REALITY TESTING. A person’s ability to distinguish reality from fantasy or his inner wishes and feelings from the external world. For example, a paranoid person believes that somebody out there is trying to get him. He doesn’t recognize that his fears are in his mind. When someone has hallucinations, he truly believes that the voices are real. When he’s treated with medication and starts to improve, he begins to wonder if the voices are real. Once he’s better, he’ll say that he used to hear voices that he thought were real, but now he knows they weren’t. Having good reality testing means being intact again.
SEDATION. The state of being sleepy. Sedation is a side effect of many psychiatric medications, including the antianxiety agents, some antidepressants, and certain neuroleptics.
SELF-MEDICATION. Using alcohol and illicit drugs, such as marijuana, in an effort to improve one’s mood and general feeling. Untreated adolescents with brain disorders frequently turn to self-medication.
SOCIAL CUES. The facial expressions and body movements that express a person’s intentions and reactions. Some kids with brain disorders are impaired in their ability to recognize and respond to social cues in their family and friends.
SPECT. Single photon emission computed tomography. This neuroimaging technique measures blood flow in the brain and the utilization of glucose, the form of sugar used by cells. It also highlights which parts of the brain are active and determines whether or not blood flow and activity are typical. SPECT is used primarily as a research tool for brain disorders in children and adolescents.
TEMPERAMENT. A set of character traits that an infant is born with. Sometimes thought of as a child’s basic disposition, temperament is the foundation of his personality.
TITRATION. The process of determining the exact dose of medication needed for a child or an adolescent with a brain disorder by evaluating his response to the medicine. Specifically, we look for a decrease in symptoms and the presence of side effects.
TRAUMA. An event, injury, or emotional shock that has a negative effect on a person’s mental or psychological state of mind.
VISUAL IMAGERY. A technique used in behavior modification in which the child or adolescent pictures himself in a certain situation and, guided by a therapist, learns how to cope with the feelings that the situation brings on. Guided visual imagery is especially useful in combating phobic reactions and anxiety.
APPENDIX 2
Resources and Support Groups
THE FOLLOWING ORGANIZATIONS and other resources—categorized according to type of disorder—can be very helpful to children and adolescents with no-fault brain disorders and can offer information and support to their parents and other loved ones as well.
ANXIETY DISORDERS
Anxiety Disorders Association of America
6000 Executive Blvd, #513
Rockville, MD 20852
Phone: 301-231-9350
This group promotes the prevention and cure of anxiety disorders (generalized anxiety disorder, obsessive compulsive disorder, separation anxiety disorder, and social phobia) and works to improve the lives of people who suffer from them. Members are individuals with anxiety disorders, clinicians, researchers, and other interested individuals. A network for parent support groups is being developed. The group publishes a newsletter.
OC Foundation, Inc.
P.O. Box 70
Milford, CT 06460-0070
Phone: 203-878-5669
This organization is dedicated to finding a cure for obsessive compulsive disorder and improving the welfare of people with OCD. It provides education, research, and mutual support and publishes a bi-monthly newsletter for families (The OCD Newsletter), a semiannual newsletter for and by kids (Kidscope), and a videotape called The Touching Tree, which describes OCD to children.
Selective Mutism Foundation, Inc.
P.O. Box 450632
Sunrise, FL 33345-0632
This organization offers support for parents of children with selective mutism. It is also open to adults who have the disorder or who have had it in the past. The group provides information and referrals as well as a quarterly newsletter. For information send a self-addressed envelope with two stamps.
ATTENTION DEFICIT HYPERACTIVITY DISORDER
Children and Adults with
Attention Deficit Disorders (CH.A.D.D.)
499 Northwest 70th Avenue
Suite 101
Plantation, FL 33317
Phone: 954-587-3700 or
1-800-233-4050
web site: http://www.chadd.org/
This international organization offers information and support for families with children with ADD and ADHD and gives guidelines and assistance to parents and others interested in starting support groups. CH.A.D.D. publishes a quarterly newsletter and magazine.
AUTISM
Autism Research Institute
4182 Adams Avenue
San Diego, CA 92116
web site: http://www.autism.org/
This is a network of parents and professionals concerned with autism. The group conducts and fosters scientific research designed to improve the methods of diagnosing and treating the disorder. It publishes a newsletter.
Autism Society of America
7910 Woodmont Avenue
Suite 650
Bethesda, MD 20814-3015
Phone: 1-800-3AUTISM or 301-657-0881
web site: http://www.autism-society.org/
This organization is dedicated to increasing public awareness about autism and the day-to-day issues faced by the patients, their families, and the professionals with whom they interact. It publishes a newsletter, holds an annual conference, and sells books related to autism.
EATING DISORDERS
Anorexia Nervosa and Related Eating Disorders, Inc.
P.O. Box 5102
Eugene, OR 97405
Phone:541-344-1144
web site: http://www.anred.com/
This organization offers free and low-cost information, distributed through booklets and a monthly newsletter, about eating and exercise disorders. It also provides speakers and programs for schools, agencies, and other groups.
American Anorexia/Bulimia Association, Inc.
165 West 46th Street
Suite 1108
New York, NY 10036
Phone: 212-575-6200
This organization educates the general public about eating disorders and provides referrals for patients and their families, recommending self-help groups, treatment centers, and health care professionals specializing in this field.
National Association of
Anorexia Nervosa and Associated Disorders
Box 7
Highland Park, IL 60035
Phone: 847-831-3438
This group seeks to understand and alleviate the problems of eating disorders; to educate the general public and professionals in the health field about eating disorders and methods of treatment; and to encourage and promote research. It offers referrals to health care professionals and support groups and publishes a newsletter.
MOOD DISORDERS
National Depressive and
Manic-Depressive Association
730 N. Franklin Street
Suite 501
Chicago, IL 60610-3526
Phone: 1-800-826-3632 or 312-642-0049
This organization educates patients, families, professionals, and the public about the nature of major depressive disorder and bipolar disorder/manic depressive illness; fosters self-help for patients and their families; works to eliminate discrimination against people with mood disorders; and improves the availability and quality of help and support. It publishes a newsletter and holds an annual conference.
National Foundation for Depressive Illness, Inc.
P.O. Box 2257
New York, NY 10116-2257
Phone: 1-800-248-4344
This organization provides referrals of doctors and support groups for people with major depressive disorder and bipolar disorder/manic
depressive illness. It publishes a quarterly newsletter and conducts regular seminars and conferences.
Depression and Related
Affective Disorders Association
Meyer 3-181
600 North Wolfe Street
Baltimore, MD 21287-7381
Phone: 410-955-4647
This organization’s mission is to alleviate the suffering arising from depression and bipolar disorder/manic depressive illness by assisting self-help groups, providing education and information, and lending support to research programs. Support services include publications and educational videotapes.
SCHIZOPHRENIA
National Alliance for Research
on Schizophrenia and Depression
60 Cutter Mill Road
Suite 404
Great Neck, NY 11021
Phone: 516-829-0091
This national organization raises and distributes funds for scientific research into the causes, cures, and treatment of severe mental illnesses, primarily schizophrenia and major depressive disorder. It publishes a newsletter.
TOURETTE SYNDROME
Tourette Syndrome Association, Inc.
42-40 Bell Boulevard
Suite 205
Bayside, NY 11361-2820
Phone: 1-800-237-0717 or 718-224-2999 or 888-4-TOURETT
web site: http://tsa.mgh.harvard.edu/
The members of this nonprofit organization include people with TS, their families and friends, and health care professionals interested in the field. The group funds research, provides services to patients and their families, and offers a variety of publications, including brochures, fact sheets, and a newsletter.
OTHER SOURCES
American Academy of
Child and Adolescent Psychiatry
3615 Wisconsin Avenue NW
Washington, DC, 20016-3007
Phone: 1-800-333-7636 or 202-966-7300
web site: http://www.aacap.org/
The Academy has a membership of more than 6300 child and adolescent psychiatrists who actively research, diagnose, and treat psychiatric disorders affecting children and adolescents. An excellent referral source for board-certified child and adolescent psychiatrists, the Academy publishes Facts for Families, a series of 53 fact sheets on topics related to child and adolescent psychiatry.
Center for Mental Health Services
5600 Fishers Lane
Rockville, MD 20857
Phone: 301-443-1333
This government organization supports the development of accessible and appropriate service delivery systems for children and adolescents with serious emotional disturbance and their families. It offers grants to groups working in the field of children’s mental health and supports their efforts to develop community-based services. It distributes several publications.
Federation of Families
for Children’s Mental Health
1021 Prince Street
Alexandria, VA 22314-2971
Phone: 703-684-7710
web site: http://www.flfcmh.org/
This parent-run organization focuses on the needs of children and adolescents with emotional, behavioral, or mental disorders and the needs of their families as well. The group publishes a newsletter and holds regular conferences.
Information Resources and Inquires Branch Office of
Scientific Information
National Institute of Mental Health
5600 Fishers Lane
Room 7C-02, MSC 8030
Bethesda, MD 20892
Phone: 301-443-4513 or 301-443-3600
This government agency, which is part of the National Institutes of Health, conducts and supports research on mental illness and mental health. Information on mental disorders is available to the public by contacting this office.
National Alliance for the Mentally Ill
200 North Glebe Road, Suite 1015
Arlington, VA 22203-3754
Phone: 1-800-950-NAMI or 703-524-7600
This grassroots support and advocacy organization, dedicated to improving the lives of people with severe mental illness and the lives of their families as well, offers education and emotional support. It publishes a newsletter.
National Mental Health Association
1021 Prince Street
Alexandria, VA 22314-2971
Phone: 1-800-969-NMHA or 703-684-7722
This large nonprofit organization addresses all issues related to mental health and mental illness. It provides public education, sponsors “May Is Mental Health Month,” and runs the Mental Health Information Center, which distributes information on various mental health topics and provides referrals.
NYU Child Study Center Letter
New York University Medical Center
550 First Avenue
New York, NY 10016
Phone: 212-263-6622
This newsletter, designed for parents, educators, pediatricians, and mental health professionals (and edited by Harold S. Koplewicz, M.D., and Anita Gurian, Ph.D.), focuses on current mental health topics related to children and adolescents. There are five issues per school year; a yearly subscription is $25.
APPENDIX 3
Psychopharmacology at a Glance
IN DISCUSSING the recommended treatment of no-fault brain disorders I refer often to various medications, describing how they work and their possible side effects. The charts that follow put it all together, disorder by disorder: brand name, generic name, nuisance side effects, and serious side effects.
In going through this material parents should bear in mind that the information provided is for reference only. Only a physician may prescribe medicine. Furthermore, psychiatric medication should be taken by children and adolescents only after a specific diagnosis has been made by a qualified child and adolescent psychiatrist and only when a disorder is severe enough to cause distress and dysfunction.
Parents should also be aware that many of the medications routinely prescribed for no-fault brain disorders in children and adolescents have not been approved for that specific purpose by the Food and Drug Administration. All of the medicines described in this book have been FDA-approved but not necessarily for the treatment of child and adolescent psychiatric disorders. (The FDA approves drugs for specific uses and age groups but only after the manufacturer of the medication applies to the FDA for approval for that specific purpose. Many companies choose not to go to the effort and the expense of asking the FDA for approval for many different purposes.) When it comes to prescribing any medication, a physician may and should use his or her own best judgment. He or she should also be prepared to explain to parents the rationale behind the use of any drug as well as its possible side effects.
About the Author
HAROLD S. Koplewicz, M.D., is one of America’s foremost child and adolescent psychiatrists and an expert in pediatric psychopharmacology. A graduate of the Albert Einstein College of Medicine, Dr. Koplewicz is vice chairman of the Department of Psychiatry and director of the Division of Child and Adolescent Psychiatry at New York University Medical Center-Bellevue Hospital Center. The division was the first child and adolescent psychiatry program in the United States. Currently professor of clinical psychiatry at New York University School of Medicine, he is the director of the NYU Child Study Center and editor of the Child Study Center Letter. He has been a member of the National Board of Medical Examiners and a commissioner of the New York State Commission on the Study of Youth, Crime and Violence and Reform of the Juvenile Justice System.
As a clinician, Dr. Koplewicz sees hundreds of new patients a year from all over the world. A May 1996 New York magazine special report called the “Best Doctors in New York” featured Dr. Koplewicz, and he was listed as one of Good Housekeeping’s “Best Mental Health Experts.” He is the recipient of many awards, including the 1997 Exemplary Psychiatrist Award from the National Alliance for the Mentally Ill as well as the Reiger Award from the American Academy of Child and Adolescent Psychiatrists.
&nbs
p; Dr. Koplewicz is a well-respected teacher and a national child expert. He has lectured internationally and is cited frequently as an expert in many publications, including New York Times, Ladies’ Home Journal, Child, and others. He is a member of the advisory board of Parents magazine. Dr. Koplewicz appears regularly on radio and television, including Today, Good Morning America, Dateline, CBS This Morning, and National Public Radio.
Dr. Koplewicz lives in New York City with his wife and their three sons.
Copyright © 1996 by Harold S. Koplewicz, M.D.
All rights reserved. No part of this book may be reproduced or
transmitted in any form or by any means, electronic or mechanical,
including photocopying, recording, or by any information storage and
retrieval system, without permission in writing from the publisher.
Published by Three Rivers Press, New York, New York.
Member of the Crown Publishing Group.
Random House, Inc. New York, Toronto, London, Sydney, Auckland
www.randomhouse.com
THREE RIVERS PRESS is a registered trademark and the Three
Rivers Press colophon is a trademark of Random House, Inc.
This book was originally published in hardcover by Times Books, a
division of Random House, Inc., in 1996.
Library of Congress Cataloging-in-Publication Data
Koplewicz, Harold S.
It's Nobody's Fault Page 31
