Nobody wants to medicate their child. Parents want their children to grow and develop naturally into young adults. Through life experiences they will learn to express themselves, to tactfully verbalize their thoughts and feelings, to give and take, to try new things, to communicate in ways that are effective and appropriate, and to grow in self confidence. With most children this happens as part of a natural process that involves loving parents, a positive school environment, a healthy, normal brain, and time. But what happens when a critical piece of the puzzle is missing? How does a child grow and develop normally if a part of their brain simply doesn't function properly?
The summer after kindergarten Grace fell apart. I don't know if it was the change in routine or if it was the anticipation that I was no longer going to be her teacher or both, but her behavior became completely irrational. Suddenly she was unable to eat at restaurants again, unable to sit in chairs, she refused to go in the pool without a specific swim vest and floatie, and sunglasses. She began having "overflow" tantrums again that would last for 30 - 45 minutes. She began repeating statements over and over again and needing to have me repeat myself over and over again as well. She retreated from touch and wouldn't let anyone but close family touch her. Tim and I became very concerned. I started looking into autism again as her behaviors looked very much like that of an autistic child.
The first day of first grade I took her hand and handed her over to Mrs. Wilkinson, her wonderful first grade teacher. Grace stood in the corner of the room having facial tics. It was very hard for me to walk away, but I knew that Mrs. Wilkinson would take great care of her. Over the next 3 weeks Grace made steady progress, but she continued to be fixated on the schedule and needing to know what was happening next. She was almost constantly asking her teacher what they were doing next and needing reassurance from her. Furthermore Grace was not allowing the other children to touch her. This was causing her great distress on the playground. I was noticing that Grace was spending her whole recess standing close to the building instead of playing. When I asked her why she told me it was because she wanted to be ready when the bell rang. She didn't want to bump into other children on the way into the building, or be late. Thus she was not interacting with the other children. Grace was isolating herself.
I knew in my heart when I saw this behavior that it was time to start her on medication. We called Dr. G. She was in full agreement that medication was the best route at this point. We started Grace on 25 mg per day of Zoloft. Zoloft is approved to treat young children for OCD. Within two days Mrs. Wilkinson came up to us and said that Grace hadn't asked her one time the entire day about what was coming up next. This was a huge deal as she had been asking 10 - 15 times per day. We waited a few more days to see if it was a fluke. It was not. Grace never asked her teacher about the schedule again. I went out to watch her at recess as well. Tears welled up in my eyes when I saw her playing on the field. She was running around with the other children. We also noticed Grace begin to try new foods for the first time! I was thrilled, when, for the first time ever, Grace ate 3 peas off her dinner plate! The next night she ate 4 green beans, She was just as excited as we were. After a couple weeks we increased her dosage to 37 1/2 mg/day (1 1/2 pills) as we had noticed a slight increase in symptoms again. This is fairly typical as one's system adjusts to the medication.
Zoloft is one of many medications that are called selective serotonin reuptake inhibitors (SSRIs). Serotonin is a neurotransmitter that plays a large role in regulating mood, sleep, and appetite. When serotonin (or any neurotransmitter) passes from one neuron (brain cell) to another some of it is naturally reabsorbed by the previous neuron. Serotonin reuptake inhibitors prevent the neuron releasing serotonin (presynaptic neuron) from reabsorbing as much serotonin so that the neuron receiving the serotonin (postsynaptic neuron) can receive more serotonin. It's just one way to get more serotonin in the system. There are other drugs to increase serotonin, but SSRIs seem to be the safest. As for why SSRI's work for OCD I don't have an answer. Actually there is little known about WHY they actually help. SSRI's work for depression, anxiety, OCD and most anxiety based disorders. Increasing serotonin seems to have an impact on these behaviors. It is thought that the brains of these people simply don't produce enough serotonin.
The decision to medicate my child was not an easy one. I had tried every natural remedy available. I had researched and utilized every possible diet, therapy and treatment. Many had helped, some had not. I had spent unfathomable amounts of money. But in the end some things can not be "cured". Some things can only be managed. A huge part of managing Grace's disorder is utilizing medication. Zoloft allows for my daughter to function on a relatively normal level. While she still struggles socially, she is able to function at school and feel good about herself.
One night as I tucked Grace into bed I asked her if she felt differently. She looked up and me and said with a big smile, "Yes, my OCD is gone now mom!"
Of course her OCD isn't gone. It is just better. And our battles are far from over. But I'll take our small victories. I think she's earned them.
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