"He is such a pleasure to be around since starting his meds."
-Mother, 16 year old son
Medications can truly helpful for adults and teens with problems such as anxiety, moodiness, eating disorders, anger or attention issues. Millions of scripts are written every year and many people benefit. So, do we just run to medicate an adolescent when he or she starts to show symptoms during a divorce? Aside from potential side effects, medicating reflexively may cause you to miss what's really going on. Here is a part one of an overview that can help you get it right. For a more complete treatment of this issue, look at my Intelligent Divorce book series which focuses on the well being of your children.
The teenage brain is a developing organ that won't reach maturity until twenty-five or so, and the psychological roller coaster of emerging independence and sexuality can be daunting for girls and boys alike. Add a divorce, and figuring out what's going on psychologically can be tricky. While your adolescent may be inherently inconsistent, moody, or test limits, during a divorce there are additional pressures to deal with over which he has little control -- the dissolution of his family as he knows it, perhaps warring parents or just worries about what the future may hold.
So how do you tell the difference between an upset teen and a teen that needs treatment, and maybe medication?
Four important questions can help.
First, does your child's problem precede the divorce? Some kids are by nature anxious, moody or inattentive. You may already have him in treatment for ADHD or another diagnosis. For kids like this, the stress of divorce can worsen an already existing problem. Anxious kids can become more anxious, depressed kids more depressed and so on. A good therapist or doctor can assess what is going on. It may be that your child will benefit from counseling, where she can express her concerns, learn adaptive techniques and feel strengthened. It may be that you and your ex are contributing to your child's stress and that the therapist can help you contain your differences to times when your teen is not present. This may take off a big burden and lighten up the symptoms that you have been concerned about.
The second question is related to the first. Does my child show evidence of extreme moodiness, extreme anxiety and the like? You should take careful note if your child stays in bed an excessive amount, or goes for long periods of time without showering or changing clothes. Or is she so anxious that she can't fall asleep or get her homework done because she is worrying all the time. Be on the lookout for flights of manic energy, sleeplessness and grandiosity. In these instances, you might be up against a bigger problem than mere teenage moodiness. Mood and anxiety disorders tend to run in families so get a handle on the mental health history of your extended family - and inquire about your ex's side as well. If your child is adopted, you will have to dig further: did the biological parents have these issues?
Psychological problems, whether they are mood or anxiety disorders, attention deficit or other issues, are defined not just by the symptoms but also by how the problem actually impacts basic functionality. If you notice that your son is acting depressed, but he's far from suicidal, he does well in school, he has good friends and an active social life, and he generally gives off an attitude of contentment, you are most likely dealing with normal teenage angst. If your daughter is anxious and complains about the divorce or your parenting, but lives life well, she is probably okay. Complaining is not a psychiatric diagnosis. If, on the other hand, your son protests constantly that he's "fine", but you clearly witness that he's having trouble getting out of bed in the morning, his friends are no longer calling, and he's lost interest in what used to give him pleasure, this well may be an actual depression. And some kids become "very good" in divorce, like super kids because they are so anxious. Be aware that your child may be so worried about her situation that she will do anything not to rock the boat. This can be a cause for concern.
The third question is about drugs and alcohol. Is my child self medicating? The typical adolescent in America has access to alcohol and many kinds of drugs. He may claim that marijuana "cuts the edge off" or that drinking lets her bond with her friends. Or, it may all be in secret and behind your back. Be careful. I have seen too many casualties from chemically dependent teens, including poor grades, depression and even fatal car accidents. Twenty five years of practice has made me very sober about alcohol and drugs. If your child is using significantly, normal treatments won't touch the core problem.
The fourth question is hard to answer for yourself because you as a parent are in the thick of it: how badly are we - as parents - hurting our children because of our inattention, anger, self preoccupation, moodiness or the way we pull them into the middle of our conflict? When this fourth question is answered strongly in the affirmative, you will almost certainly need outside help. In cases like this, it is a shame to medicate a kid when he or she is overwhelmed by realistic pressures from home. Therapy and/or medication takes a back seat to the divorcing parents working on getting their act together and if this can't happen because the acrimony is too intense, then just know that meds and therapy may work, but it is a sad second choice.
Now let's assume that you have answered the four questions and have brought your child in for an assessment. Often the first stop is your pediatrician who knows your son or daughter well and can help find a therapist who can do a job for you, such as a psychiatrist, a psychologist a social worker or a drug counselor trained in dealing with teenagers.
In Part Two of this blog, to be published shortly, we will look at how treatment decisions are made and give you a handle on how to work with your mental health professional to make sure that your child is getting the best of help. There are a number of treatment strategies available, and not all require pharmaceuticals. If, however, medication is required, you will need to be reassured that proper steps have been taken to ensure minimal side effects and an effective treatment.
The goal is to help you teen gain the strength and stability to deal with obstacles that are getting in his way, be it a troublesome divorce, a girl breaking up with him or just the challenges of being an adolescent (not easy). Your son or daughter should look back at this moment as a time that you stepped up and got them the help they needed, when they needed it.
You can get this right.
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Paul Heroux: Depression in Children
Divorced couples may not agree on much ... but at least they can agree that their children should not be drugged.
Just note that it may cost more money to separate like this. Three separate dwellings may be necessary and parents have to get along more or less. So, this arrangement is not for everyone.
Adults are in denial about what divorce means to kids. Their view is shallow. Family is one thing to children and it gets totally blown up no matter how nice you try to be, no matter how mindful. You can't change the fact that they have LOST their family. The family was all of them living together. It wasn't dating, adjusting to step parents, never having one home again, adjusting to split of going back and forth between some elses's home (it is now their parents homes, not theirs). The kids lives now revolve around the parents, not as it was before.
A lot of misunderstanding about antidepressants. They don't make you happy, they only allow access to normal levels of serotonin (and others). If you are depressed/anxious due to not enough available serotonin, then they might help you. Then there are side effects. The family physician writes the scrip because she is in no position to get in this families life and make them do this, that or this.
Sometimes medicine is often used as a stop gap measure in order to settle things down.
Antidepressants are rarely the "answer" but can help sometimes. We fail badly as a society in taking care of these stressed out families. And, sometimes, the proper treatments are simply unavailable or too expensive.
We have to do better.
I don't understand why a therapist wouldn't mention healthy options before the meds. Like making sure everyone is eating. Pets are usually disposed of during divorces but it would be great for the kids to have something loveable around. Hobbies? Mentors? Instead, kids are taken out on day long hikes with Dad and his new girlfriend. How fun is that?
Have a strong faith in God, but go to the doctor if you have cancer....or depression, anxiety, etc. Trust God, he gave us doctors for a reason.
How is this for the first question?
Are we as parents making things worse for our kids?
If the answer is yes, then the grownups need to get some help - and pronto.
But, it doesn't have to be this way and I am glad that Closer to Reason shared this point.
Parents must step up and act like adults -- agreed.
It is just that this is often easier said than done.
Kids are generally acting out their parent's conflicts and hatred toward one another. They don't do this purposeful, but are confused and can benefit when the parents go into therapy and stop blaming their partners for their plight and their kid's behavior. These lablels are often stuck with the kids for life and are treated differently in school and other social activities. Also, beware of the long-term side effects of these drugs as there is now strong evidence that they will reduce the brain's frontal lobe and cause great problems for them in their future. Quick drug fixes may temporarily take the pressure off of the parent's hostile behavior, but before blaming the kids or making them drug dependent, do the adult thing and work out the hostile and negative behaviors with your spouse.
I have an ADHD daughter who voluntarily takes medication because it helps her. She, her parents, her pediatrician, her therapist, and her psychiatrist make the determination. When she said she was ready to stop, we stopped. When she said she wanted to try the meds as she was struggling, we tried again under the guidance of professionals. It bothers me that I can't (or won't) list her as ADHD with her school because of the labels applied to our family and specifically to her. We've already heard the "if you just disciplined her" and "it's easier to just drug her."
If it helps her, and she's aware, and we have and use every tool at our disposal for the best interest of our child then why must the "problem child" label be attached to her while she is simply treating and coping with a condition.
All that said, I still think you have made one of the most common sense statements on here
Back then I could have really used all of the suggestions you've put forth, some during but mostly after my Moms death; that’s when my condition became worse. I was emotionally introverted, anxious, depressed and the activities you mentioned would have really helped clear my head and given me a break from what felt like a constant drum beat in my head.
I agree that people are too quick to give kids medication before trying other things like your suggestions. Children get really stressed out too, they lose their hair, they can't concentrate on school, don’t make friends, and they get fat When I was 15 doctors wanted to give me valium but cooler heads prevailed and I was given muscle relaxers instead for my stress headaches and migraines, but I'll always remember what one doctor, who happened to be from Sweden, said to me: "Have you cried?" (I had only a little bit), "don't sleep so much and take long walks." Those few statements (admittedly along with the muscle relaxers (not sedatives or antidepressants)) helped tremendously, and subsequently I learned that physically activity, and of course getting out of the stressful environment, are great stress relievers.
Anyway, you are very wise to have chosen an alternative to the labels and medicine. Frankly, I think that if children and their parents were fully understood and were engaged without judgment and labels these creative alternatives can be openly discussed...that is, if the Dr. has time, interest and skill. If not, he can employ a professional social worker to discuss the family system and explore health and wellness options. I really enjoy reading your posts, Lucille.
what is "normal" anyways? isn't that debatable?
thank cosmo there are drugs to make being around the guilt tripping lil jerks tolerable.
it is also the bias of most of my friends and acquaintances whose mothers messed up their lives and destroyed their fathers in the no fault divorce craze of the nineties.
i'm "ok" now. i'm happy, i have my own child, and a fulfilling life. i don't see how pills would have helped me.
i'm sure pills work for some kids, mainly ones with preexisting conditions or chemical imbalances. pills aren't a one size fits all, despite the commercials.
if you want your kids to be happy, put their needs above yours, spend truly quality time with them, listen to them, invest in their emotional needs, love them unconditionally.
This needs to be the real war on drugs!!