No question: for most adolescents there are going to be times of emotional upheaval and periods of problematic functioning along the challenging road of growing up.
By themselves and often with support of parents, young people usually manage to work these troubles through. However, in some stubborn situations outside psychological help can be useful, and in extremely debilitating cases chemical intervention can be advised.
While most mental and emotional difficulties encountered navigating the adolescent passage do not warrant psychoactive (mood and mind altering) medication, there are some impacted or protracted problems that may. For example, these medications might be prescribed to moderate such conditions as intense anxiety, profound depression, extreme mood swings, frustrating compulsivity, uncontrollable emotional outbursts, or cases of high distractibility.
As a psychologist, I believe psychoactive medication works best when accompanied by some education (through counseling or therapy) that enables the young person to learn how to better understand and manage themselves around the issue of concern. In this way, the young person can reap hard-earned benefit from painful emotional experience, becoming stronger and wiser as they grow.
Of course, as with any chemical prescription, psychoactive medication, is not like a rifle bullet precisely targeting a problem. Rather, it is like a shotgun blast that impacts the whole individual system. In the case of an adolescent we are talking about drugs that may formatively affect the brain at an age when it is still maturing. What lasting influence psychoactive medication has on a developing young brain is simply unknown. Therefore, such medication should usually not be the first choice of help. Unless the young person is in life threatening crisis, it may be better to start with less dire alternatives first – educational, counseling, or therapeutic interventions, for example.
In addition, as with any drug, there are intended, known, and beneficial consequences, and there is the possibility of unintended, unknown, and costly consequences. All of this is to say that psychoactive medication should not be given to young people without serious consideration. This is a significant intervention, and parents (who I believe play a key role here) should not treat it casually or take it lightly.
Therefore, here are some suggestions for parents.
Do not depend on your prescribing physician to tell you all your need to know about the teenager’s condition and the prescribed drug. Do your homework. Use the Internet and other sources to get what seems to you reliable information about both the psychological problem being medicated and the medication itself. Have your questions in order when you meet your medical doctor. Certainly ask about any doubts or concerns, dosage and duration of treatment, interactions with recreational or other drugs, problem signs to watch for, how getting off the drug will be decided, and any cautions to be taken at that time.
Do not treat psychoactive medication as a cure for whatever mental or emotional duress afflicts the young person. This medication is primarily to help relieve the suffering. It targets symptoms; it does not address psychological causes. By itself, this medication will do nothing to teach the young person about themselves or how to better manage themselves. For this, some kind of psychological or educational help is required. As an example, psycho-stimulant medication to reduce distractibility does not teach the young person how to manage wandering attention and increase power of concentration.
Do not treat seeing a physician and getting prescribed psychoactive medication for your adolescent as a handoff, making less parenting work and responsibility for you now that a “doctor” is in charge. Quite the contrary, it will make more work and responsibility because now you stand in a Supervisory relationship to your teenager and in an Informative relationship to your physician. With your adolescent, in addition to making sure the medication is taken as prescribed, and adequately communicating with your teenager about how symptoms are responding, you must stay on the watch for problematic outcomes. For your physician, you must gather data on a regular basis that describes specific outcomes and changes, signs of improvement and setbacks, any problems, to help inform the doctor’s knowledge of how the course of treatment is proceeding. Parents are on-site; the doctor is not. Parents must work in partnership with their physician.
Finally, tell your adolescent: “Because I believe taking psychoactive medication is serious, I will be continually checking to see how it is working for you. If it’s important enough to take, it’s important enough for us to keep talking about.”
For more about parenting adolescents, see my book, “SURVIVING YOUR CHILD’S ADOLESCENCE” (Wiley, 2013.) Information at: www.carlpickhardt.com
Next week’s entry: The Two Worlds (Real and Virtual) of Parenting Adolescents