‘It’s cruel’ and ‘she’ll grow out of it’: Parents’ decision to medicate their children faces judgment

When Andrew Leach trained as a GP 11 years ago, he thought the main issues he would see in children would be coughs and colds.

He didn’t expect a wave of children so worried they couldn’t go to school or young children struggling to function. He didn’t expect to see so many young people struggling with depression, or young people who spent their whole lives thinking about ending it all.

“I would say, on an average week, I’ll see at least one or two teenagers who have very strong suicidal thoughts,” he said.

“I had cases [children] Writing down suicidal thoughts or plans and submitting them to me here can be as low as eight-seven.

A growing number of Australian children and teenagers are taking anti-depressants, according to data revealed by the ABC. Prescriptions for SSRIs, which have grown 247 percent in the past 10 years, are the most commonly used type of depression.

Dr. Leach is not surprised by these figures. He sees calls for mental health help every day and has prescribed SSRIs to many young people himself.

And while doctors say the rise in antidepressant use likely reflects a growing number of people seeking help, rather than overprescribing, some parents say if they were to give their children “medication “If they do, they feel judged.

Treating a child who suffers from “paranoia” that things will hurt him.

Among the children prescribed medication to manage their mental health is Patrick, seven, from Perth.

His parents Christine and Warren suspected from an early age that he was neurodivergent and when they took him to a pediatrician at age six, he was diagnosed with ADHD and prescribed stimulant medication.

Once they worked out the right medication for him, the effect was profound: he was able to focus on tasks and control his emotions better.

“I still remember the first day we gave him medicine,” explains Christine.

“He took a shower and said to me, ‘Mom, it looks like the rain came and took the bad cells with it.’ That was what he was six.

One side effect of managing ADHD was that it revealed an underlying concern that had not been apparent before.

Patrick struggled to leave the house because he was afraid of flying insects. When out at shopping malls and swimming pools, he would look at the ceiling and wonder if it caved in.

“It was almost like a paranoia and a phobia that things would hurt him,” Christine said.

Christine and Warren tried the usual methods of dealing with a teenager’s anxiety, such as “exposure therapy” – where you gradually expose someone to the things they fear – and psychological support. It didn’t work.

It was only after trying SSRIs, on the recommendation of their GP, that they noticed a difference.

He’ll still say to me, ‘Oh, I saw something fly!’, or he’ll still say, ‘Oh, is that roof safe?’ But SSRIs, I think, manage it so well that now we can reason with that,” said Christian.

“Now we can say the bees didn’t come for you, they want the pollen,” or, ‘This building is safe, we wouldn’t be allowed in here if it wasn’t safe.’

“Before, if we tried to reason with him, there was just a complete block. He just couldn’t. It didn’t matter, because those feelings were so intense.”

Patrick’s parents even caught him chasing a dragonfly recently – something that was once unthinkable.

‘Reducing stigma’ means more people get help

The theories behind the development of mental disorders among young people are different. Experts have pointed to inequality, climate change and global instability, among other things, as damaging to young people’s mental health. The rise of smartphones and social media has also been cited, as well as the ongoing impact of the COVID-19 lockdown.

As Dr. Leach sees it, it’s also a reflection of the increased stress families and children are under.

He said, “There is a lot of pressure on families at the moment. “From the cost of living, the way they are under the pressure of school – the daily chores of the child, the homework, the extracurricular activities – the busy lives that people lead, leaving two full-time parents who often work. It creates a huge pressure.”

Most doctors say we don’t know exactly what causes it. All we have are well-informed opinions, and a growing number of young people who need help.

There is more awareness of mental health conditions today than there was 10 years ago – and that only means more people are seeking treatment.

“We have a lot of data from surveys that show that we are not really meeting the needs of children and young people, that there are high rates of mental illness,” says Elizabeth Moore, chair of the royal family. Australian and New Zealand College of Psychiatry.

“So what I would say is that people coming forward for help is actually a really good thing … We’ve worked hard to reduce the stigma, so people feel like they can come forward.”

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Philip Hazell, a 36-year-old psychiatrist who wrote guidelines for prescribing antidepressants to young people, says it’s not just medication levels that have risen – it’s all mental health treatment.

“To give you a parallel, we know that the number of children hospitalized for mental health conditions has increased dramatically from the early 2000s to the present,” he said.

“There’s certainly very compelling evidence … that more young people are reporting stress now than they were a decade ago or two decades ago. But if you look objectively. [underlying] Mental disorders, mental illness and population rates, which haven’t changed much.”

‘He’ll grow out of it’: Parents face unsolicited advice

For Warren and Christine, there was no outsider that caused Patrick’s anxiety: it was simply a part of who he was.

But despite increasing awareness of mental health, they were judged for “medicating” Patrick.

“We actually have it from extended family,” Warren explained. “Also from my parents, [comments like] And just give him another meal and that will fix it.

“And we’re still getting it,” Christine added. “Like, ‘Why are you giving him medicine? It’s cruel. He’ll grow out of it.’

There are other strategies that patients can try before SSRIs, such as lifestyle changes and seeing a psychologist. Even a tool called psychoeducation, which helps a mental health patient understand their situation, can help reduce anxiety levels.

But when these strategies don’t work, or when a child is too anxious to even begin to engage with them, that’s when SSRIs may help, says Harriet Hiscock, a pediatrician and researcher who’s 18 years He has experience, he says. Murdoch Children’s Research Institute.

“If they [antidepressants] work and they help that child, it can be life-changing,” Professor Hiscock said.

“They can feel relaxed. They can find the courage to get out of bed and go to school. They can enjoy being with their friends again. They can be at home with their parents. Be less irritable and aggressive.

“They will also begin to be able to use these cognitive behavioral strategies, because they will be in a situation where their anxiety is so high that they … can’t do anything.”

Some doctors, including Dr Leach, say accessing these other supports can be more difficult – and more expensive – than seeing a GP and getting a script. Many psychologists, occupational therapists and specialists have long waiting lists and can cost hundreds of dollars, he said.

Antidepressants are ‘well researched’ but come with side effects

There are risks with taking SSRIs, as with any medication. Weight gain is common. Paradoxically, there is also a risk of suicide when you first start taking them.

The more they are taken, the harder it is to stop taking them.

Catherine Wallace, a GP and professor at the University of Queensland who researches antidepressants, says these issues should be carefully considered before prescribing.

He also believes that there is only so much medicine can do.

“I think it’s important to have social connections. It’s important to have social skills, and not hide in your bedroom online,” she said.

“I think the idea of ​​leaving antidepressant prescriptions at the end of the spectrum — so people who are very seriously ill — is important, and that we don’t see it going from the gastrointestinal to the mild end of the spectrum.”

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Research shows that SSRIs are most effective when combined with psychotherapy, and not taken alone.

Some doctors said they would like to see more research on the long-term effects of antidepressants in children. In response, other doctors said that antidepressants were among the drugs prescribed to children.

“The drugs we use in mental health are very well researched. The thing is, they’re not as well researched in children as they are in adults,” Professor Hazel said.

Appointments for the ‘Pandora’s Box’ of mental health issues are very short

Meanwhile, GPs say they are seeing an increasing number of young patients coming through the door seeking help for their mental health.

Often forgotten in discussions of the youth mental health crisis are the effects of those on the front lines: physicians.

When talking to Dr. Leach you can see in his face how much he cares for his young patients, and seeing their many struggles also weighs on him.

Cathy Andronis, director of psychiatry at the professional body for GPs, the RACGP, also described the burden on doctors.

“The reality is that GPs are still managing it,” she said.

“I just think GPs often feel hopeless or powerless to help these young people with their problems as a young person. It’s a systemic issue. It’s a whole community issue. “

Dr Andronis wants to change the GP system to accommodate longer appointments for people with mental health issues, so that doctors don’t feel rushed if a patient develops a problem.

“People hate opening Pandora’s Box in the short term,” she said.

Dr. Moore, a top psychiatrist, wants the federal government to fund more training positions for psychiatrists to boost the mental health workforce.

What helps Dr. Leach stay positive are the days when he can make a difference. When he sees a child who has no hope and re-engages with the world.

“I’ve had some amazing transformations of kids as young as eight, nine years old who come in with serious issues around anxiety, especially school avoidance and social problems as well,” he said.

“I’m explaining [young patients considering SSRIs]’These tablets are not going to be a magic wand and then you wake up feeling absolutely amazing and life is complete.’

“It’s a small step, and we don’t want to numb the kids, and we don’t want to numb the youth, we want them to have feelings, because that’s life.

“Sometimes it doesn’t work, and that’s where we have to go back to the drawing board.”

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