Most foster parents and many stepparents have to help our kids through bouts of anxiety and depression. Inevitably, the question comes up of whether to opt for medication and how much of it to agree to. Often it seems that therapy isn’t helping, and that medication is the only option. Some articles that I’ve seen recently, however, raise the serious question of whether we should resist the medical model for treating our kids.
A recent investigative report raises the possibility that our mental health system prescribes to teenagers too many psychotropic medications that haven’t been tested for that age group or haven‘t been tested in combination. One reason is a cycle we have seen in other areas of medicine: a patient is prescribed one drug for a medical problem, then prescribed another drug to deal with the side effects of the first drug, and so on. Another reason is that the first medicine often doesn’t work as advertised, so doctors prescribe a second medicine as a booster, then another to deal with side effects, and the cycle continues. Either way, teens and young adults end up with a host of medications and the same, or worse, emotional problems. The consensus of the doctors interviewed in the article is that therapy is a much better long-term solution than multiple medications.
This theme fits into another article from a few months ago arguing that we need to rethink teen anxiety and depression from the ground up. The author argues that we have medicalized the normal up and downs of life and trained our teenagers to think that if they are not happy all the time, then they have a problem that needs professional attention. Instead, we should help them understand that happiness is a skill that, like all skills, requires repetition and perseverance after setbacks. “You are less likely to build these skills if you are told that you have a disorder and ‘services’ will fix it. You don’t build skills when you expect your brain to be fixed the way your car is fixed. Happiness is a learned skill, and unrealistic expectations get in the way.”
A literature review looking at children caught in the middle of armed conflict noted a similar effect in our approach to trauma. “Most of the authors in this literature review agree on the necessity to move beyond the dominant medical paradigm, which tends to pathologize children’s suffering and consequently fails to recognize personal resources of agency and psychological adjustment. . . . the mainstream Western definition of children as weak and vulnerable needs to be called into question.” To the contrary, the review authors noted, children even in the middle of armed conflict and physical threats have the ability to find emotional equilibrium. Children in the various studies that the authors reviewed “demonstrated remarkable agency in many creative ways and under many different forms.”
These articles raise important issues that those of us parenting traumatized children need to grapple with. Yes, our children do struggle with anxiety and depression. But how much of the problem is due to unrealistic expectations? Our culture, especially social media, makes it appear that everyone except us is happy. The movies and posts don’t show the unavoidable difficulties, insults, and setbacks that make us unhappy. Nor do they show the hard-won skills that enable us to be happy in the face of those problems. Maybe it is time to rethink our medical paradigm for understanding anxiety and depression. The best long-term help for teens may be helping them understand that happiness is a skill and that they have the ability to develop it.
Of course, moving away from the medical model doesn’t mean that we ignore professional help. Our kids will need therapy, and sometimes they need medicine to get to the point of being able to develop coping skills. What this new focus means is that we find therapists who help us encourage our kid that they can learn the skills to be happy. That word — encouragement — is the key. We can’t pressure our kids, as lots of research shows that parental pressure to achieve simply increases anxiety. Rather, we should let our kids know that we believe that they can eventually learn the necessary skills, and that we’ll walk beside them on that journey. Of course, they will have setbacks and struggles. Those problems are simply part of life, and they are an inevitable part of learning new skills. In the long run, though, learning happiness skills will serve them better than treating normal emotional cycles as medical problems to be solved with medication.