Being on social media is the norm for kids today — and the age of initiation is getting younger and younger. At the same time, parents say they’re seeing unhappy kids who sulk and shut themselves up in their rooms on a regular basis. What’s going on?

A new study published in the Journal of Social and Clinical Psychology says there’s a link between social media, depression and loneliness, so is that what’s happening?

Depression is serious business. Before you rush off to have your child screened, know that antidepressants may be over prescribed today. The Citizens Commission on Human Rights International (cchrint.org) reports alarming statistics for U.S. kids: In 2017, the number was 38,534 of kids on antidepressants. Broken down by age, it’s 0 - 1 years (6,687), 2 - 3 years (10,957) and 4 - 5 years (21,299).  

TREATMENT

“Antidepressants can be used to treat both depression and anxiety,” says Yasas Chandra Tanguturi, M.D., assistant professor of clinical psychiatry and behavioral sciences at Monroe Carell Jr. Children’s Hospital at Vanderbilt. Tanguturi says it’s very rare for children younger than age 2 to be prescribed for depression, and the statistical number may be related to children being treated for other things beside depression.

However, if a child older than 2 has severe anxiety or depression, he may be prescribed antidepressants says Tanguturi.    

“We know antidepressants work best when used in conjunction with other modalities of treatment such as counseling or psychotherapy,” says Tanguturi.

He adds that before any treatment begins, kids should always have a full psychiatric and medical evaluation. On top of that, there should also be a treatment and monitoring plan in place, and the patient and family should be educated regarding the disorder.

LIMITED DATA on USAGE

While there’s not enough good data on usage of antidepressants in kids younger than 5, the usage rates for older kids showed a big drop after the Food and Drug Administration (FDA) issued a black box warning in 2004. However, the pendulum has swung back to pre-2004 levels and in some studies is even higher.

“There is not much data to show that the use of antidepressants is rapidly increasing, but there have been mild increases,” says Tanguturi. “This could be explained by many factors including greater awareness among people about depression and anxiety and less stigma around their use,” he adds.

WORDS OF CAUTION

Tanguturi says antidepressants are some of the safest medications used in psychiatry.

But kids first starting out on them may experience nausea, vomiting or stomach issues. Tanguturi adds that monitoring kids on antidepressants is extremely important since an increase in suicidal thoughts is possible, too. (In an extensive analysis of clinical trials, the FDA reported that antidepressants may cause or worsen suicidal thinking or behavior in a small number of children and teens.)

“While the data behind this is not very strong, the FDA added a black box warning in 2004,” says Tanguturi. He says children prescribed an antidepressant should be well monitored for the first month (see a provider at least once a week). He also says unsavory side effects are not something that occur on a long-term basis. In fact, there are no real long-term side effects for antidepressants.

“If you tolerate them well, they can be used pretty safely for many years,” says Tanguturi. “The overall message for parents to remember about antidepressants is they are pretty useful tools for helping kids, but they should be used carefully and along with other tools (such as behavioral therapies and/or counseling).”

In the event that a child is to be taken off of antidepressants, Tanguturi says symptoms akin to starting the medication may occur. 

That’s why antidepressants should ALWAYS be withdrawn from slowly.