Depression, suicide rates have increased among
our youngBy Cynthia Beaudette of the Muscatine
MUSCATINE, Iowa - Strong families, a feeling of acceptance,
physical exercise and a variety of interests.
Two Muscatine psychologists say these factors enhance the quality
of life for children and adolescents.
However, if a young person becomes one of the 3 to 5 percent of
U.S. children who suffer from depression, psychiatrists and
psychologists may recommend prescription drugs that target the
biochemical triggers of this medical problem.
More kids depressed
According to the National Institute of Mental Health (NIMH),
depression in children and adolescents has increased throughout the
past several decades and the suicide rate in young people has
By 1996, suicide was the third-leading cause of death in
15-24-year-olds and the fourth-leading cause among
Dr. David Fassler, trustee at large for the American Psychiatric
Association, said that, in recent years, more than 500,000 depressed
children attempt suicide each year in the United States. Their need
for professional help may include a prescription for an
Sieg Hoppe of Family Resources in Muscatine and Ruth Evans, owner
of Four-Seasons Counseling Clinic, are two licensed psychologists
who work in Muscatine. Both say they are seeing more children and
teens who are dealing with depression, and they do recommend
prescriptions for some of their young patients in combination with
other forms of therapy.
While they had no current local statistics, Evans said that, in
2001, there were at least 1,883 U.S. children ages 10-19 who
Evans and Hoppe answered the Muscatine Journal's questions about
prescribing antidepressant medication following recent reports that
Food and Drug Administration officials suspect a link between the
use of antidepressants and increased suicidal thoughts in young
A Columbia University study indicated that 2 to 3 percent of
young people using antidepressants such as Luvox, Effexor and Paxil
have increased suicidal thoughts.
"The jury is still out," said Hoppe about the effects of those
"But it is fair to say we're over medicating and there are
better, healthier solutions. Almost all medicines, with the
exception of antibiotics, treat the symptoms but not the cause."
Hoppe also said that sometimes those symptoms are severe enough
to warrant a faster form of relief than
therapy can provide.
Another study's view
Evans also referred to results gleaned from the Treatment for
Adolescents With Depression Study (TADS), coordinated by Duke
University Medical Center and sponsored by the National Institute of
The results, posted in August, apply to the antidepressant
fluoxetine, or Prozac, that was tested in this study and
cognitive-behavioral therapy (CBT).
Participant groups were tested in four different ways.
The study showed that 71 percent of those receiving medication
and therapy improved after 12 weeks. Medication alone produced a
success rate of 61 percent. Those receiving therapy alone improved
at a rate of 44 percent.
Another group of patients received a placebo, which is a pill
that actually has no medical properties. The persons in a placebo
study do not realize they are receiving a placebo. These groups are
used to determine whether or not a form of medication has a high
rate of suggestive properties. This placebo group had the lowest
rate of improvement at 35 percent.
A cautious approach
Evans and Hoppe recommend medication when it is warranted but
combine it with regular therapy sessions and close monitoring.
Psychologists, unlike psychiatrists, do not prescribe
prescription drugs, but they can call a patient's medical doctor and
ask that professional to order a prescription.
Most students can take antidepressant medications at home, Hoppe
said, because they are usually dosed in the morning and evening.
However, school officials should be made aware the student has
started medication so they will be alert to any significant change
in the child's behavior.
Hoppe said he also places patients on an exercise program because
exercise can help create chemical changes in the brain similar to
those initiated by prescription drugs.
Evans and Hoppe said antidepressants can be effective in lifting
a person from depression but they should be prescribed judiciously
for children and adults.
"A person using antidepressants needs to be monitored," said
Evans. "But it would be a shame not to continue using these
medications. They do have their use."
Evans pointed out that none of the children referred to in the
Columbia study actually committed suicide, but for every 100, there
were two or three that had heightened suicidal tendencies.
And both psychologists said it isn't unusual for depressed
persons of all ages to have suicidal thoughts.
"Some experts say the natural course of depression can increase
the tendency of suicidal thoughts and that's not always because the
person is using medication," said Evans.
Hoppe said the target of antidepressant medication is to increase
neuro transmitters to the brain that deliver chemicals such as
serotonin and norepinephrine.
As these chemicals increase, the person's energy level follows
"A person finally gets the energy to get out of bed but they
don't feel any better," said Hoppe. "It's possible that the
antidepressants affect the vegetative symptoms first and give people
the energy to carry out suicide."
Evans said family members sometimes look at the increased
physical activity as a sign that the person is coming around. But in
fact, the individual may be more focused because he or she now has
the energy to concentrate on a plan to end their pain.
"When we look at people who commit suicide, family members
sometimes will say, 'They were just starting to feel better,'" said
The key factors
Both psychologists said the family of a child battling depression
can be one of the most important parts of a return to a brighter
outlook on life.
"Adolescents don't have life experiences that give them the
coping mechanisms we have," said Hoppe. "A 16-year-old breaks up
with a girlfriend or boyfriend for the first time and that was the
love of their life. They don't understand it."
Moving away from the television and closer to one another can
promote the kind of conversations that allow teens to develop
trusting bonds and an emotional safety net with their parents and
caretakers, the psychologists said.
"The media often dwells on violence or problems. We even see
beheadings on TV now," said Evans. "And in many homes, there's a TV
in everyone's bedroom."
Evans also cited an increased incidence of street drug use among
parents as a factor that can contribute to a child developing
"We're seeing more second and third-generation people using these
drugs," said Evans. "It creates instability in the family."
Hoppe said more mental health professionals are also studying the
long-term effects of a parent's street drug use on unborn
Although the evidence of the effect of drug abuse is often
evident in a baby born to a mother who used drugs during pregnancy,
there are also concerns that parents of both sexes may damage their
own genetics by abusing drugs and that may affect children born to
Evans and Hoppe said they strive to assist families in developing
stronger relationships that extend into the next generation.
Contact: 563-263-2331 Ext. 323. E-mail