Our young people are struggling with mental health. Two years ago, the American Academy of Pediatrics, along with two other professional groups, declared a national emergency in child and adolescent mental health. The October 2021 declaration included a call to action for funding and policies to address “soaring rates of depression, anxiety, trauma, loneliness, and suicidality.”
Families can’t wait on new policies, though. When your child is suffering, you need help now — in the form of support, therapy, medication and sometimes even hospitalization.
That may be why the use of antidepressants among teens is on the rise. A 2020 report from Express Scripts revealed that between 2015 and 2019, there was a 38% increase in the use of antidepressants among ages 13-19 in the United States, with 10.2% of girls and 5.3% of boys filling prescriptions for mental health medication.
As this newspaper reported daily on the fentanyl crisis last month, I continued to wonder why so many young people are willing to pop a pill that’s not prescribed for them. I’m concerned about the emotions they are trying to ignore or numb and worried about the risks they are willing to take — or perhaps not fully understand.
I recently spoke with Dr. David Atkinson, medical director of the Teen Recovery Program at Children’s Health and an associate professor of psychiatry at UT Southwestern Medical Center, for his advice on keeping kids safe with medication.
“We really need a healthy, moderate mean between two extremes because there should be concerns about medication overuse because any medication is with risk,” Atkinson said. “Medications, by definition, are altering something in the chemical composition or the functioning of the body. At the same time, we need to really watch out for a skepticism that is pre-emptively damning all medications. There are people who notice that there are situations where things are overprescribed … and then they jump to the other side of this conclusion where all of this stuff must be unnecessary and unhelpful.”
While medication is sometimes the appropriate answer for some patients, Atkinson said, parents and community leaders do need to consider the causes of mental health problems in the first place.
“When we have a lot of known risk factors, such as not being physically active, not going outside, too much time on social media, suffering some kind of bullying or abuse, those are factors that we ought to focus on intervening so that the kids do not come into situations where they have conditions that are typically treated by medications,” he said.
He said parents and guardians should ask questions when medications are recommended or prescribed, such as, “What is the evidence base behind what you’re prescribing? Is it better than allowing the child to react without the medicine?”
He also said families should ask physicians about experiences based on other patients and on discussions with other clinicians.
As both a mom of young adults and a middle school teacher who glimpses the pressures that our young people face, I frequently consider the availability of healthy coping skills. What can adults do to guide children and teens toward effective methods of dealing with stress and pressure?
Atkinson has a list — open up to a trusted adult, exercise, cut off social media, consider cutting out toxic friends and get adequate sleep (eight to nine hours a night).
“Inadequate sleep is probably a big reason for frayed nerves,” he said, which leads to another tip. “Before you add more chemicals in your life, make sure you’ve tried cutting out the ones that are already in there.” That includes caffeine, which can actually increase anxiety. And we often use caffeine because we didn’t get adequate sleep; these factors feed one another.
Adults should help their kids be a part of the real world.
“One of the real main drivers of depression in teens, I think, is the lack of person-to-person social interaction,” Atkinson said. “All the evidence is converging on that point, that teens, especially, and preteens, too, need social interaction and the joy of being around people.”
When we have face-to-face interactions, when we hear another person’s voice, cortisol (stress hormone) is lowered and oxytocin (positivity hormone) is increased. But using screens and keyboards to communicate doesn’t do the same thing. “We are living in a situation where our natural chemistry is a little bit messed up,” he said.
We can correct that imbalance, he said, by participating in real life — volunteering, getting out in nature, learning about different cultures, exploring neighborhoods, participating in faith-based groups, creating art, joining a team.
This is good advice for adults, too. Everyone feels better with healthy coping skills and real-life interaction — and those young people we’re worried about will take notice.
Tyra Damm is a middle school teacher in Frisco and a frequent contributor to The Dallas Morning News.
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