My stepson has Selective Mutism. He is 8 years old. I was wondering how you felt on giving him one capsule of St. John’s Wart a day. It seems to help keep mood levels on an even level. Both myself and M…’s dad take St. John’s Wart. We know how much it helps both of us so we were wondering about giving a capsule to M… each day. M…’s dad is 43 years old and he is sure that as a child he had selective mutism but was not aware of it at the time. He has since grown out of it. Because of this he is very protective of M…. He is very quick to answer for M… in unsettling situations. What we are wondering is if this is a good idea. Are we best to just answer for him etc. or should we be insisting that he try and answer more for himself. Thank you for all your help.

Sincerely, L…..

Answer

If you check back on some of the ASK THE DOC responses on our member site, the question about herbs has been brought up a few times. My opinion is this: Herbs are very, very nonspecific, and are not studied in children at all. St John’s Wort is more for depression than anxiety, and SM is an anxiety. You would need a relatively high amount, but we have no idea how much to give to children because, even with adults, the dosages are so variable. Extracts vary and amount of real herb is different from brand to brand. Honestly, I am not a fan of herbs, so I cannot recommend them to children. If you are seriously considering this route for an 8 yr. old, perhaps speak to an herb specialist who studies and works with herbs as a profession.

Regarding ‘answering for your child, this is tough because when a child is SM, it is natural to try and protect the child and answer for them to minimize embarrassment. What needs to be done is for you to work with your child and to let them know you understand it is difficult for them to answer sometimes…if they answer that is great, if not, it is okay too. Just this message alone takes off pressure.

You see, verbalization will occur once anxiety is lowered. So, until this happens through a variety of ways (behavioral therapy with or without medication) you cannot expect a young SM child to all of a sudden start to speak. Without therapy to help with coping skills, and to lower anxiety, ‘ASKING’ a child to answer or telling him to answer will only promote more anxiety.

Bottom line, once your child is under treatment to help with lowering anxiety, building self-esteem and increasing their confidence in social situations, verbalization will naturally occur…and you will soon know when and how to gently encourage so that anxiety is not heightened

Dr. Elisa Shipon-Blum