Depression, Part 2 — Medications and Implications for School

Medications

One type of medication that is frequently used is a class of medication called Selective Serotonin Reuptake Inhibitors (SSRIs). Please note that such medications should be used only under the guidance of a child psychiatrist, primary care provider, or other qualified medical provider who is knowledgeable about childhood depression. Serotonin is one of the neurotransmitters in the brain. Research has shown that low levels of serotonin can contribute to depression. SSRIs help increase the amount of serotonin available in the brain. Examples of SSRIs include Prozac®, Zoloft®, Paxil®, Celexa® and Luvox®. Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) form another class of medication, which act on levels of both serotonin and norepinephrine (another neurotransmitter that plays an important role in mood regulation). Like the SSRIs, SNRIs treat depression by increasing the amount of these neurotransmitters in the brain to improve mood regulation. Examples of SNRIs include Effexor® and Cymbalta®. Possible side effects of these types of medication include:

Depression has many faces.
  • heartburn
  • nausea
  • poor appetite
  • hyperkinesis (restlessness)
  • agitation
  • tremor
  • drowsiness
  • dizziness
  • diarrhea
  • constipation
  • changes in sleep (either too much or too little)
  • headaches
  • upset stomach
  • dry mouth

Side effects should be reported to the provider managing the medication regimen.

Attention:

On October 15, 2004, the FDA released a "black box label" (the highest level) warning physicians and patients that some antidepressant medications MAY increase the risk of suicidal thinking or behavior in a small proportion of children and adolescents, especially during the early phases of treatment. While there is no evidence that antidepressants increase the risk of suicide, there is evidence that depression increases the risk of suicide. Children and adolescents taking SSRIs should be monitored to assess for a possible increase in suicidal thoughts or behaviors. For more information, visit http://www.parentsmedguide.org/parentsmedguide.htm.

What can I do to help myself if I think I am depressed?

Talk to an adult you can trust. This might be a parent, teacher, school counselor, aunt, neighbor, minister, priest, rabbi, scout leader, anyone at all. Just find an adult you trust. The most important point is to start talking. People around you will gladly help, but they cannot help you if you keep all your emotions locked away where no one can see them. Speaking honestly can be scary, but it just might be the most important thing you ever do.

What can I do if my friend is depressed?

Support your friend.

If you believe someone you know might be seriously depressed, the most important step is to encourage your friend to start talking and open up to parents, teachers, counselors, doctors, or some other trusted adult. If necessary, speak up yourself. Do not be afraid that you might be mistaken. Your friend is too important. Talk to your parents, your friend's parents or the school counselor. Your friend needs professional help, evaluation and treatment. Praise your friend for the honesty and courage required to come forward and seek help. Provide reassurance that your friendship will not change. Your understanding, patience and encouragement are priceless! Reassure your friend that depression and other concerns are not rare, and they are definitely treatable. Make sure that your friend remains in "the loop" socially and continues to participate in fun activities.

If your friend talks about suicide, report this immediately to parents, teachers or your friend's therapist. If you believe that your friend's life might be in danger, call 911, and keep your friend safe.

Implications at school

Children who are struggling with depression often are preoccupied with negative thoughts and the physical discomfort of depression. Therefore, they find it difficult to concentrate on class material, directions and homework. Children with severe depression lack motivation and energy, and so might have difficulty getting up on time and preparing for school. Children with depression also frequently isolate themselves from their peers. This puts them at risk to lose social support and to be teased and bullied. These children likely will need additional support from teachers and counselors if they are to succeed academically.


Note:

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For more information, see

Part 1 — Introduction, Symptoms and Treatment

For more information about TeleKidcare services for youth depression and adjustment concerns, please contact:

Eve-Lynn Nelson, Ph.D.
enelson2@kumc.edu
913-588-2413

Also see:

American Foundation for the Prevention of Suicide
http://www.asfnet.org

National Alliance for the Mentally Ill
http://www.nami.org