11 | IMPRINT MAGAZINE APRIL 2020
“...there are
Q&A
specific
diagnostic Q: When prescribing
antidepressants to
criteria for adolescents, what factors are
important to consider?
mental A: We have to balance the
wishes of the parents and
disorders." respect the patient’s autonomy.
I always recommend talk
therapy or counselling as first
M
line treatment. There are
families that are not interested
ental illness is quite common in
and I do my best to educate on
children and most of the time is the benefits. Therapy is not
without the side effects, but a
diagnosed as depression, ADHD, skilled therapist can help to
decrease the likelihood of those
or anxiety.
side effects.
But as a parent how do you
Q: How do you differentiate
differentiate between your child between a moody teen and
something more serious like
being emotional and a more depression?
serious issue? Who would you call
A: The teen years are often with
more rapid emotional changes
for help? What is the best option?
where individual temperament
Mother of two, Marie Kook can contribute to a more moody
than average teen. That being
interviews a child psychiatrist Dr. said there are specific diagnostic
criteria in the Diagnostic and
Moyers, to answer these questions.
Statistical Manual of Mental
Disorders. “Major Depressive
Episode: Five (or more) of the
following symptoms have been
present during the same two-
week period and represent a
change from previous
functioning; at least one of the
symptoms is either one
depressed mood or two loss of
interest or pleasure.”
11 | IMPRINT MAGAZINE
Q: An adolescent wants to
be prescribed
antidepressants and the
parent thinks it’s a bad idea
OR vice versa. How would
you go about this situation?
A: What I will do is educate
both on the risks and benefits
and how appropriate a
medication would be with the
current diagnosis and severity
of condition. There are also
cases, where mild depression
or anxiety are best addressed
through therapy.
Q: How do you know there
won't be severe side effects?
A: We don’t always know. A
risk benefit analysis that
accounts for the wishes of the
patient always comes first and
risks have to be communicated
for informed consent. Luckily
we have came a long way over
the years and with the use of
medications that act as partial
agonists have less side effects
than many of the older
medications.
Q: How can you access
behavioral services?
A: Most basic screening for
mental health issues can be
performed by a primary care
provider or pediatrician. They
can then give
recommendations for therapy
or beginning a medication. To
access care you often do not
need a referral. You can
simply call and make an
appointment with a
psychiatrist or Psychiatric
Nurse Practitioner. Some cash
pay and other will accept
insurance plans. It is
important to ask this before
an appointment is made. More
serious cases can be accessed
through emergency
departments or suicide
helplines in the case of suicidal
ideation.
Q: What would be the “best
practice” treatment for
depression?
A: Best practice depends on
severity, timeline, and patient
preference. From a purely
theoretical stand point if the
depression is mild or moderate
with low or no risk of suicide
then therapy is always first
line. If severe then therapy
with an SSRI is first line. If
acutely suicidal, we initiate a
medication, therapy, and have
24 hr monitoring for safety.