If ADD was the catchcry of the ‘90s, anxiety and depression are the health concerns that mark our current times. Anti-anxiety/anti-depressant medications, once prescribed sparingly and only for adults, are being given to kids in record numbers, and most adolescents can make a long list of their classmates on Zoloft, Paxil, and the like. Kids go off to college and are home before the end of first semester — “depressed”.
So prevalent is this problem that Consumer Reports Medical Guide (www.ConsumerReportsMedicalGuide.org) — the health bible — has just released an in-depth report on ‘Depression in Children’. The material, available online, describes types of depression, gives early warning signs, compares the various available treatment options — including non-drug interventions, and provides an easy-to-read chart differentiating depression in children from other mental health conditions that share symptoms.
Medical advisor to CRs’ Medical Guide is Dr. Beth Nash, a Westchester mother of teen daughters aged 14 and 17. Which makes her a double-duty expert!
Dr. Nash readily acknowledges that defining depression in young people balances parents on one of the classical fine lines of child raising. Consumer Reports’ evidence suggests that only a third of teens who need help for depression will ask for it; younger kids often express themselves through tantrums and headaches. When teens and tweens cry, get angry, lie on the sofa for hours on end, become secretive and non-communicative, lose interest in once-joyful pursuits, refuse to get up in the morning, bemoan their lack of self-worth, wail that school . . . people . . . life . . . is hopeless, what is normal and what is not? Then there’s ‘reactive’ or ‘situational’ depression — when kids overreact to something or someone, but soon this passes and equilibrium is restored. How does a parent, head spinning, make sense of it all?
“Depression,” says Dr. Nash, “lasts a minimum of two weeks. When kids don’t ‘come out’ of the symptoms in a two-week period, when it’s all day every day” — that’s when it’s time for a parent to focus attention on a potential problem.
Going to the Consumer Reports’ checklist is a great place to start. Here you’ll find a list of symptoms of ADHD, anxiety, bipolar disorder, and depression. But Dr. Nash urges parents to stay calm, to use the chart as a source of information, “to see that the different mental health issues have some overlap, but also some significant differences” — so that if you end up going for professional help, you are armed with information. Important, she notes, because “there’s no one treatment that’s right for everyone.”
Which is why she describes an “ideal world — where parents have a pediatrician they really trust, who can refer the child on to a specialist if needed, and who will create a communication network. Otherwise you’ll end up with fragmented care — if doctors are not talking to one another and nobody has the full picture. The role of the pediatrician, in this case, should be to orchestrate all the pieces.”
Providing information that is well researched and unbiased was paramount in Consumer Reports’ mindset, Dr. Nash insists. “These days, there’s almost too much healthcare information out there,” she believes. “A lot of it comes from people important in their fields, but a lot of this is opinion.” The British Medical Journal was already in the process of pulling together the proven information, so Consumer Reports joined forces with this work in progress. Dr. Nash combines her work on the CR Guide with her position as clinical editor of the British Medical Journal Publishing Group.
Whether depression is over-diagnosed and people (young and old) over-medicated remains controversial. “Whether we’re diagnosing more anxiety and depression, or just recognizing it more — when once we swept it under the rug — the data is not there,” Dr. Nash reports.
But she adds: “We live in difficult times. And young people are aware of what’s going on around them.”
