A few months ago my then 15 year old daughter was unwell. Not cold or flu unwell, just non-specific symptoms that left her feeling generally terrible. She was headachey and exhausted all the time, struggling to get through every day at school and unable to do anything but sleep when she was home. She’s a bit of a perfectionist, so missing school and not being able to perform properly when she was there was also making her anxious and miserable.
The symptoms didn’t disappear after a week or two, so I took her to a doctor. She had never seen this particular doctor before, and had only been to that clinic once before, about a year ago, with a stomach upset.
After a ten minute consultation she walked out with an order for some blood tests. And a prescription for anti-depressants.
Luckily the kid and I have a good relationship and she told me about it straight away, she was half way between laughter and bewilderment, wondering if she really was depressed and didn’t know it. “She’s a doctor, I mean, she’d know wouldn’t she?”
Again, luckily, I know a bit about mental illness and I was fairly sure that wasn’t her problem, so I took her to another doctor. As it turned out, she wasn’t suffering from depression, she had glandular fever, not something commonly treated with anti-depressants.
I am very aware of the dangers and damages caused by mental illness, and I know there are people for whom anti-depressants are a life saving medication. I know this from research and because I have people like that in my life.
However, anti-depressants are not drugs to be taken lightly, they are highly addictive and can have serious side effects, particularly in adolescents.
Yesterday the ABC reported that an anti-depressant drug, commonly sold in Australia, had a high risks of adverse effect, again, particularly for adolescents. Conversely, it had almost no benefits when measured against a placebo based control group. Professor Jon Jureidini, who led the international team of researchers from Adelaide University’s Critical and Ethical Mental Health Research Group said:
The study claimed to show that paroxetine, an anti-depressant, was effective and safe for young people and in fact, it’s the opposite.
The team have established that the drug carried twice the level of severe adverse effects across the board, and four times the number of psychiatric adverse events.
Eleven patients experienced suicidal behaviour or self-harm out of less than 100 in the paroxetine group compared to just one in the placebo group.
The specific drug prescribed for my daughter carries a warning that requires parents or guardians to monitor teenagers daily when they first start taking it because it has been known to cause suicidal ideation in children.
The doctor that gave these drugs to my daughter did not warn her about any side effects, did not tell her to pass that warning on to her parents, did not contact to me ensure she was monitored for unusual behaviour.
I was, as you might imagine, utterly horrified by the way a dangerous drug was prescribed so cavalierly to a child, when a little bit more thought and one simple blood test uncovered an easily diagnosed physical illness that explained all her symptoms.
Anecdotes are not data, we are told this all the time, but I disagree. They are actually data, they’re not statistical data, but they are data that tell us about personal or even common experiences.
After what happened to my daughter I asked around a bit. In the space of a single day one women told me that she was prescribed anti-depressants after her dog had died (she wasn’t depressed, she was grieving), another woman told me she was given them as a treatment for insomnia (not depression, tiredness) and a man told me he was offered them because he was unemployed (bored and scared, not depressed). Not one of those people had also been offered any therapy, none of the doctors involved had talked to them about diet, exercise, mindfulness techniques or any other non-invasive treatment that have been proved to assist with feeling a bit crappy.
Depression is a terrible, dangerous thing; it is not sadness, grief, boredom or frustration, although it can, at times, have elements of all those things. It is a very specific illness that must be taken seriously and absolutely needs treatment.
But medication, particularly for children, is not the first step, it should be the last step, after thorough diagnosis by doctors who understand the complexities of mental illness and have methodically determined that medication is called for and will be one of a number of treatment options given.
Even if any of these people I mentioned above had been suffering from genuine depression, tossing a script at them and sending them on their way is not treatment, it’s an appalling abrogation of responsibility from medical professionals who should know better.
My daughter is mostly ok now, glandular fever takes a long time to get over and it’s a virus, so there’s no treatment beyond rest, nutritious food and taking good care of her.
But she was lucky, if she’d done as the doctor had said, if she’d not known to talk to me, or not had anyone to talk to who knew something about the dangers of these drugs, the results could have been tragic.
Anyone experiencing problems with depression or anxiety can find help at Beyond Blue or call Lifeline on 13 11 44