Drugs For Kids Pose Parental Dilemma

Double bind: n.
1. A psychological impasse created when contradictory demands are made of an individual so that no matter which directive is followed, the response will be construed as incorrect.
2. A situation in which a person must choose between equally unsatisfactory alternatives; a punishing and inescapable dilemma.
This definition from the American Heritage Dictionary of the English Language describes the quandary parents often face when a child needs antidepressant medication.
If a teenager begins to withdraw from friends, has trouble sleeping, feels overwhelmed by schoolwork and loses interest in activities, parents should be concerned. These could be warning signs of serious depression.
The problem is that a prescription for an antidepressant now comes with a warning that the medicine may increase the risk of suicidal thinking and behavior. That is exactly what the parent is trying to prevent.
One possible way to address this dilemma is to monitor the child carefully in the weeks after receiving a prescription for an antidepressant. If agitation, anxiety or suicidal thinking appears, parents and therapists must take immediate action.
Relying on prescription drugs instead of therapy might seem like a solution to the high cost of treating mental illness. The price, unfortunately, has been some tragic deaths.
“One reader shared the following heartbreaking story: “I am writing to let you know that my nephew committed suicide at my house. He had been on antidepressants and should have been taking them at that time.
“He was a good guy and wouldn’t harm anyone. He was living with me because his religious family couldn’t tolerate him smoking cigarettes.
“When he arrived, his parents didn’t give me any information about his situation and told me nothing about his antidepressant medication. I feel it’s a strong possibility these medicines caused his fatal act. He hung himself. Sign me a grieving aunt with a broken heart.”
We do not know whether she could have prevented this tragedy if she had known more. But lack of information was clearly devastating to this family.
FDA warnings are meant to provide useful advice. The problem is that they put parents and physicians into a classic double bind. Parents need better guidance so they can identify emerging problems with medications before they get out of control. It is essential for all involved-parents, children and prescribers-to stay on top of the situation as it evolves.
Two psychiatrists, Joseph Glenmullen of Harvard and David Healy, Director of the North Wales Department of Psychological Medicine in Great Britain, have been sounding the alarm about this predicament for years. Both believe the drugs are valuable, but they warn that some individuals are vulnerable to serious side effects and must be monitored closely.
An hour-long conversation with these psychiatrists is available on a CD of our radio interview on antidepressants. To order a copy, send $15 to Graedons’ People’s Pharmacy (Dept CD-493); PO Box 52027; Durham, NC 27717-2027.
Families need help dealing with a complex condition like depression. Counseling can play an important role in bolstering the benefits and reducing the risks of antidepressants.