Children and Depression

Have you ever felt like nobody?

Just a tiny speck of air.

When everyone's around you,

And you are just not there.

 - Karen Crawford age 9

   Miracles: Poems by Children of the English-speaking World

Childhood is a time of magic and wonder when children are still unaware of the realities and hardships that come with an adult world.  Though, as society and its trouble's evolve and become too big to handle, these problems and worries are pooling down into our youth.  They are becoming more aware and influenced by the world around them, forced to take on our hardships as their own.   In this newly adapted child's world, where medication replaces make believe and childish doodles end up therapy tools, one cannot deny that something is terribly wrong with our kids.  Depression has been in our homes always, filtering now into our children, because we choose to include them in our pain or are too selfish to hide it.  What is our answer for an unhappy child?  Like pez dispensers, we fill them with all kinds of anti depressants, instead of teaching them how to happily and healthily navigate through this world that we have created for them.

It is understandable that some teenagers experience depression.  Depression is a mental illness which is a brain disorder brought on by changes in the chemistry of the brain.  While these changes can occur due to hormonal changes in the teen and young adult years, it is also starting to happen within younger school age children and even toddlers.  It is still considered rare in the very young because they do not have the right chemical anatomical changes that can cause mental illness.  According to the medical world, in most cases of depression, it is neither caused by parenting nor environment.  Children are now showing signs of mental disorders including: depression, bipolar disorder, schizophrenia, anxiety disorders, autism-spectrum disorders, attention deficit hyperactivity disorder and other behavioral conditions that in the past were only associated with adults.  The medical industry considers this to simply be a DNA blip that can be rectified with medication.  Perhaps children are simply growing up faster and taking on the hardships that come with growth and realization and the medication is a way to subdue them.

Children get sad just like adults and usually after a few days these feelings will go away, but apparently some stay sad.  Childhood is the most important time for inner and outer development.  Feelings of trust and love develop during these first crucial years and depend on good parenting.  Is it easier to love and spend time with our children, making sure that they feel good about themselves and us, or is it better to hand them a get better quick fix when things go bad?  If a child is suffering from a Major Depressive Disorder (MDD) the sooner it is acknowledged and cared for, the better, absolutely.  But the best time to treat it is before the child ever experiences signs of depression and not with medication. 

Currently, it is estimated that five percent of adolescence suffer from serious depression and while there is a great deal of medication on the market, whether it is a help or hindrance is questionable. Children suffering from severe depression need to be seen by a doctor to determine whether or not medication is necessary and to get it prescribed.  There are a number of medications currently on the market for youth and to go with them, a number of growing concerns.  While none of the medications for them claim to be addictive, which is questionable, there are confirmed side effects.  Nervousness, agitation, irritability, mood instability, aggressiveness and sleeplessness are signs that a parent is instructed to look for and to seek medical advice if detected.  MDD medication that is currently available, clinically termed "selective seratonin reuptake inhibitors" (SSRI's) are:                     

                            Fluoxetine (Prozac)

                            Sertaline (Zoloft)

                            Paroxetine (Paxil)

                            Citalopram (Celexa)

                            Escitalopram (Lexapro)

                            Fluvoxamine (Luvox) 

While it is stated by the medical industry that these anti depressants are better than one's that were offered in the past, having less side effects and are less likely to harm if taken in an overdose, the question remains how effective, safe and necessary are they?

Studies have shown that taking anti depressants can be effective, but these studies are in most cases results taken from testing adults. Knowledge about youth and children's reaction to anti depressants is still limited as the prescribing of these types of drugs to young people is a somewhat new practice.  Anti depressants have been shown to be safe and effective for adults.  In the case of bipolar disorder, which is now being diagnosed in children as young as six, testing according to the findings at www.webmd.com, shows that children are more prone to side effects than adults taking the same treatment.  Children taking anti depressants are encouraged not to abruptly stop taking SSRI's as this can lead to other problems, the most minimal being a relapse.  Therefore, a child will have to continue to experience side effects caused by medication because they must continue to take the medication until it is deemed appropriate and safe for them to stop taking it, by a professional.  Families are forced to weigh the risks of medication against the apparent benefits.

Diagnosing a mental illness in a child can be difficult.  Bipolar symptoms, for example, are very similar to that of attention deficit hyperactivity disorder (ADHD).   If medication for an ADHD child is given to a bipolar child, this can induce mania in the child.  Mania in turn, can cause delusions and psychotic behavior.  Diagnosing the right illness is crucial and consequently both a daunting and dangerous task.  Furthermore, there is the possibility that the child is not suffering from any type of mental illness but is simply acting out as children do.    

There are a number of experts that believe that mental illnesses are being over diagnosed in children who may just need more attention and love.  There is the belief that children are being offered medication too quickly. This brings up the question of the long-term consequences of misdiagnoses.  One person who experienced such medical mistake, explains how this has affected her life:

"For twenty-five years I was medicated for obsessive compulsive disorder and two months ago I went to a new doctor feeling that I was receiving no benefits from my pills and thinking that I had developed some sort of immunity to this particular mood altering drug.  I was in a constant state of despair and had lost interest in everything including my beloved family, pets and friends and my own existence.  My new doctor was very empathetic and after a prolonged interview he told me that he felt very certain that I had been misdiagnosed and that he believed I was suffering from anxiety.  I was prescribed a drug to treat this.  I went home rather shaken and confused about my sense of identity.  If my new doctor was right, then who might I have been if I had been on a different med all those important years past?"

Physical side effects are clearly not the only way that medication can alter a life.  Anti depressant medication is known to numb emotions.  A fifteen year old who recently stopped taking the anti depressant prescribed to her explains that the medication was making her numb to everyone around her.  She couldn't cry any more out of happiness or sadness.  She didn't feel normal.  The most important thing to a teenager is to feel normal.  This teenager was prescribed medication because she was feeling depressed.  She comes from a broken family, having little involvement with her father, alcoholism is present within her home, there are financial hardships, she is currently experiencing confusion about her own sexuality and is being bullied and ostracized at her new school.  This is the type of situation that would affect any person, adult or child.  Is medicating her going to solve her problems?   Childhood is an emotionally packed time.  It is important for a child to experience and learn how to cope effectively. It is an important part of the growth process.  It is the child's parent’s responsibility to protect them from hardship. How safe can it be to hinder or stagnate a child's growth by medicating them?  Do we not owe it to our children to fix the problem at the root, not just nip it in the bud? 

Not yet mentioned, is the most serious effect that prescribed medication is having on some children, an increase in suicidal tendencies.  In Canada, suicide remains the second highest cause of death for youth aged 10 to 24.  According to the Canadian Mental Health Association, almost 300 youth commit suicide every year. The Association does not say how many of those children were taking anti depressants.  In 2004, the FDA held a hearing warning that there were new findings that stated that there was an increased risk of suicidal attempts, thoughts, and behaviors amongst children and teens taking SSRI's.  While Prozac is the only approved anti depressant by the FDA, occasionally doctors recommend the other one’s previously listed.  While Prozac is approved, there are strong signs that it has some serious problems, suicidal risks being the main one.  Specialists state that individual responses to SSRI's including Prozac cannot be predicted with certainty.  There are not enough youths currently suffering from mental illnesses to do a study that would in reality require thousands.  Tests using a small number of young patients though, have not been able to discredit this claim. 

Like adults, young people can be depressed.  Life is difficult to navigate through, especially through the younger years. But unlike adults, children's cries for help are not always answered in the way required.  Acts of rebellion or periods of sadness are termed signs of mental illness.  Studies show that there has been a shift away from generalized care for people suffering from depression under the age of eighteen.  More young people are seeing specialists such as psychiatrists and other mental health professionals for their illness. This being said though, there is a shortage of these types of professionals available which may mean fewer youths that are suffering are getting the help that is required and making it questionable that the ones who really need it are the one's receiving it. 

What our children need most from us are protection, love, guidance and a chance to be heard.  In many cases, medicating them is not the right answer.  The risks associated with medication are serious.   We are in essence, gambling with the most valuable thing we have.  Are we really willing to loose?