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Kids, depression, and the use of medication ; Walking along a fine line in treatment
Copyright 2002, The Record

Are we as apt to seek antidepressants for unhappy kids as we are to ask for Ritalin for antsy ones? Are we overprescribing these meds?

A reader recently wrote to ask those questions.

"With the wide use of antidepressants nowadays, I feel that parents of young adults who are prescribed them for mild anxiety need to have more understanding of them," she wrote. "I have been meeting young girls who are on antidepressants for anxiety and I'm wondering whether there's really any difference between coping [via the use of] illegal drugs versus prescribed medication. Does a parent treat the young adult differently because a doctor is giving the pills?"

Up to 2.5 percent of children and up to 8.3 percent of adolescents in the United States suffer from depression, according to the National Institute of Mental Health. Research indicates that the onset of depression is occurring earlier in life today than in the past. Depressed young people are more apt to have other mental disorders, including anxiety, disruptive behavior, and substance abuse problems and even some physical illnesses, such as diabetes.

NIMH-supported researchers found that among adolescents with major depression, as many as 7 percent commit suicide in the early adult years.

This is serious stuff. But, as the reader asked, with the easy availability of prescription antidepressants, are we medicating young people who would be served better by learning to analyze and deal with the challenges in their lives?

"Well, the general view of people is that medications for psychiatric disorders are to be avoided," said Dr. Arnold Scham, a psychiatrist who is director of mental health services at the Valley Hospital in Ridgewood. "Their thinking is that if it's below your neck, it's a real illness, but if it's above your neck, you should just handle it with willpower.

"But depression is a medical disorder, not just a mood problem. There are biological and chemical changes in the brain that accompany it. There are people who prescribe antidepressants too casually, but equally I've seen people devastated by problems and not getting medications that could help."

Scham also noted that antidepressants are used for children and adolescents who suffer from panic disorder and obsessive compulsive disorder as well. Often, these disorders run in the family and, untreated, get worse over time.

"These are recurrent, long-lasting conditions, and antidepressants are an important part of the treatment," he said.

But he cautioned that you have to be extra cautious when prescribing medications for children, and he advised that you consult a psychiatrist if your primary care provider is suggesting antidepressants for a child or teen.

"Seventy percent of psychiatric medications in general are being prescribed by non-psychiatrists," Scham said. "It's important that the person evaluating your child is skilled in these areas, it's important that your child's reaction to the drug be monitored, and it's important that there be psychotherapy along with the medication."

And is there evidence that antidepressants are handled differently by the developing bodies of children and adolescents, or that these drugs can interfere with development?

NIMH says there are two studies showing that the newer antidepressants - the selective serotonin reuptake inhibitors (SSRIs) - have been shown to be "safe and efficacious" for the short- term treatment of severe and persistent depression in young people.

"There are very few studies on children, but these drugs are still used commonly in children with no evidence of any effects that are long-term and dangerous," Scham said. "On the other hand, there's plenty of evidence that not treating these disorders early in life can lead to long-term disabilities. If, for example, a kid had panic disorder and doesn't go to school, that's a problem that clearly interferes with his development."

 

This Article has been submitted by the Jeremy's Prophecy Dot Com team for informational and educational purposes. Jeremy's Prophecy Dot Com is a website dedicated to telling the story of Jeremy Jacobs, a character in the novel, Jeremy's Prophecy Dot Com.

 

 
 


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