Two approaches to treating depression
Treatment for clinical depression can be straightforward or very complicated for children, according to Dr. Frederic Flach, author of “The Secret Strenghth of Depression.” Parents’ problems – such as alcoholism or pathological gambling – and psychiatric illnesses, such as adult schizophrenia, must often be directly addressed, since a child’s disturbance is often a mirror for destructive interactions within the family.
At other times, Flach said antidepressants, such as the selective serotonin reuptake inhibitors, may be indicated. While studies of these medications in children are still limited, they seem to be relatively free of serious side-effects and no interference with normal growth and development has been reported.
“As with any medical procedure, the risk-reward ratio must be kept in mind,” Flach said.
“Would a particular child’s progress be better served by allowing him or her to struggle within the limitations imposed by chronic depression, relying entirely on his own and his parents’ psychological therapy to do the job, or by giving him or her an antidepressant that would improve mood and enable more effective function while other therapies are being carried on?
“This decision must be made collaboratively between doctor and parents, with the child being encouraged to cooperate in an informed way, mitigating the fear of stigma that both family and patient may experience,” she added.
If a child has bipolar illness, Flach said the use of medications is even more compelling, considering the key role played by biological and genetic causes.
Failure to diagnose and treat these children quickly and effectively carries the serious complication of denying the child the opportunity to experience vital educational and interpersonal growth.
It also bears a significantly increased risk of school failure, alcohol and drug abuse and suicide.
“Every depressed child is unique, in his or her own way,” Flach said.
“In some ways, in Western countries, growing up is easier than it was a hundred years ago-physically, that is. But psychologically it is probably just as difficult if not more so. Two-parent homes and healthy, happy families are increasingly hard to find. It is sometimes hard to tell whether physical and sexual abuse of children is more widespread or just more visible.”
Many schools have failed at their missions, not just to educate but also to encourage the development of character and the skills and values necessary to cope with life’s challenges, according to Flach.
“Many parents have lost sight of the genuine spirituality that once served as a beacon to enrich the souls of other generations,” he said.
“Children are the future of humanity. In all too many instances, they deserve a good deal better than they are getting.”
Frederic Flach, M.D., K.H.S., is an internationally recognized psychiatrist and author whose highly acclaimed books include “The Secret Strength of Depression,” “Putting the Pieces Together Again,” “A New Marriage, A New Life,” “Resislience,” “Rickie,” “The Secret Strength of Angels” and “Faith, Healing and Miracles.”
In 1996, he was awarded the Maxine Mason award by the National Alliance for the Mentally Ill (NAMI).
He has appeared on numerous radio and television programs across the country, including “Today,” “Good Morning America,” “CBS This Morning,” “Good Day New York” and “Donahue.”