According to the Royal Society for Public Health (RSPH) in the UK, there has been a 70% increase in anxiety and depression in the under 25s. The current news story that American schools are considering mandatory depression screening for students, once again raises big questions about teenage anxiety, the level of mental health disorders amongst our children and young people and how we treat them.
The driving force behind the proposal in the States is obviously the attempt to prevent, or at least to pre-empt, future school shootings following the most recent terrible events in Florida. However, the clear evidence is that our children and young people are suffering more mental health disorders, and this is just as true in Ireland as it is in the US. According to Mental Health Ireland, mental health problems affect about one in ten children and young people. They include depression, anxiety and conduct disorder.
Our experience at Transformarive is that, if you include social anxiety and general anxiety in the run up to school and state exams, this could be a significant under-estimation.
In the past, the prevailing medical wisdom was that depression is in fact, the result of a spontaneous chemical imbalance in the brain, that it is produced by low serotonin, or a natural lack of some other chemical. The medical treatment was therefore pretty much always a prescription for antidepressants.
However, this approach started to be questioned in the 1970s, after American psychiatrists produced a manual for doctors that laid out all the symptoms of different mental illnesses so that they could be identified and treated in the same way across the Unites States. It was called the ‘Diagnostic and Statistical Manual’. In the latest edition, they laid out nine symptoms that a patient has to show to be diagnosed with depression: for example, decreased interest in pleasure or persistent low mood. For a doctor to conclude they were depressed, a patient had to show five of these symptoms over several weeks.
The manual was sent out to doctors across the US and they began to use it to diagnose people. However, after a while they came back to the authors and pointed out something that was concerning them. If they followed this guide, they had to diagnose every grieving person who came to them as depressed and start giving them medical treatment. If you lose someone, it turns out that these symptoms will come to you automatically. So, the doctors wanted to know, are we supposed to start drugging all the bereaved people?
The authors conferred, and they decided that there would be a special clause added to the list of symptoms of depression. None of this applies, they said, if you have lost somebody you love in the past year. In that situation, all these symptoms are natural, and not a disorder. It was called “the grief exception”, and it seemed to resolve the problem.
Then, as the years and decades passed, doctors on the frontline started to come back with other questions. If you agree that the symptoms of depression are a logical and understandable response to grief, to losing a loved one, might they not be an understandable response to other situations? What about if you lose your job? What if you are stuck in a job that you hate? What about if you are alone and friendless? What about if you have been abused?
And when it comes to teenage anxiety and depression… What about if you are being bullied or excluded from a friendship group or taunted on social media? What about if you are facing an imminent exam that will decide your future opportunities and your tutors are no good?
As a result of this questioning, it is now accepted, as stated by Mental Health Ireland, that mental health disorders are “often a direct response to what is happening in our lives”.
This raises huge questions about how we treat mental health and specifically, the mental health of our children and young people. If teenage anxiety and depression are not the result of chemical imbalances in young people’s brains, but are a response to what is happening in their lives, how should they be treated?
This question becomes particularly acute when you consider that antidepressants are not without their side effects. The most common type of antidepressants are Selective Serotonin Reuptake Inhibitors or SSRIs, which can have both physical and mental side-effects.
According to Harvard Medical School, some patients taking SSRIs develop insomnia, skin rashes, headaches, joint and muscle pain, stomach upset, nausea, or diarrhoea. These problems are usually temporary or mild or both. A more serious potential problem is reduced blood clotting capacity because of a decreased concentration of the neurotransmitter serotonin in platelets. Patients are at increased risk for stomach or uterine bleeding and are more likely to require a blood transfusion during or after surgery.
Side-effects, again as detailed by Harvard Medical School, can also include involuntary movements such as tics, muscle spasms, dyskinesia (repetitive muscle movements), parkinsonism (rigid and trembling limbs, a shuffling gait, loss of fine motor control), and akathisia (compulsive restlessness), any of which may be accompanied by severe anxiety.
On top of this, according to Johann Hari, author of ‘Lost Connections: Uncovering the Real Causes of Depression – and the Unexpected Solutions’ it turns out that between 65 and 80% of people on antidepressants are depressed again within a year.
To be very clear, at Transformative, we are not medical doctors, and we must stress that we are not suggesting that anyone should or should not take antidepressants. We are simply presenting the following two facts:
i. That it is becoming increasingly accepted that anxiety and depression are often caused by a response to life events as well as by possible chemical imbalances in the brain.
ii. That as the medical profession and pharmaceutical companies will themselves confirm, antidepressants can have side-effects.
With these facts in mind, there must be another way to treat anxiety and depression in children and young people and especially the kind of conditions that are caused by responses to what is happening in their lives. This is where treatments like clinical hypnotherapy can come in.
Clinical hypnotherapy focuses on re-framing, processing and resolving experiences in life, removing the triggers for depression and anxiety responses. Get in touch with us if you’d like to find out more about how we work, our successes and what we can do for you or for someone you care about.
Author: Tim France
Date: March 2018