What will become of Madeleine?

Madeleine was sleeping poorly. The 8-year-old girl who had always been a joy to have in my office stopped sleeping about 3 months ago. She won't fall asleep until 2 am, and she is afraid to go to sleep, afraid of monsters and sounds in the night. Of branches scratching the house and the wind. When she does get to sleep she gets up screaming uncontrollably, or she is up walking around the house in the middle of the night but not really aware of what she is doing. She is sleepwalking. And because she gets so little sleep, she can't get up in the morning for school. She's tired at school and beginning to be irritable and to lash out at her younger brother. Laura, her mother, is at her wit's end. She is getting no sleep either. First I tried standard pediatric sleep interventions, then a little hypnotic, but it was getting worse, not better. Finally, 3 weeks ago, Laura was pleading for me to find a way to help her daughter. I decided she may have an anxiety and depressive disorder, and started her on a low dose of an antidepressant, Zoloft. I explained, a few children may become more agitated, we need to watch closely and stop the medication with the earliest sign that it may be making her worse. I hoped for the best, and sent her off to a child psychiatrist.

Yesterday, Madeleine returned. I opened the door and Madeleine shot me a huge smile. Laura said Madeleine is back to her old self. She is sleeping through the night, her sleep cycle is restored, and she is back to her old self during the day. The psychiatrist concurred with the medication. And now Madeleine has the most infectious, beautiful laugh I can ever remember hearing. She will stay on that little, miraculous dose of antidepressant for now. Drugs may be overused in children, but I hope they will never be completely taken away from us. Children like Madeleine need them.