Perhaps the loudest and scariest debate among adolescent experts has to do with medicating teenagers for depression. Since these drugs burst upon the scene a professional civil war has raged about whether using antidepressants with depressed adolescents saves or takes lives. Objective, well respected and caring experts have lined up on both sides (not including “shills” for the drug companies) waving research to prove their respective points. Maddeningly for clinicians, and terrifyingly for parents, that research often seems diametrically opposed. The “anti med” side offers data showing how some kids for unknown reasons may actually be pushed to suicide by these meds, while the “pro med” side has numbers showing how overall suicide rates rise when the docs cut back on these prescriptions after reading the “anti” research. A brand new study powerfully questions an original “pro” study’s methods, saying a reanalysis of the data actually show an “anti” result (BMJ 2015; 351 doi: http://dx.doi.org/10.1136/bmj.h4320 (Published 16 September 2015) Cite this as: BMJ 2015;351:h4320.
So what in God’s name is a parent of a depressed teen supposed to do? First, TALK AT LENGTH WITH YOUR OWN EXPERTS. Be sure to ask the line I like hearing from my clients: “If this were your kid, what would you do?” This is where you must weigh out the risks and benefits for your particular child and make that tough decision. That’s why us parents make the big money, right?
If your kid has already been on these meds for awhile the odds are very good that nothing bad will happen since the nightmare side effect seems to occur early on (if it really occurs at all). If this med question is new for you, then chat with your experts about trying other powerful “meds” before using the antidepressants. That other med list includes radical treatments such as diet (“did you know a string bean won’t kill you?”) exercise (just a 30 minute brisk walk everyday, not Ranger School) and, that most powerful med of all, sleep (she needs 9 hours, she gets 6 on a good night). Oh! I almost forgot the last medicine: counseling/therapy. This is where the experts’ civil war disappears, since everyone agrees that these are wonderful wellness options that can work as well or better than any antidepressant pill ever made.
Of course, getting a depressed kid to do any of these is the trick. Focus on just one of these options at a time. Success with one makes the next more doable. Try modeling, gentle encouragement, and, my personal favorite, bribery. For example, “How ‘bout I pay you for each hour of sleep I see you get? The psychologist will help you figure out how to make that happen.” Let the shrink break the bad news to him that the electronics will have to be killed an hour prior to sleep. You’ve got enough to fight about already.
For more tips on these wellness option strategies, check out my latest book WHEN THINGS GET CRAZY WITH YOUR TEEN. THE WHY, THE HOW, AND WHAT TO DO NOW! You’ll find many free chapters available to you by clicking here.
Take care, and whatever you do, don’t stop laughing. It keeps my wife and me sane. Sort of…
Doctor Mike Bradley
Official Website and Parent-Teen Resource