family, fostercare, mental illness

Belief in One Girl: The Argument FOR Medication In Foster Care

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It’s taken me quite some time to decide if I should share something this intimate, this painful.  The reason I blog is to give hope to other trauma mamas. I also blog to give TRUTH to other families going into foster care and adoption. People need to know what it’s like herding chickens! Sometimes I only wish I knew then, what I know now.

I’m about to tell a very raw, very real, and very ugly story. It’s also an amazing and very hopeful story.

There are some things about my children that I’ve been reluctant to share. What if they read this someday? What if they are horrified to see these intimate details out in the world? I balance this with the fear that there is a family out there, somewhere, debating if it will ever get better. Debating if they can do this any longer. This family needs to know that it’s possible before giving up on a child/ children from the foster care system.

This story is about the face of trauma and attachment challenges and a genetic predisposition for mental health disorders. This story is about the face of a little girl the first time she actually feels safe enough to admit she loves her new parents.

Foster kids come to us from a variety of backgrounds. They come from broken homes, abuse, or neglect. Sometimes they come from homes of crippling mental health concerns. Sometimes they come quite by mistake from healthy families. Either way, they all come out of their home and into ours. No matter what preceded it, this is a crushing trauma. All foster care starts with trauma.

“The Over Medication of Children in Foster Care” seems to be a big headline these days. A few years ago the headlines were all about kids in group homes and not with families. Are these connected? I believe so. I often hear statements such as, “I don’t believe in medication.”  It isn’t a religion. It isn’t a political stance. Since when did choices about our children’s health start falling into the “belief” range? Truth be told, unless your religion prescribes an actual belief about medication (and some do) wouldn’t this be more of a “preference?” I don’t believe either way about medication. I believe in my child. I don’t care about medication. I care about my child.

When we first brought the children home, it was after 4 months of overnight visits, phone calls, and traveling out-of-state to be at their school functions. We knew them fairly well by the time they came home. We were trained, ready, and prepared. Or so we thought…

The 4 siblings had been split up into 3 separate foster homes for their 3 years in care.  Only one of the children was receiving any kind of counseling. Coming into our home permanently was an enormous change for them.

Placing them all together again, with a set of forever parents, triggered their survival skills big time. It started with hoarding food and hiding food in their rooms. This progressed into urination and deification in odd places such as the trash can or the towels.

It quickly turned violent. Mostly towards mom, but also towards each other. They would try to push each other out of a moving vehicle if they even suspected the other had more food or more attention. They hit me, yelled at me, and threatened me , “you’re gonna be sorry!” They also screamed in terror every time I raised my arms to adjust my ponytail. They were waiting for me to hit them. History had taught them that moms hit, moms are drunk, and moms don’t feed you.

This was pretty typical trauma behavior. So we did what foster parents do. Did we go right for medication? No! We sought out counseling for our children. We went to a support group. We read all the books. What we didn’t bargain on was the extreme reaction of our youngest child.

The trauma of the move into our home, impending adoption, and trauma triggers of living with her brothers again, weighed on her. This was nothing compared to her early onset mental illness. The poor girl.

There was a strong history of mental illness in the maternal side of the birth family. Combined with precocious puberty, and all of the changes in her life, she entered into the perfect storm.

At first she would scream and cry alone in her room. This could be over any problem such as seeing a stray cat, being asked to let someone’s else steer the shopping cart, or even an argument she got into with her backpack one time. She would yell out, “Stop murdering me!” And “Owie, owie, oww!”while all alone. She threw herself straight down the stairs, stiff as a board.

Sometimes she would begin laughing hysterically for no reason and then immediately shift into screaming and pulling her hair. She would attack us and her brothers. She stabbed us with pencils and threw shoes at us. She tried to grab the car keys and drive the car. She ran into traffic many times.  She would smash her head against the wall over and over. She bit us. She bit herself. These things happened multiple times a day. Every day. It wasn’t safe to drive her to therapy because she would try to shove her brother out of the car, or jump out of the car, while it was moving. We were trapped at home during the summer months because it took 2 adults to transport her anywhere and my husband was at work.

Once, following an out-patient therapy session, she had a full-blown tantrum in the parking lot. Her three brothers and I got her in the car. The child locks were on so I settled in with her brothers to keep her from climbing out of the hatchback on our SUV. She smashed her head against the glass, tried to kick out a window with her feet, and tore at my clothes. The entire time she screamed, “Somebody help me! Help! Ouch! Owie!” We were there for an hour and then bystanders called the police. Once the police came she cowered in my lap and begged me to protect her. She begged me not to send her away.

There were many times she sobbed that she was an awful girl and no one would ever adopt her. She said she wished she was dead. She clung to me and hugged me and panicked if I was out of sight. She never slept for more than 45 minutes at a time. Ever. We constantly had to watch her vigilantly for the safety of her brothers.

We found scissors in her room, hidden under the mattress.  At 44lbs. she could pick up and drop her bed, complete with heavy wooden bed frame. There were holes in the drywall, closet doors hanging by their hinges, and broken windows. The adrenaline kicked her into super human strengths when she was afraid. I wore long skirts and long sleeves throughout the summer months to cover my bruises and bite marks.

Did she do any of this because she was “bad?” Of course not! This little girl was surviving. It was taking everything she had just to live in a family setting, surrounded by love. She loved us so fiercely that she was afraid. She pushed us away because she only knew loss and grief.

In her first 9 months home, she was hospitalized at an in-patient psychiatric unit 5 times. She went to a short-term residential facility once. Mary spent most of her first year home in a partial hospitalization program. Then an intensive outpatient program. We had intensive in-home therapy services, too. My husband and I participated in family therapy, trauma therapy and training.

Did all of this therapy work? Well, she could talk the talk, but she couldn’t access the skills when she needed them. Our daughter was in a heightened state of fear all of the time. She was trying her hardest just to survive. Her nightmares never let her sleep. Ever. I would often wake to find her standing over our bed silently.

Once, after trying to escape our moving vehicle on the highway, she told me “I can’t live like this. My feelings are just too BIG. No one understands what this feels like!”

She needed the help of medication to access the skills she was learning in therapy. It’s not a religion. Sometimes people ask me if I “believe” in medication. Believe in it? Don’t believe in it? That sounds more like a question for scientific research and the FDA. I’m not talking about snake oil magic potions here. I’m talking about psychotropic medications that are sometimes used for children. And, yes, sometimes they are necessary.

It’s not a matter of “making it easier to parent them” or “making things better for parents.” It is a matter of life and death. Permanency versus disruption. Home with family or hospitalized. Again. Type 1 diabetics require insulin to live. Some children require glasses to read. Some children with psychiatric conditions require medication to function in the world. Why would I ever deny my child what she needed?

There has been a lot of media coverage in the last year about medication over-use in foster care. Yes, there are certainly cases where a child is medicated without therapy and behavioral interventions. That’s terrible and probably not very effective. A treatment plan should have many components and should always include therapy for the foster child, if not the entire family unit. If therapy isn’t working, and medication isn’t an option, then kids disrupt. Families cannot manage like this long-term. Many would not. Many would give up.

Then foster kids move into a “therapeutic” or “intensive” foster homes. Often, they are moving away from their siblings who just may be the only stability they’ve ever known. If this doesn’t help they may end up in group homes or bouncing from place to place when their behaviors become too much for one family.

Let me be clear. The behaviors are a symptom. They are a symptom of trauma. They are a symptom of pain and grief and loss. They are often a symptom that the child is developing the very mental illness that prevented a birth parent from actually parenting them. We need to treat the problem the child has, not just the symptoms.

But, if the symptoms prove too much for the child to access therapy and healing? Treat them in addition! Treat them with medication if needed. Every child will need something different. Why would we toss out a whole category of help because it comes in the form of medication? Why not do whatever is best for the individual child?

I am aware that there are side effects. I am aware that we may be changing her brain chemistry. I hope we are. In this case, the benefit outweighed the risks. If she hadn’t settled into a family? If she hadn’t learned to love? If she hadn’t been able to access therapy? She would have been lost in a foster care cycle that too often repeats across generations. We would not give up on her or leave her to that fate. Our little girl deserved a family. She needed a family. She needed us. 

After her medication was right? The uncontrollable raging stopped. It ended. It’s been over 8 months since she had a violent outburst. She is still working through major trauma and emotional issues. We still have in home and outpatient therapy services to support her. But she is with us. She is functioning in a family setting. We can use the car and go places. She sleeps through the night now, on most nights. She isn’t having toileting accidents out of fear and anxiety anymore. Instead, she is making friends, playing with barbies, and hunting for bugs in the yard. She leaves me sweet little “I love mommy” notes and she means it.  She is loved beyond imagining.

Will she be on medication forever? It’s a possibility, given her diagnosis. I hope not, but we will face whatever comes. She is our daughter. Our heart. Our littlest chicken.

Here’s the thing. My daughter’s past does not define her. Her trauma will not define her. She is more than just a mental illness. She is more than just a series of behaviors. Now she is able to shine because those things are all getting better.

She is just a normal little girl, experiencing a normal childhood. It took a long time to get there. It took  a lot for her to trust in us never to leave her. She was able to get there because she had the right supports, including medication.

This is just one story. It is a beautiful story. It is a story of hope and healing and family. It is the story of a little girl brave enough to try to love again. Brave enough to heal.

When did this ever become a conversation about “beliefs?” If you believe in one thing, I urge you to believe in the power of love. Medicate or don’t medicate, I won’t judge you. It isn’t fair of us, as a society, to pass so much judgement on parents. Why do we do this?

Have compassion. Know that all kids are different, and kids in care are traumatized to a whole other level. If we want to stop passing kids around from home to home? If we want to break the cycles of mental illness, trauma, and abuse? We need to be open to anything that works.

Yes, the number of children in foster care on psychotropic medication is vastly disproportionate to the general population. However, all of our kids in care have experienced huge trauma. It may be hard for us to comprehend a hurt that big in the general population. I have no idea how hard that must be. I will not judge another family for trying to help their child any way they can.

I urge you to remember our story. We never gave up. We do believe in something. It has nothing to do with medication. We believe in the power of love.

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**Names have been changed to protect the privacy of those involved.

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14 thoughts on “Belief in One Girl: The Argument FOR Medication In Foster Care

  1. Thanks for sharing. Putting yourself “out there” can be terrifying. Especially since you are already broken and bleeding inside. Subjecting yourself to possible cruelty …. well that takes courage. But if we love our little ones we must be willing to stand up and speak for them. Keep posting, your are educating the world!

    Liked by 1 person

  2. Carol says:

    My only child…..the one I fought so hard to adopt lived a very similar nightmare. I fought the system and refused to ‘drug’ my baby for many years. At the age of 7 I finally gave in because we had not slept in several years and at 45 I could no longer climb a set of stairs. My body was closing down on me. The first night she slept through. I remember waking in terror, unable to move from my bed. I was so sure she had killed herself during the night. Fast forward 10 years, she is still medicated and no the medication didn’t cure the trauma but what it did do was make it possible to stop ‘surviving’ this child and start raising her. Today she is a well rounded 17 year old and while life still isn’t always easy for her, there are far more ‘normal’ days and far less terrifying days. Her Doctor once said to me “If you don’t give her the medication she needs, you are sentencing her to a life of pain”. I didn’t give her medication to make my life easier, I gave her meds to make her life livable.

    Liked by 1 person

  3. Lynn says:

    Beautiful story. It gives hope to those who are feeling hopeless in their situation. I know I have and still do at times. My daughter was adopted through foster care. She has been in therapy and probably will be again. She takes meds. We fought it for a while but the change when she started was amazing. It wasn’t just the increased attention and decreased fidgeting (she has ADHD and attachment challenges), it was the attitude because her interpersonal relationships were better, she was doing better in school, etc. I’ve read that kids with Reactive Attachment Disorder are being falsely diagnosed with ADHD; however, as you pointed out, helping your child is the only thing that matters. Thanks for sharing.

    Like

    • Lynn, thank you for reading. I admire you for doing the right thing for your daughter. You’re right, there is a lot of controversy over trauma vs ADHD symptoms. Kids who are constantly in fight-flight mode can exhibit hyper-arousal characteristics. Honestly? Who cares? Kids come first. If medication and therapy help? Then that’s what we do. I’m so happy your daughter is doing well. I hope she feels proud of herself and what she’s accomplished. I hope you do, too!

      Like

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