Is your daughter depressed about acne? Soon, you may be able to take her to a dermatologist for peppermint-flavored Prozac. Is your son blue over an ingrown toenail? Take him to a podiatrist for some antidepressants. Is he angry about having to wear braces? His orthodontist may soon be handing out pills along with a dinosaur toothbrush.
Already, at least 580,000 children are being prescribed antidepressants--and those numbers are likely to increase dramatically. For now, doctors can prescribe Prozac to kids but Eli Lilly, which manufactures the drug, can't market it as a children's remedy. According to the Medical Sciences Bulletin, however, "the FDA is currently evaluating Prozac for use as an antidepressant in children." If the FDA gives its blessing, Eli Lilly will be free to peddle "children's" Prozac--especially now that the FDA is about to clear the way for TV advertising of prescription drugs. The company already has on the market a peppermint-flavored version of Prozac. And where Prozac leads, other antidepressants, such as Zoloft and Paxil, are sure to follow.
Doctors may prescribe antidepressants to children without any psychiatric evaluation. Yet the symptoms used to identify depression in a recent Prozac ad range from feeling "unusually sad or irritable" to finding it "hard to concentrate." I have two healthy little girls, ages 6 and 8, both of whom have experienced these symptoms. Indeed, I don't know any normal children who haven't.
No doubt there are children and teenagers who could genuinely benefit from antidepressants. But it's easy to see how millions might wind up taking antidepressants as a false cure for childhood and adolescence. One father in Southern California wrote to me recently to say that one of his son's friends is on antidepressants "because her parents are 'too strict' and she is depressed at not being able to do what other kids do."
A passing cloud. Signs of depression may be nothing more than a passing cloud--or an indication of unresolved grief and loss. A doctor spending a few minutes with a child cannot possibly know the difference. "It's part of the human condition to feel crummy if something bad is happening in one's life," says Harold Koplewicz, vice chairman of psychiatry at the New York University Medical Center. "But that is very different from having a clinical disorder."
Indeed, substituting the quick fix of a drug for the often frustrating reality of parenting can be a subtle form of child abuse. It is our job as parents to help our kids navigate life's emotional roller coaster. Their mental health depends not only on their life experiences--good and bad--but on how they learn to cope with them.
Children behave notoriously in line with the expectations of the adults around them. If we think they can't cope without a pill, they will grow up believing that. If we teach our children that pills will make them feel better, how can we then tell them not to try a joint or a few drinks to lift their spirits?
It may not be long before stressed parents and teachers, bombarded with ads promising immediate relief for their kids--and themselves--will turn to Prozac with alarming frequency. Forty percent of American children live without a father in the house. How tempting antidepressants will seem to those overwhelmed mothers.