ACADEMIC CHILD, ADOLESCENT AND ADULT PSYCHIATRY
Reprinted with permission. "Florida Health Care News," Collier County, Spring 2003
Comprehensive approach to ADHD and
child behavior problems pinpoints the right treatment
"Our daughter/son is behaving worse than before!" "We've tried everything! Nothing works."
For parents who find themselves distraught when sincere parenting and medical science fail to help their "out of control" youngsters, James L. Schaller, MD, MAR, offers a broad academic approach to their challenges that provides answers.
"We have published over fifty-five solutions to helping children control their behavior," assures Dr. Schaller, "and we love offering real hope. The first step is to avoid hastily assigning labels to these children. Many children are quickly diagnosed with Attention Deficit/Hyperactivity Disorder (ADHD) so they never receive the right treatment, the full treatment, to properly control their symptoms. Unfortunately," he cautions, "the wrong treatment or incomplete treatment often makes the problem worse."
Part of the difficulty in treating children with behavioral problems, says Dr. Schaller, is that ADHD is not the only condition that is characterized by disruptive behaviors. Fully one hundred conditions look like ADHD, and treatments that work well in controlling ADHD do not provide long-term control when those same symptoms are rooted in other causes.
Another challenge is that ADHD rarely occurs as an isolated condition. It usually is one of several disorders influencing a child's behaviors, each affecting the other, and each requiring a carefully prescribed treatment. The order in which these co-existing disorders are treated can have an important effect on the outcome.
With a friendly academic approach, Dr. Schaller is continually involved in research that can offer insights and treatments for those suffering from psychiatric and behavior disorders.
His clinical work incorporates the use of traditional medicines, including new medications he sees as a reviewer for medical journals. He also has access to proven complementary approaches in customizing treatment plans. "I don't offer a single treatment option," explains Dr. Schaller. "I work closely with the parents to determine the modality that is right for their child."
His willingness to search for causes beyond the easy ADHD label in diagnosing behavior disorders is particularly important for children, because children's symptoms differ from adults' symptoms. This makes it difficult for a physician without child psychiatric training to see the intricacies of co-existing disorders and make an accurate assessment. Dr. Schaller reports that depression and anxiety each occur in one-fourth of youth who have ADHD.
"A child or adolescent suffering from anxiety or depression may not seem particularly anxious or sad," observes Dr. Schaller. "Instead, the child may demonstrate mild irritability or be less attentive. Many children still have fun, but less than usual. The indications are subtle; they require persistent and comprehensive questioning to uncover them."
If a mild depression is missed, explains Dr. Schaller, stimulants may treat a child's symptoms for as long as a year, but then burn out. If anxiety is missed, stimulants make the child's anxiety worse.
Dr. Schaller adds that environmental toxins can also trigger behaviors that mimic the symptoms of ADHD. "One youngster was brought to me with a 'sudden onset' of ADHD behaviors," recalls Dr. Schaller. "That is highly unusual; so, I suspected there might be an environmental factor affecting the child's physical condition. After talking with the family and the child, I considered a number of options, including the possibility of heavy metals in the child's environment. Tests of the home's water supply and the child's blood screening confirmed that possibility, and we eventually treated the family's water supply. After the contamination was addressed, the child's 'ADHD' symptoms disappeared."
A child's story
Nancy Edmond has personal knowledge of the importance of securing a proper diagnosis. "My son is in grade school," says Nancy, "and his teachers all suggested the use of Ritalin to control his 'attention deficit disorder.'
"I didn't want to accept that solution impulsively, but I didn't know what else to do. My son needed help. I took him to Dr. Schaller, who started from scratch in learning about my son and his attention problems."
Because of Dr. Schaller's insistence on a careful and thorough academic approach to the boy's problems, Nancy's son was found to have specific learning challenges, an auditory processing disorder, that would not have been improved by Ritalin.
"He also had a lot of anxiety related to my medical problems," confides Nancy, "and Ritalin combined with that anxiety would actually have made my son more nervous."
Proper diagnosis and treatment now have Nancy's son achieving at grade level, without the anxiety or the interference caused by his learning disability.
Not just kid stuff
Nancy says Dr. Schaller has helped her, too.
"I'd been suffering from depression for more than eleven years and had consulted many sincere physicians when I finally consulted Dr. Schaller," shares Nancy.
Dr. Schaller was able to suggest medication to fight Nancy's biological depression and introduce cognitive therapies to her treatment plan to help her cope with life's daily challenges.
When Nancy's symptoms of depression did not abate, Dr. Schaller suspected another underlying physical cause. "I don't know any other doctor who is so persistent in finding the right answers," says Nancy. "In my case, Dr. Schaller suspected Lyme disease, and sent me for tests.
"Several standard tests came back negative," reports Nancy, "but Dr. Schaller suggested I take a new, more sensitive, test. It was amazing," says Nancy. "That test came back positive not only for Lyme Disease, but also for two other tick-borne diseases. I'd have gone years, maybe my whole life, without proper diagnosis and treatment if it hadn't been for Dr. Schaller."
Now, Nancy's depression is gone and her outlook is much improved. "Thanks to Dr. Schaller, I'm the best mom and woman I can be for my son and the people in my life," she confirms. "The people in southeast Florida are lucky to have Dr. Schaller in their community." FHCN - Billie S. Noakes
Make a note
Dr. Schaller is currently accepting patients at Professional Medical Services of Naples. To schedule a consultation appointment, please call the office (239-263-0133) located at:
Community Bank Towers
5150 Tamiami Trail, N
Naples, FL 34103
Dr. Schaller: clinical academic approach comes to Naples
James L. Schaller, MD, MAR, opened the doors of Professional Medical Services of Naples early in 2003. He offers the residents of S.W. Florida his research-based, academic approach to the treatment of child, adolescent and adult psychiatric disorders.
Certified by the American Association of Clinical Psychopharmacology, Dr. Schaller is a Grant Reviewer for the National Institute of Health. His writings appear in more than thirty-five publications, many of them leading journals of psychiatry, medicine and neurology. Topics include preventing child medication side effects, treatment-resistant depression, panic disorders, ADHD, autism, oppositional youth, fatherhood, impulsivity, obsessive-compulsive disorder, pre-menstrual syndrome, nutrition, obesity, customizing medications and anger.
Dr. Schaller vigorously pursues promising leads in research and continually incorporates appropriate new information to help improve his patients' lives.
"My initial consultations with a patient - child or adult - are very detailed, designed to give me a comprehensive understanding of my patient's situation," assures Dr. Schaller. "I want to be careful not to simply treat my patients' symptoms," he points out. "I want to discover the underlying causes of those symptoms and design a treatment that will solve the problem, not mask it."
Visit Dr. Schaller's 500-page website at www.personalconsult.com to sample more than 130 free articles on diverse topics: ADD, ADHD, Panic and Depression; Bipolar Disorder; Breast & Prostate Cancer Prevention; Uncontrollable Youth; Treatments for PMS/PDD; Autism; the natural nutrient SAMe in Treating Child Depression; Mercury Testing of Fish Oils; and Controlling Your Waistline.