Doggie Downers (or: Better Living through Chemistry)

emscrip.jpgFor the last two weeks we have been dosing the dog with Xanax. This is not a matter of caprice on our part. Since the Em-dog broke her toe she’s been under virtual house-arrest: allowed out for functional walks, but no cavorting, no social life, no bounding about to examine the smells and textures of her world. So the vet prescribed the generic for Xanax, which scrip was filled at the local Walgreens. The scrip was filled for “Emily the Dog Robins,” which oddly tickles me. And I have to say that the stuff didn’t seem to be doing much to help the dog cope with her imprisonment–the first week Emily was reasonably good-humored about things, but this week she’s been a wreck (which means that the rest of us haven’t been having much fun either). Today I took her in for her checkup; while the bone is mending well, it looks like there’s going to be at least two to three more weeks of house arrest, a thought which chills my blood (and would likely chill Emily’s). The vet gave us a new and more intense Doggie Downer to help the dog get through the next couple of weeks, with instructions to try her on half a pill before we go whole hog.

I have mixed feelings about this; would I so quickly stuff my kid with drugs just to keep her from driving me nuts? And yet, I’m a consumer and a believer. In 1986 my mother, who was very ill–in part as a result of years of tobacco and alcohol abuse–was put on an early SSRI (selective serotonin reuptake inhibitor), so early it didn’t even have a brand name. For the last three months of her life she did not drink, and showed no signs of withdrawal; further, she became the person I remember from my childhood: funny, appreciative, charming. And about a year ago I went on a low-dose anti-depressant which has been immensely helpful to me, personally. So I truly do believe in the power of chemistry to help, sometimes life-savingly help.

On the other hand (and there’s always another hand, have you noticed?) I don’t love the way drugs are marketed for everything from restless legs to tearless eyes to sleepless nights. A few years ago I was at a friend’s house; said friend had a child who had some unspecified problems; his mother just knew that he had ADHD and needed Ritalin. When she found a doctor who agreed, the kid was prescribed Ritalin, and one of the most unsettling things I’ve seen is David taking his pill–all bouncy and goofy one minute, and the next, soft and boneless as the Ritalin kicked in. In the end, his mother decided that Ritalin wasn’t the answer and took him off the drugs.

Now, I am a bona fide Older Person and a Veteran of the milder skirmishes of the Drug Wars of the 60s and 70s. Back in the day, watching my peers get toasty on a couple of hits of pot, or a line of coke, or whatever, never bothered me particularly. But watching essentially the same thing happen to a kid who hasn’t opted for it himself, because his behavior made his mother worry troubles me. And I guess, in the same way, I feel a little guilty dosing the dog so that I can get a little something done.
Emily’s sleeping next to me as I type; the half pill has taken the edge off her anxiety and quieted the restless pacing and keening; she’s relaxed and comfortable. And I’m not having to play tug o’ war for hours on end. I should enjoy that, right? And I do. Sorta.

Pardon me: I’m gonna pet the dog.

8 thoughts on “Doggie Downers (or: Better Living through Chemistry)

  1. We drug our child.

    She’s on small amounts of generic adderall for ADD. Not hyper but the opposite, unable to stay on an assigned task unless an adult sits there beside her constantly redirecting her attention to the task at hand.

    We resisted this for years.

    And the educational team who worked with us were pretty constant in their support of any direction we wanted to try. But they did say this: When it works, it works really well.

    And so, finally, we tried it.

    She was always brilliant, identified as gifted long before we tried medication, but she does better, for now, with this drug. She’s better academically, socially, and physically.

    But boy do I understand not wanting to use drugs when you don’t have to.

  2. Yes. I fought hard against the diagnosis, for years. But ultimately, I’m thankful we had access to medication for TNGirl.

    Her ADD is so severe that it resulted in major developmental delays early on. With years of intensive interventions and therapies, she had overcome those developmental delays and soared intellectually, but it had no effect on the inattentiveness, which made it difficult for her to accomplish anything.

    When we finally tried medication, at the urging of a specialist, it was as if someone had switched on a light in some area of her mind that had been in shadow before. (And then, of course, I had to contend with the guilt of not trying it sooner, because they had been telling us for years they thought she might have ADD.)

    For people with ADD, apparently, there is a part of the brain that doesn’t work properly — the part that tunes out sensory “noise.” The medication activates that part of their brain, and finally they are able to tune stuff out that they don’t need. It calms them and enables them to focus normally. For the rest of us, it makes us hyperstimulated and obsessive.

    It can be hard to obtain a certain diagnosis of ADD/ ADHD, without expensive MRIs and whatnot that expose the child’s brain to lots of radiation… but if behavioral/ observational screenings suggest that the child has the symptoms and they are interfering with their ability to function at home and school, I strongly advise parents not to shrink from trying it.

    ADD is both over-diagnosed, and under-diagnosed, because its symptoms can mimic other conditions. But for people who suffer from it, while behavioral and other therapies can help them compensate to a degree, medication is really the only thing that works reliably to restore their ability to dampen out all the unwanted inputs and concentrate. It’s no different than diabetes or other physiological disorders in that sense. And if your child is not ADD, you can tell pretty quickly that the medication isn’t helping.

  3. I’m resisting pontificating about this… But —

    I worked for a couple of years on a psych unit. Before then, I’d kinda inchoately believed that psychoactive meds were best used for short times in moderation, to get past a really tough spot. During and after their application, insight therapy and hard work on your own self should be the preferred treatment.

    Until I encountered a lot of people who simply weren’t gonna be able to manage without daily doses of some heavy drugs. You don’t talk people down from schizophrenia, and manic-depressive disorder, and… so many other things that make us less-than-optimally-us, in major and minor ways.

    The reality is that our brains are delicately balanced dynamic webs. And some of us need some additives to attain and keep the balance. Being good and brave and strong and moral and smart and insightful doesn’t enter into it. It’s just neurochemistry. Yeah, counseling and diet and exercise and better sleep and training in stress management are all good and can help tremendously.

    But sometimes our brains just don’t quite make all the right chemicals. And there are consequences for denying this and trying to tough it out.

    I spent much of my adult life on the cyclothymia roller-coaster. The depression was jagged and unmanageable, often completely chemical, unrelated to life events. The mild mania was quite pleasant.

    I always avoided drug treatment for this, as that would have been a sign of weakness, and the other warriors of the tribe would have killed me.

    Then I tried a six-month course of St. John’s Wort. Smoothed me out. When I discontinued, I was no longer cyclothymic.

    Some mechanism, some channel, got opened up and changed my neurochemistry. I still have my ups and downs, but they tend to be related to something concrete in my life.

    I miss the mania. I’m smarter and quicker and funnier then.

    But I’m willing to make the trade.

  4. Rory, I’m glad the St. John’s Wort helped you. One of the many things I tried in a multi-year attempt to control “non-stop PMS,” as those of us who are heavily into denial refer to severe depression.

    There was NO way I would take psycho-meds. No way in hell.

    That would be admitting failure and defeat. Not to mention I was more than a tad doctor-phobic. Until Warren Zevon was diagnosed, and was quoted as saying that being afraid of doctors was not, as it tuned out, a good survival strategy.

    That seriously spoke to me, as I’d already decided that I wanted to survive. I got up the nerve to see our “regular doctor” — and was totally blown off and insulted because I was presenting with obvious symptoms of severe agitation, and a self-diagnosis of non-stop PMS.

    What the hell did I know? My problem was that I needed to quit smoking, but since I thought was depressed, he’d prescribe Wellbutrin for a couple of months. Let’s just say I never filled that prescription and have never seen that doctor again.

    Obviously, I didn’t give up, and found a kind, caring, intelligent OB/GYN who believed in listening to his patients, and who believed that his patient’s quality of life was of utmost importance.

    So now I’m on “happy pills,” and will be for the foreseeable future. I can just barely see the edge of where I can go off the meds off there on the horizon.

    I totally empathize with anyone’s angst, anguish, hesitation and indecision regarding psych-meds. I can also affirm that if you need them, you NEED them, and when they work, they WORK.

  5. Finally, at the end of high school, the contradiction between acing standardized tests and failing classes became too vivid, and I was pshrunk. ADD. So I went off to college with a bottle of Ritalin.

    The problem with taking an older person and putting them on such meds (at least in my case) was that they made me more normal. All the adaptive mechanisms I had in place to deal with the problem suddenly overbalanced me – like letting go in a tug-of-war. I could sit and do my homework for uninterrupted hours – and when I stood up, I couldn’t even have a conversation – I defocussed hard and fast. I eventually went back to the tried and true.

    So I am still ADD, but I have enough control that I could, with a couple decades of prodding, adjust – and be functional, even if my wife still complains about a certain lack of focus. The meds were too late. I’m glad TNGirl has the right meds and can bridge that gap early.

    T.S. Eliot – The Hollow Men (excerpted):

    Between the idea
    And the reality
    Between the motion
    And the act
    Falls the Shadow

    Between the conception
    And the creation
    Between the emotion
    And the response
    Falls the Shadow

    He meant it differently, I expect, but that’s what it’s like for me.

  6. What’s interesting is that I had pretty much the same symptoms as my daughter but there was some sort of shift around the time I was a junior in high school. Went from D’s and C’s to A’s and B’s.

    But there was the point in second grade that one of my teachers told my mother, “I was so relieved when I read this poem Steve did. I was beginning to think he was retarded.”

    No meds back then for this stuff.

  7. I come from a long line of differently emotional people–I have one of those Victorian great-greats who, overwhelmed, simply went to bed for seven years (leaving my great great grandmother to pick up the slack around the house for the whole family. Don’t get me started.) My grandfather was an alcoholic, as was my mother. (I suspect the alcohol was, at least in part, a pre-SSRI attempt to medicate for depression.)
    Through the miracle of genetics, I’m likewise prone to depression, but it wasn’t until last year that I did something medical about it. I tend to feel that I should be able to handle stuff: straighten my shoulders, take a deep breath, and just not be troubled; this approach didn’t work when it came to asthma, and last year I finally admitted that it wasn’t working well for depression.
    I’m fascinated by the extent to which all this stuff–ADD, depression, etc.–seems to have a genetic component. And I’m so glad that there are meds now that weren’t available for my great-great grandma.

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