What Parents Should Know About Children and Psychiatric Medication

While pediatricians are an important part of a child’s healthcare team, seeing a psychiatrist for medication management can be crucial for a child’s mental health treatment. Here are some reasons why:
Expertise: Psychiatrists are medical doctors who specialize in mental health. They have extensive training and experience in diagnosing and treating mental health conditions, including those that require medication management. While pediatricians have some training in mental health, their expertise is primarily focused on physical health and development.
Diagnosis: Psychiatric diagnosis can be complex, and accurate diagnosis is key to effective treatment. Psychiatrists have a deep understanding of the various mental health conditions that can affect children and can provide an accurate diagnosis based on a comprehensive evaluation. They can also differentiate between similar symptoms that may be caused by different conditions.
Medication Management: Medication can be an effective treatment for many mental health conditions in children, but it must be carefully managed to ensure safety and effectiveness. Psychiatrists have a deep understanding of the medications used to treat mental health conditions, including their potential side effects, interactions, and appropriate dosages. They can also monitor a child’s response to medication over time and adjust treatment as needed.
Therapy: Psychiatrists can provide clinical guidance well as medication management. Because they understand and specialize in mental health diagnoses, they can help make sure that all of the mental health pieces are being considered and addressed. As such, they can help connect children to a therapist who would be an appropriate match for the specific issues that they are treating, and can then collaborate with this therapist to provide the utmost quality of care.
Overall, while pediatricians are an important part of a child’s healthcare team, they may not have the specialized training and expertise needed to effectively manage a child’s mental health treatment with medication. A child seeing a psychiatrist can benefit from their specialized knowledge and experience in mental health diagnosis and treatment, leading to more effective and safer medication management. At West County Behavioral Health, we have the complete team – therapists and psychiatrists collaborating together – to make sure that your child gets the BEST care possible!!
West County Behavioral Health offers full service medication management for both children and adults.  Please contact our office at 314-200-5119 to schedule and appointment with one of our providers.
Meet Our Medication Management Team
Shelah Radke, MD, JD
Pursuing mental wellness is a sign of strength. As a Child and Adolescent Psychiatric Physician, I have enjoyed celebrating my client’s strengths for the past 10 years, having dedicated my career to working with children, adolescents, and young adults in the field of psychiatric medicine.
  • Double Board-Certified in Psychiatry and Child and Adolescent Psychiatry
  • Graduated from Case Western Reserve University School of Medicine
  • Residency at University Hospitals of Cleveland and Fellowship through Rainbow Babies and Children’s Hospital in Cleveland, Ohio.
  • Recently served as the Medical Director of Child Crisis Psychiatry Services at Mercy Hospital in St. Louis
  • Provided direct clinical care in two private practice settings in the Washington, D.C, area
  • Worked with clients at Monarch boarding school in Cleveland, Ohio, collaborating with teachers and parents frequently to optimize opportunities for creative learning.
I am committed to using evidence-based practices, including integrative, lifestyle, and pharmacological interventions, to help my patients achieve better mental health outcomes. I also enjoy partnering with clients by using the shared decision-making model of care. I work with clients to understand their unique needs and goals, and together we develop personalized treatment goals that are tailored to their individual needs. This approach empowers patients to take an active role in their own care and can lead to more positive outcomes and greater overall satisfaction with the treatment process.
Jeff Boatman, APRN-MHCNS
I received my Bachelor of Science in Nursing and my Master of Science in Nursing from St. Louis University, specializing in Psychiatric Adult Mental Health Nursing. I have worked for over 25 years as a certified Advanced Practice Clinical Nurse Specialist in Adult Psychiatric and Mental Health Nursing. While in private practice, I have had a collaborative practice arrangement with Dr. Adam Sky.
I function as an Advanced Psychiatric Practice Nurse with prescriptive authority and have seen patients in hospital, office, and nursing home settings. I serve the adult population, age 25 and up. I am affiliated and have privileges at St. Mary’s Health Center in St. Louis. In addition, I am an active member in the American Psychiatric Nurse’s Association and the APNA Missouri Chapter where I have served on the Board.
I look forward to serving your psychiatric and medication needs with compassion and skill – I want to take the time to truly understand your situation and offer you the tools to feel better and stay well.

Sitting with Grief

Molly Meyerson, MSW, LMSW
Typically, when we think about grief, we think about the loss of a loved one. We think about having to continue living our life without the presence of a person we thought we would never be without. While this type of grief is profound, we can feel grief in other areas of our lives as well. It is important to acknowledge and identify the times in our lives in which we experience grief. However, I want to do more than just acknowledge grief. I want to talk about sitting with grief. I want to talk about allowing ourselves to feel it fully, and how we can create the space in our lives to do so.
We may experience grief when we are navigating major life transitions; where we find ourselves parting ways with versions of ourselves or lives we have lived in order to grow. We may grieve those versions of ourselves we were before experiencing a life-altering event. We may experience grief as a result of making hard decisions, losing a job, or changing careers. In all of these examples, grief is a result of changes we experience. Whether change is planned or unexpected, the grief that accompanies it can feel heavy. Sometimes it can feel debilitating. We may find it difficult to embrace or even accept certain changes.
When grief is present in our lives, a normal reaction can be to avoid it – to distract ourselves from it. To find ways around feeling it when it feels too painful. An unfortunate truth about avoidance is that it does not help our feelings “go away.” We may not realize it at first, but when we avoid our grief, we are avoiding many other things too.
Dr. Brene Brown speaks beautifully about this topic when she says, “you cannot selectively numb emotions.” When we attempt to numb negative emotions, we inadvertently numb the good ones too. Our capacity to feel painful emotions correlates with our capacity to feel joy, love, happiness, etc. When we don’t allow ourselves to feel our grief, we often feel stuck, anxious, and unhappy.
So, what does this mean? If grief is unavoidable, and inevitably comes with change, what do we do when waves of grief crash on our shores? How do we ride out the storm when we can’t stop it? We can start by letting ourselves feel it. We can create an environment for ourselves to feel everything we need to feel while grieving. Just as we create space in our lives for happiness, it is important to be intentional when creating an environment to feel our sadness and grief. If we can feel safe while sitting with grief, we facilitate our own healing.
Give yourself permission to slow down. Go on a walk, listen to your favorite music, let yourself cry, practice self-care, and take time out of your days to just be. Lean into social support and loved ones while navigating your grief. Acknowledge the love that still takes up space in your heart for whatever you are grieving. When we honor our grief, we are honoring our love as well. And the most important thing to offer yourself is TIME. There is no way to expedite the grieving process. It will take time, and time will feel incredibly slow. While it feels slow, remember that it is still passing by. And, each day that passes is another day that we have survived. When we find ways to sit with pain and grief, we can be reminded that we have already survived the loss.
Unfortunately, there is nothing I can write to remove grief from our lives, and that is not my goal. The purpose of this piece is to remind you that you have every right to sit with your grief for as long as you need. We live in a fast-moving world, but grief is an experience in which fast-paced living will be unproductive and potentially harmful. It is okay to slow down, it’s okay to not be okay. It’s okay to just be while we’re processing these changes and losses.
If grief is something you are sitting with right now, you are not alone. Grief and change are inevitable, but they are only waves in a storm, and eventually, the worst of the storm will pass. If we are willing to experience the grief that comes with change, we can grow into new versions of ourselves, and experience lives yet unknown to us. We owe it to ourselves to feel it all, so we can experience life to the greatest capacity possible.
Whatever life looks like for you right now, if you are experiencing grief, I hope you have the courage to sit with it and honor all of who you are. If you find yourself feeling stuck and unable to move through the grieving process, reach out to a therapist for help. Grief is not something to run from. It is a reminder of how deeply we can love.

Being a Mom is in Fact Not Easy The Journey into Pregnancy and Postpartum

By Mollie Appelbaum, MSW, LCSW, PMH-C

 

When a mom gives birth, she is immediately bombarded with inquiries about how the baby is doing. Is the baby happy? Is the baby sleeping? How is the baby eating? Rarely is mom asked how she is doing. Is mom sleeping? Is mom eating? Is mom happy? Without anyone asking or checking in, mom may be struggling in silence. And even if she may occasionally be asked about her well-being, she may feel ashamed to admit that she is feeling anything short of wonderful. We are told that having a baby is supposed to be the best thing to ever happen to us, right? So, what do we do when the feeling of joy we are promised is overshadowed by feeling lost, overwhelmed, anxious or depress
Women are typically informed about the birthing experience, what to expect when expecting, and what a healthy pregnancy looks like. The post-partum period, however, is often glossed over. We may have heard about post-partum depression or anxiety in passing or read about it in a small handout provided to us in our OB’s office, but most of us don’t take the time to become educated on it. Mothers may be afraid to share their struggles – worried they somehow make them a bad mom. They are often left with a myriad of uncertainties. I remember as a first-time mom, scouring the internet for answers on breastfeeding, sleep schedules, and developmental milestones. Attempting to find some answers to those late-night questions spiraling in my head as I rocked my new baby to sleep, I would be met with many women struggling with the same questions. Post after post of women wondering – is this normal? Is there something wrong with me? Why do I feel depressed when my sister seemed so happy when her baby was born? Why am I so anxious about everything all of a sudden?
We don’t discuss the ways moms’ hormones continue to fluctuate drastically after birth, how mothers are hit with the pressure to quickly “bounce back” to pre-pregnancy weight, or how they are expected to get back to work after an eight-week maternity leave. We downplay the impact of sleep deprivation on the body. We don’t tell them that they are likely to experience some anxiety or intrusive thoughts after giving birth. We send them on their way with a brand new human and check in around 6 weeks later. As they navigate this new life, women are often left questioning; “who am I outside of being a mom and how do I find myself again?”
Perinatal mood and anxiety disorders can impact anyone during pregnancy or following birth; one in five to seven women and one in ten men report having symptoms of these disorders. Baby blues, although not a clinical diagnosis, can also be incredibly challenging for new mothers. Sixty to eighty percent of new mothers experience these and they can last between two days to two weeks after birth. A multitude of symptoms can present themselves in an individual suffering from perinatal disorders including a depressed mood, loss of interest, inability to cope, lack of connection with the baby, feeling worthless, irritability, and inability to control one’s own thoughts. There are many risks associated with untreated postpartum mood and anxiety disorders including relational problems, exacerbation of medical conditions, child neglect and abuse, infanticide, homicide, suicide, drug use, separation/divorce, and loss of interpersonal resources. If you are struggling with any of these issues, it is imperative that you reach out to an individual trained in the evaluation and treatment of perinatal mood disorders. This individual will have the tools and training to treat the symptoms at hand. They can help gather a clear history, develop a treatment plan with you moving forward, and be a safe space to walk through the journey of motherhood with.
Whether or not you are struggling with postpartum depression or any type of perinatal disorder it is essential that you care for yourself during this time. I have provided some relatively simple strategies that new and expecting mothers can utilize during this challenging time.
Reach Out
Utilize your support group; your mother, your sister, your cousin, your friend, your doctor, or your therapist. Tell them how you are feeling. Ask for help. Let someone make a meal. Allow someone to hold the baby while you get some time to yourself to shower and brush your hair. You are not only taking care of yourself but also providing for another life, which requires you to make yourself a priority. If someone offers to help, and you are in the position to, take the help. Please feel empowered to ask for help when you are struggling. It is not in any way a weakness, in fact, it takes a great deal of strength to do so.
Reconnect
Try your best to make time for the things you enjoy. Whether it is grabbing lunch with friends, hitting the pickleball courts, going out on a date night, or simply picking up the phone to have a long overdue conversation with a friend. Find ways to let your “old life” creep back in and remind you of the foundation of who you are. And most of all, don’t feel guilty. You deserve personal time. Who you were before you became a mother is still who you are. You may have extra responsibilities and a few less hours of sleep, but you are still you. And if you are struggling to find who “you,” is, please be patient. It can take time and a lot of adjusting, but you will get there.
Reset
“Sleep when the baby sleeps,” is often easier said than done. You have fifty things on your to-do list, and one hour to get those fifty things done. And let’s be honest, sleep isn’t always number one on that list when you’re staring at the mountain of laundry from the past few days. But slowing down and resetting is vital to your overall well-being. Give yourself fifteen minutes to sit with a cup of coffee and let your mind rest. Put on your favorite television show or read a book. Whatever it may be that allows you to hit the reset button and more effectively tackle the day ahead, do that. The best thing you can give a child is a healthy parent.
At the end of the day, it is important to remember just that – you cannot be fully present for your new baby and family if you are not prioritizing your own self-care. It is not selfish to focus on yourself when you can and to create time and space for that. It is essential! And remember – if you cannot get in balance and feel yourself struggling, please reach out because support is available!
I believe that we all go through ups and downs in life, and I am dedicated to supporting you and guiding you through those trying times. Navigating life transitions can be complicated and difficult, and one of the most monumental transitions is that of pregnancy and postpartum. I have a particular passion for helping new mothers (and fathers) move through those challenging times. I have gone through extensive training to highlight the need for maternal mental health services and am committed to offering the best care as a Perinatal Mental Health Specialist. I am here to offer a safe space to those experiencing perinatal anxiety and depression, intrusive thoughts, pregnancy loss, and labor and delivery challenges, and to support those who just need help navigating through this journey called motherhood.
In addition to this specialty, I also work with a variety of other issues, including general depression and anxiety, as well as relationship issues. I believe that our relationships with others play a vital role in our functioning, and I enjoy working with others to help strengthen those relationships. I enjoy working with those who are ready to take the next step to develop a healthier relationship with themselves and others (whether that be their significant other, family, or friends). My goal is to help you achieve your goals while uncovering and processing the tough emotions that have been barriers to your happiness.
I use a variety of modalities depending on your needs – including CBT, EFT, and mindfulness. I will be here as a nonjudgmental, supportive clinician, helping you in your personal growth. I look forward to working with you!