel for every time I heard “Our kids are overmedicated” or “Every kid has ADHD — it’s called being a kid” or “The pharmaceutical companies are trying to cultivate a new generation of pill poppers” or any variation on that theme.

What if there was a treatment for children and teens with mental illness that did not involve medications? I thought about this on Saturday as I listened to doctors from the McLean Psychiatric Hospital in Boston talk about how they treat young people with more than medication.

Their discussion led to a discussion about transcranial magnetic stimulation. TMS sounds a little “out there.” It is not — I repeat not — shock therapy. There are no restraints or sedation.

A small magnetic coil is placed against one side of the scalp. Magnetic impulses penetrate approximately 2 to 3 centimeters beneath the coil directly into the brain to produce electrical currents. These currents activate cells that are thought to release neurotransmitters, which play a role in mood regulation. It is painless, lasts about an hour and does not require a linebackeresque mouth guard.

It is a when-everything-else-fails kind of treatment, used on people who have found no relief from medications and therapy. It is a daily procedure done for about 4-6 weeks. The FDA approved the procedure for adults in October 2008. It has not been tested on children and teens. In fact, there have been no proposals to use TMS on young people.

But maybe someday TMS — or something similar — will be.

I stared at the floor as the doctors took more questions on a smorgasbord of topics. I saw myself many, many years ago, a teenager, sitting in what looked like a dentist’s chair with something about the size of an iPod Nano stuck behind my ear. I felt no pain. I woke up and my hopelessness and despair were gone. I no longer wanted to sit alone in the basement listening to The Who’s Quadrophenia and reading Sylvia Plath. I no longer wanted to get drunk and stoned. I wanted to fit in. I wanted to go to the prom. I did not want to die.

We are not there … yet. In the meantime, the doctors from McLean showed their respect and willingness to try other treatments: talk therapy; 12-step programs; cognitive-behavioral therapy, which focuses on changing negative patterns of thinking (“I am worthless”); and dialectical behavioral therapy, which uses Buddhist principles to enhance cognitive-behavioral therapy.

I started “What if-ing.” What if these types of treatments had been around in the 1970s — when all hell broke out in my head? What if there had been psych hospitals like McLean for kids like me? What if I had gotten help? What if? … what if? … what if?

“What ifs” are a waste of time
adhd doctor