My daughter-in-law, now 34, was diagnosed about three years ago with diabetes. In the beginning, she handled this news relatively well. But the disease became worse and shortly after that I saw a change in her personality. She now thinks of herself as almost completely disabled by the disease even though her physical problems appear to be minimal. I know that chronic illness and injecting oneself with insulin everyday can be depressing. What can we do to help and at what point should she consult a mental health professional to deal with her physical illness?

Over the past year or two, there has been much discussion and controversy about the use of anti-depressants in adolescents. To help parents better understand and make decisions about the use of Selective Serotonin Reuptake Inhibitors (SSRI) antidepressant medication for their children, the National Mental Health Association (NMHA) has prepared this fact sheet.

Childhood depression is a very serious health problem that affects 1 in 8 adolescents and 1 in 33 children. Left untreated, depression can lead to significant problems at home, in school and with peers – as well as to life-threatening problems such as substance abuse and suicide. The good news is that depression in children is very treatable, with psychotherapy, medication, or a combination of the two. In October 2004, the U.S. Food and Drug Administration ordered that SSRIs prescribed for children carry a “black box” label, the strongest warning the agency puts forth, regarding the potential risk for suicide. In light of this warning, NMHA offers the following tips for parents on how best to approach their child’s mental health care.  

• Seek help if your child shows signs of depression or other mental health problems. Discuss all available treatment options with your child’s doctor, and carefully weigh all the risks and benefits associated with each treatment. If your child is already being treated, express any concerns you have to your child’s doctor.
• If your child is prescribed an antidepressant medication, watch her/him closely and make sure s/he receives a thorough evaluation, continual follow-up and careful monitoring – particularly in the first several weeks – by a qualified doctor.
• Educate yourself about the warning signs of suicide and act quickly if you are concerned. Many people are afraid to discuss the issue of suicide for fear of “planting” the idea, but it is actually better to be open and direct.
• If your child is taking an antidepressant, do not abruptly discontinue use. Doing so can lead to significant side effects.
• Separate “fact from fiction” by using credible sources with information based on sound medical science rather than rumor or opinion. Beware of extreme claims, such as antidepressants are “always dangerous” or “never effective.” Medical research has demonstrated that such statements are misleading and dangerous.
• Remember that the worst possible situation for a child with a mental health problem is to go without any treatment at all.

Additional information for parents and families concerned about the use of medication in treating depression in children and adolescents is available at www.parentsmedguide.org. Information on other childhood and adult mental disorders is available under the Mental Health Information link at www.nmha.org or by calling the NMHA Resource Center at 1-800-969-NMHA (6642). For a free brochure on adolescent depression and/or warning signs of suicide, call the Mental Health Association of Greater St. Louis at 314-773-1399. 

Education Department
Mental Health Association of Greater St. Louis

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