Parental opposition: why you shouldn't put your child on antidepressants
Most teenagers in Russia trust psychologists and believe that having psychological problems is not a shame at all. As they say, there is nowhere to go: according to WHO, the age of 10 to 24 years accounts for a third of all cases of mental disorders in the world. And if parents used to bring their children to specialists mainly in adolescence, now even moms and dads of elementary school students are asking for help. What problems young Russians face, whether it is worth solving issues with the help of pills and whether it is possible to avoid shocks by protecting the child from everyday difficulties — in the Izvestia article.
Anxiety and addiction
The doctors themselves are now saying that parents have begun to bring their children to psychologists and psychiatrists more often. Tatiana Meteleva, a clinical psychologist and head of the rehabilitation program at Dr. Isaeva's Clinic, notes that mental and behavioral disorders are "getting younger", so the help of specialized specialists is required much earlier.
— If earlier teenagers were most often brought to the reception, today the first applications are not uncommon at the age of 9-10, — the expert explains. — The most common cause is behavioral disorders, and it is precisely by the type of deviant, deviant behavior. Parents are starting to pay attention, for example, to early involvement in smoking.
Addiction to vapes, according to the expert, is becoming one of the most common situations when adults notice that something is wrong with the child. However, by the 9th and 10th grades of school, in relation to some students, we can talk not just about episodic behavior, but about formed addictions — nicotine (including vaping) or gaming.
— In parallel, there are anxiety disorders, emotional instability, as well as pronounced behavioral difficulties. At the age of 9-10, a child becomes almost uncontrollable — rude and rude to parents, throws tantrums, and may threaten suicide. It is with such complaints that families most often come to specialists for help," the Izvestia interlocutor points out.
Can teenagers take antidepressants?
Parents sometimes hope that special medications will help bring back the obedient child they used to be until recently. However, adolescence is not a failure or deviation, but a necessary stage of development, a complex and inevitable process of growing up, during which a new personality is formed.
— The crucial point is that the decision to prescribe antidepressants always remains with the doctor, — Svetlana Meteleva comments. — Parents can express their concerns, expectations, and sometimes requests, but they do not make clinical decisions and do not have the necessary competence for this. The choice whether to prescribe or not to prescribe psychopharmacotherapy is made by the doctor.
The approach to prescribing medications, especially for minors, remains as cautious and balanced as possible, the clinical psychologist emphasizes. It is necessary to carefully collect an anamnesis, assess the child's condition in detail — the features of his behavior, emotional background, dynamics of symptoms.
— A conversation is held with the minor, the nuances of his experiences, the context of his life, and the family situation are clarified. And only after that can we talk about the expediency of medical intervention," continues Meteleva. — Both psychologists and doctors try to build assistance based on the principle of sufficiency. First of all, this is diagnosis, psychotherapeutic work, building contact and understanding what is happening.
If it is possible to do without drug therapy, then this path is preferred. However, there are conditions in which prescribing antidepressants is justified. But in such cases, it is not about the desire of the parents, but about the clinical need and concern for the child's condition.
— They say that there are supposedly more prescriptions, but this is not so much due to the fashion for drugs, as to the fact that in general there are more requests for help and mental disorders are better detected at an earlier age, — the specialist emphasizes.
Catch a "bipolar girl"
The list of antidepressants officially approved for use in people under the age of 18 in the Russian Federation is limited, Nikolai Neznanov, Acting Director of the V.M. Bekhterev National Research Medical Center of Psychiatry and Neurology of the Russian Ministry of Health, draws attention. In clinical practice, when working with children and adolescents, priority, especially at a younger age, is given to non—medicinal methods - psychotherapeutic care and comprehensive support for the child and his family.
— Prescribing antidepressants is a fairly rare and strictly regulated medical practice. However, in certain clinical situations, such drugs are prescribed to children and adolescents strictly for medical reasons. It's not just about depressive states.: According to the instructions, certain drugs are used, for example, for obsessive-compulsive disorder or enuresis," the expert explains.
According to him, the key principles in prescribing psychopharmacological drugs in childhood remain the priority of safety, a careful assessment of the risk/benefit ratio and consideration of age characteristics.
"Thus, prescribing antidepressants to children and adolescents is always the result of an in—depth clinical diagnosis and a balanced medical decision," Neznanov emphasizes. — We are not talking about the doctor's reaction to increased emotionality, but about the relief of severe symptoms that significantly disrupt the development and social adaptation of the child. At the same time, we do not see any grounds for conclusions about a decrease in the age of prescribing such drugs.
It is wrong to say that medications are prescribed more often now than before, confirms Peter Bezmenov, chief freelance child psychiatrist and director of the Sukhareva DZM Scientific and Practical Center for the Mental Health of Children and Adolescents.
"But new drugs are emerging that make it possible to help with medication in cases where it was previously impossible, or to achieve an effect with a lower risk of complications," he clarifies.
At the same time, it is much more dangerous than the obsessive desire of parents who insist on prescribing medications to their children that teenagers themselves want to take medications, because it is now fashionable to have a "bipolar disorder" and drink antidepressants, the doctor warns. Similarly, minors, believing that they have problems with excess weight, struggle with it by buying diuretics and laxatives without a doctor's prescription.
An adult child
According to Tatiana Meteleva, it is also important in what condition the parents themselves come to the reception with their children. Adults often feel helpless and powerless, complaining that they do not understand how to talk to a child and what to do in general.
— A paradoxical situation: on the one hand, society has become much more psychologized, there is a lot of information, but on the other hand, it is difficult to separate scientifically based approaches from pseudoscientific ones in this mass. As a result, parents have a mess in their head, and they lose their sense of support," the clinical psychologist comments.
As a result, what psychologists call a normal parental position suffers — the ability to remain an adult in a relationship with a child: to keep boundaries, take responsibility, and be stable.
"Today, it often feels like there's not enough adult in this relationship with a confident, mature attitude,— the expert complains.
Since the mid—noughties, adults have been chasing the "successful success" of their children - they take them to educational classes, send them to sections and clubs, hire tutors from elementary school and actually compete with other parents whose child is cooler. This practice eventually makes life difficult for all family members.
— Such an attitude towards children may be related to the parents' subconscious desire to realize their own dreams at their expense. But sooner or later, a reckoning inevitably comes, primarily with the physical and mental health of the child, warns Peter Bezmenov. — Two polar opposite situations may arise. The child either closes in on himself, becomes more and more insecure and clamped down, or, if there are certain traits in his character, he goes into protest, begins to show aggression in response to the demands of his parents.
The acceptable level of parental requirements is individual in each case and depends on the characteristics of the child's personality, the psychiatrist believes.
— There are children who need a clear alignment of their lives from the outside, in particular with regard to the daily routine, exercise, etc. And others differ in character traits in which direct pressure, even minor, can easily lead to disruption of the compensatory capabilities of the body, — he comments.
Therefore, any kind of activity that parents offer to a child should be consistent with his natural abilities and preferences.
— Parents should know and feel their child, see non-verbal signals when the load becomes too heavy. And knowing your child is work, and, as a rule, it's hard, it takes time, patience, love and willingness to help not in words, but in deeds," the specialist emphasizes.
Where did the "son of mom's friend" go?
Time throws up new causes for adolescent neurosis. The "mom's friend's son" template, which made millennials shudder, is becoming a thing of the past, but Internet stars — young bloggers and unpackers - are chosen for the role of the ideal child. At the same time, from the point of view of a psychiatrist, it does not matter who the child is compared to.
— It is important to understand that the very fact of such a comparison, especially in public, can have extremely serious consequences, — Peter Bezmenov emphasizes. — Of course, it is necessary to form a child's sense of healthy competition, desire to develop, and excitement in the end. However, the "final product" should not be measured in terms of bloggers or "sons of mom's friend" ("on a scale, you're 1.5 bloggers now, and you should be 2.8"), but in terms of the goals that the child has managed to achieve.
The psychiatrist advises breaking these goals down into stages, "steps", and for climbing to each height, it is necessary to make the child feel that he is doing well. If necessary, according to him, parents can seek help from specialized institutions. In Moscow, for example, a doctor identifies an Urban psychological and Pedagogical Center, where there are highly qualified specialists who are able to work with various forms of protest behavior among adolescents.
What absolutely cannot be done is to try to treat a child on their own according to articles from the Internet. And also to turn a blind eye to the problem, blaming everything on a difficult age.
If we talk about objective factors that really affect the state of modern adolescents, Tatiana Meteleva calls a huge amount of information one of the key ones.
— Children are faced with a stream of data that they are not yet able to process and comprehend due to their age. This information comes continuously — through gadgets, social networks, and the digital environment in general — and often turns out to be undosed, the clinical psychologist warns.
This information overload increases anxiety, which is becoming increasingly difficult for a teenager to cope with on his own. It gradually accumulates.
"In clinical practice, we now more often observe anxiety disorders, obsessive—compulsive symptoms, eating disorders, and various neurotic manifestations - largely as a result of increased levels of internal tension," comments the editorial interlocutor. — The question is not even that teenagers have become weaker, but what conditions they have to develop in and whether they have enough support to cope with these conditions.
For example, exams turn into a real hassle. Most often, at this moment, parents are thinking about how to support their offspring with antidepressants.
— Psychological readiness for a challenging situation, the ability to adaptively cope with subjectively significant difficult life situations is all that is included in the concept of "psychological maturity". It is formed throughout the child's life. A psychologically mature student will be prepared for exams and other tests," concludes Bezmenov.
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