Are we facing a future in which children will be wrongfully medicated, as parents, teachers, doctors, psychiatrists turn readily to chemical fixes as a substitute for understanding and resolving childhood distress through relationships and psycho-social interventions? In Britain, and gradually in Ireland, there is a loud chorus of politicians, teachers, religious leaders, doctors, child- and parent-interest associations claiming that too many of our children are experiencing considerable stress, family conflict and even depression. All sorts of credible reasons are being put forward for children’s inner and outer turmoil – inadequate child-rearing, lack of physical affection, family conflict, marital breakdown, unprecedented pressures at home and at school (parental ambitions, educational system that is driven by government-legislated school tests, lack of adventure in school classrooms). Childhood misery can also be found in the pressure of back-to-back ‘improving’ activities – from piano lessons, to singing lessons to tennis training, to private maths tuition, to team games, to horse riding.
In terms of causes, it is best not to generalise, but to focus on the individual life circumstances of each child who is troubled. No two children have the same problem.
A stark proposal being made in response to the pleas for action is: let children take Prozac. In many ways, this proposal is not as shocking as it seems. After all, in the past ten years there has been a tenfold increase in prescriptions for Ritalin to combat a range of perceived childhood and adolescent problems – from restlessness to lack of concentration in class, even though there is no hard evidence that these difficulties have any biological bases. Already in Britain, an estimated 40,000 children are being prescribed anti-depressants. In America, a pandemic is happening; one in every six children is taking a prescription anti-depressant. At a time when so many parents worry about their teenage offspring resorting to illicit drug taking, it is very odd, to say the least, that there is further demand for children to be put on prescribed medication. It is contradictory, if not hypocritical; to warn young people of the evils of street drugs, but not warn them of the well-documented side-effects and possible addiction to prescribed drugs.
Those professionals who are endorsing prescribing anti-depressants for children base their campaign on the mis-notion that ‘behind every crooked thought there lies a crooked molecule’. The opposite is true: for every distressing response within children and adults there is a chemical response, but it is the distressing response arising from a distressing environment that requires treatment, not the chemical-fixing. Furthermore, there have been repeated warnings about anti-depressants for children (and, indeed, for adults) that the perceived benefits of treating children and adolescents with these drugs are heavily outweighed by the risks of side effects, the most serious being suicide risk. Prozac is also associated with other side effects such as stunted growth and adverse effects on the sexual organs of children. The bottom line here is that the neuro-physiological unknowns are considerable.
In my own opinion, I believe that children who manifest emotional and behavioural reactions to the disadvantaged circumstances of their lives, do not need drugs to resolve their sad situations. I can understand that labelling and drugging children may make it easier for parents and teachers who are faced with the children’s challenging behaviours, but, surely, we can find more creative ways to help children. In any case, drugs do not resolve the causes and intentions of children’s troubling responses. Very often, the first therapeutic response is for parents and teachers to look to the quality of relationships within themselves and between them and the children. The close involvement of the young person’s family is always needed. David Healey, a psychiatrist, who believes it is wrong to put children on psychotropic medication, claims that there is great pressure on children to conform to unrealistic expectations arising from parental insecurities and ambitions. There are the beginnings of a campaign against the use of drugs for children and the need for professionals to tackle the true problems of children. In brief, a holistic approach is essential, involving the family and a range of psycho-social approaches. Children’s rights need vindication more than ever.
Dr. Tony Humphreys is a clinical psychologist and author of All About Children.