When We Should Consider Psychiatric Medications for Children and Teens

The topic of psychiatric medications, especially regarding children, is a controversial one. Many people are greatly against any meds, others talk about how their lives or the lives of others were saved by them, but most don’t know enough to make the right decision. As my knowledge and experiences have grown, my own opinions about meds have changed throughout the years. But this blog post is less about my opinions, and more about the facts and what I have learned. My hope is that it will help you be more prepared to navigate the psychiatric system in case you ever must do that.

Fact#1: Sleep, nutrition, exercise, support, meditation, and therapy are essential parts of care, but medications at times must be part of that care.

Holistic care is important for all children, even those without mental health issues, but especially those who have temperamental, emotional, and sensory sensitives, those who are neuro-atypical (e.g., ADHD, Autism, giftedness), or those who have significant environmental stressors. Try to think of all mental health issues on a spectrum. Take depression for example, we all have days of feeling sad and down and lack interest in things we usually enjoy. Sometimes we go through weeks of feeling that way, and getting major tasks done becomes really hard. And sometimes, the sadness is so great or chronic that we have thoughts of hurting ourselves or ending our lives. The same applies to attention issues, anxiety, hyperactivity, impulsivity, trauma, obsessions, etc. When issues pass a certain degree of severity, when all other holistic things are not improving the situation, when there is significant impairment and dysfunction at home, school, or in relationships, and when the risk for harm to self or others is high, it is important to seek a consultation with a psychiatrist to discuss whether medications would be a good option.

Fact#2: Most children with psychiatric conditions don’t receive any treatment.

But that does not change the fact that majority of children in our country who are prescribed psychotropic medications are done so by pediatricians and family physicians who haven’t had the proper training and education on this topic. Sadly, they have to do it due to the severe lack of licensed child psychiatrists. If tomorrow you needed to find a child psychiatrist, you will soon realize that you will have to drive far, wait many months to be seen, will have to pay out of pocket for those services, and/or settle for a psychiatrist who hasn’t had adequate training in treating children.

Fact #3: Untreated mental health conditions are far more dangerous than medications.

When we think of psychiatric medications, we picture people whose personalities have changed because of their meds, people whose conditions have worsened and are now dependent on their meds to get by, or people who have a whole new set of issues they are dealing with. But that’s far from the truth when the correct medication is prescribed to the right patient at the right dose and monitored over time. Most psychotropic meds do have side effects, but the severity of the side effects can be easily tolerated for a for weeks until tolerance is built when the medications are prescribed at a low dose and increased gradually over time. Often, we must deal with the side effects in order to be safe and get better.

If a child or teen’s mental health is untreated, when the current treatments are not improving the child’s condition, when there are major systemic issues (e.g., the child’s school cannot give the child the additional support he/she needs; the child’s parents cannot modify their parenting or the child’s environment; child is being exposed to trauma), or when the child is at risk for hurting self or others, than it is very important to consider medications with the help of a psychiatrist. Many parents will not do this because they fear what meds will do to their child, but what this often leads to is that the child’s mental and physical condition continue to worsen, and so does the impairment they are experiencing at home and at school. It is important to remember that untreated mental illness can be fatal, and the longer you go without properly addressing the issue, the harder and more complicated it will become to make things better.

I always recommend that if your child has been diagnosed with any mental health condition, whether it be any mood disorder (e.g., depression), anxiety disorder (e.g., phobia), neurobiological disorder (e.g., ADHD, Autism), that you find a reputable psychiatrist and schedule an appointment with them for medication consultation. This will do several things for you:

  1. Your child gets evaluated by another mental health professional, so you get a second hand opinion.

  2. You are now under the care of a psychiatrist and can much more easily make as needed appointments.

  3. You learn about the different medications and whether any option is best for your child.

All three of the above things are priceless for you and your child, even if you will never choose to have your child take any psychotropic meds. Straight Talk about Psychiatric Medications for Kids, Fourth Editionis a great book anyone can purchase and read on this topic.

Questions to Ask Your Psychiatrist About The Meds They Are Recommending

  • What are the side effects of this medication?

  • How will it impact my child’s sleep, appetite, energy, focus, and mood?

  • Is this drug habit forming?

  • Are there things I should be looking out for?

  • We have a family history of bipolar, schizophrenia, or addiction in our family. Is this drug safe for someone who has a genetic vulnerability to these conditions?

  • For how long do you think my child needs to be on this medication?

  • How do we know when it’s time to stop taking this medication?

  • What is the safest way to stop this medication?

  • What are other ways aside from this medication that will help improve my child’s condition?

Hasti Raveau is a child and family psychologist and the founder and owner of Mala Child and Family Institute. Much of her work is focused on helping children improve their emotional well-being, supporting parents on their parenting journeys, and empowering families so they can repair, grow, and thrive.
The topic of psychiatric medications, especially regarding children, is a controversial one. Many people are greatly against any meds, others talk about how their lives or the lives of others were saved by them, but most don’t know enough to make the right decision. As my knowledge and experiences have grown, my own opinions about […]

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