Getting help, Lessons learned

Lesson #7: How do you know if your teenager needs antidepressants

There’s a lot of debate about antidepressants for teenagers. So how do you know, as a parent, if your teenager needs antidepressants for their depression.

One on the one hand, doctors will tell you that antidepressants, combined with psychotherapy, is a very effective treatment for clinical depression. On the other, studies show that antidepressants may not work on teenagers. That they could do more harm than good.

I believe antidepressants saved my daughter’s life. But the decision to give her medication that carries a “black box warning”, the most serious type of warning issued by the Food and Drug Administration (FDA), wasn’t an easy one.

If you’re wondering whether your teenager should take antidepressants for their depression, here are three things I’d urge you to consider.

Once declining in population, the Eastern Bluebird is making a comeback. Their arrival in early spring signals the end of winter. Photo by Noah

Does your teenager want antidepressants for their depression?

Soon after my daughter asked me for help with her depression, she said she felt she needed antidepressants. I disagreed.

It wasn’t stigma that held me back. It was ignorance.

I had it in my head that antidepressants were a last resort. Something we’d try only after exhausting the other options. She had just started talk therapy. I thought she needed to give it some time.

If I’m honest, it was also because I thought she wanted an easy fix to her problems. A magic pill to make everything better rather than going through the hard work of unburdening herself in a therapist’s office.

I now know that nothing about my daughter’s depression was easy, including trying medication to relieve her suffering.

And contrary to my self-centered view of things, she hadn’t just pulled onto the “road to recovery.” She had been trying to manage her illness on her own, without success, long before I got involved.

If you read my earlier post, you’ll know that I missed signs of depression in my daughter for months. While there was some grade-eight girl drama, she had good friends, was doing well in school, and managing a regular babysitting job. On the outside, she looked fine.

It was this very ability to function that made me question the need for medication even more. It made me think her illness wasn’t severe enough to warrant medication. After all, how could depression and ambition co-exist in her brain? It didn’t make sense to me.

It my husband who reminded me, thankfully, this wasn’t about me. What I thought she was feeling, what I thought she needed, and what I thought depression looked like was irrelevant.

I needed to put my own feelings and beliefs aside and focus on hers.

Does the doctor recommend antidepressants?

I am all for mama-bear instincts when it comes to my protecting my kids, but when it comes to treating my teenager’s depression, I have learned to defer to medical doctors and trained professionals. It wasn’t easy.

The first therapist we saw recommended my daughter might benefit from antidepressants after a single appointment. The second therapist lasted only a few sessions and came to the same conclusion. She couldn’t prescribe them, but suggested we find a psychiatrist who could.

I was furious. Literally angry at them. I felt they were encouraging my daughter down a path I hadn’t sanctioned.

But what did I know? What do you know? If you haven’t asked yourself this question, I’d encourage you to do so.

Looking back, here’s what I knew to be true at that time.

We were in a holding pattern, sitting uncomfortably in one of the gaps of Canada’s mental health care system between therapy and psychiatry.

I knew my daughter wanted and, according to trained therapists, likely needed medication for her depression.

I also knew my daughter’s mental health was declining. While we waited for a psychiatrist, she started cutting. She assured me she wasn’t suicidal. The cutting helped her feel better, she said.

I also knew her resistance to her depression was weakening. She was coming to me more often, late at night and in tears, asking how much longer. On those nights, we’d debate whether or not to go to the hospital, neither one of us knowing what that entailed, or hold on another day.

I knew her therapist didn’t think she was suicidal. The fact that she was reaching out when she felt vulnerable was a good sign.

That’s what I knew.

I didn’t know why she felt the way she did. Nor did I know what she said to the therapists or later to the psychiatrist who prescribed medication on her first visit.

I was untrained, uninformed, and entirely green when it came to dealing with depression. So, why did I ever think I knew more than the doctors?

Do you have other treatment options at this time?

I think most parents are reluctant to have their teenagers take antidepressants. It’s a natural reaction.

We’ve worked their whole lives to keep medication out of reach. As kids become teenagers, we warn them about the risks of drugs and alcohol. I think we’re programmed to resist.

I also think most parents who “decide” to give their teenagers antidepressants, do it because they’ve run out of options. The risks of not trying antidepressants starts to outweigh the risks of the medication. At least this was how it was for me.

While my daughter was high functioning, she wasn’t able to manage her depression. She agreed to talk therapy, but only as a stop gap while we searched for a psychiatrist who could prescribe medication.

She wasn’t sleeping well at night and she wouldn’t eat dinner with us. I rarely saw her eat at all, though I know she’d do it in private. I didn’t know back then to pull her phone from her clutches.

And though she acknowledged she was in significant pain, she wouldn’t tell me why. As her condition declined, she boarded up herself further, shutting out even a sliver of light.

Within four months, therapists and a psychiatrist in the wings, I watched her mental health decline to the point that we wound up in emergency.

Today, she says she’s “happy.” It took three years of trial and error with antidepressants and continued talk therapy, but she’s currently symptom free. And I’m cautiously optimistic.

Am I sorry she’s on antidepressants? No way. I’m still concerned about the long term effects, and I wonder constantly when and if we can start to wean her off, but I don’t regret it.

The best depression treatment may be the one they want

If you’re still debating, consider this article on WebMD. It’s about a 2005 study involving 335 patients with depression.

Researchers at the VA Puget Sound Health Care System and the University of Washington in Seattle found that 72% of patients matched with their preferred treatment were significantly less depressed than those not matched. Patients who got their preferred treatment also tended to be less depressed after nine months.

So, what does your child want? What do the doctors recommend? Do you have other options?

These three questions might not solve your internal debate about whether or not your teenager needs antidepressants, but I hope they help you help you take the next step, whatever that is.

Leave a Reply

Your email address will not be published.