Examining the Antidepressant:Suicide Link Ten Years After FDA Warning

When I hear debate over the association between SSRI’s (selective serotonin re-uptake inhibitors, a class of antidepressant medication) and suicidal behavior in children and adolescents, I am immediately brought back to a night in the early 2000's.  As the covering pediatrician I was called to the emergency room to see a young man, a patient of a pediatrician in a neighboring town, who had attempted suicide by taking a nearly lethal overdose. 

That night, as I watched over him in the intensive care unit, I learned that he was a high achieving student and athlete who, struggling under the pressures of the college application process, had been prescribed an SSRI by his pediatrician.  His parents described a transformation in his personality over the months preceding the suicide attempt that was so dramatic that I ordered a CT scan to see if he had a brain tumor. It was normal. When, in the coming years the data emerged about increasing suicidal behavior following use of SSRI's, I recognized in retrospect that his change in behavior was a result of the medication. But at the time I knew nothing of these serious side effects.

At that time, coinciding with pharmaceutical industry's aggressive marketing campaign directed at the public as well as a professional audience, these drugs were becoming increasingly popular with pediatricians.

As the possible serious side effects of these medications came increasingly in to awareness, the FDA issued the controversial "black box warning" that the drugs carried an increased risk of suicidal behavior. Following the black box warning, pediatricians, myself included, became reluctant to prescribe these medications. We did not have the time or experience to provide the recommended increased monitoring and close follow-up.

Recently the Boston Globe published an article reviewing the data addressing the concern that the warning, by discouraging prescribing, led to increased suicidal behavior. It includes this key finding.

Studies also found no increase in other treatments for depression, such as psychotherapy; leading to what Fritz called “a net decrease in the amount of treatment."

This finding offers evidence for more insidious and perhaps more dangerous side effect of antidepressant use in children. The fact that we as a society condone use of these medications in children in the absence of relationship based treatments- - CDC report from December 2013 indicated that 50% of adolescents who are on psychiatric medication have not seen a mental health professional - itself changes the landscape of mental health care.

When medications can be used alone, the professions who offer opportunity for listening and human connection are devalued, both culturally and monetarily.

This kind of devaluing sends qualified professionals away. Pediatricians, whose longstanding relationships with children and families makes them ideally suited for preventive interventions, are discouraged from using their time to listen. Social workers, psychologists and others who offer relationship based treatment in which feelings can be recognized and understood, when paid less and less while being required to jump through increasing number of hoops, are less likely to accept insurance.  The drug itself becomes inextricably linked with the shortage of quality mental health care.

A recent study, a survey of close to 2,000 people being prescribed antidepressants, showed a much higher than expected rate of serious psychological side effects. Almost half described, “feeling emotionally numb” and “caring less about others.” These findings occur in the context of a social acceptance of medicating away feelings, and in doing so, devaluing the “being with” that is necessary for growth and healing. The absence of opportunity for meaningful human connection where feelings are recognized and understood, in combination with these psychological side effects, may be what leads to increased risk of suicidal behavior.

I wonder if before we can change what we do, we need to change how we think. Prescribing psychiatric medication to a child without simultaneously offering time and space to listen to him and his family is unacceptable. A change in perspective and attitude is needed before we can to begin to repair our broken mental health care system.

Andrew Solomon, in his sweeping tome about depression, The Noonday Demon, respects the role of medication in treatment. But, recognizing that medication alone it is not sufficient, he writes, "Rebuilding the self in and after depression requires love, insight, work, and most of all, time."

New Years Wrap Up & Black History Month Fun!

Boy, am I seriously adjusting to being back in school after a two week break! I find myself yearning for my 1pm nap time...lol! I hope you've all adjusted back better than I have :)

Since returning from the break, we've been working on Winter, New Year's, and Black History Month activities all rolled into one! We've since wrapped up our New Year's Unit and we'll be moving on to Chinese New Year next week. Last year my kids had a blast with that theme, I can't wait to do it again!

Here are some pictures from my New Year's Pack that we've worked on:

New Year's Emergent Reader

Inside pages:

New Year's Kids Glyph- We did this over a two day period. The kids had fun with this :)

And let's not forget the boys...this sweetie was the only one done!

We also worked on a few things from my Black History Month Pack

We wrote various sentences inside

Inside:

Here's more....sorry I couldn't resist :)

Inside:

"We're all in this Together" Peace Wreath (I used Pacon Multicultural Construction Paper)

Rosa Parks

Whew! Check out the picture for a closer look.

 We'll be working on the rest of the crafts in this packet this week. I'll come back & post more. 

Also, keep your eye on the look out for some freebies!! :)

New Years Activities Galore & More!! {Freebies}

Hi friends! I hope your new year is off to a great start! I've been a little M.I.A because I've been overhauling my house, going room to room and getting rid of everything that we haven't used in a while, or no longer have a need for. It's a new year's tradition of mine that I've done for years! It feels so good to have a clutter free home- but wait- let's see how long it lasts! ;)

 I return to work on Monday and I wanted to share some of the activities I've prepared to use next week. I made this glyph with my kids last year but just recently posted it.

Here are some pictures of the glyph:

and few activities from the packet:

 

A closer look: 

I've also updated my New Year's Themed Pack & nearly doubled it in size. This was my second tpt item ever listed and it was in dire need of a makeover!! So if you've previously purchased it make sure to download the updated version for the added goodies :)

 Here are some items included in this packet:

AB, ABB, ABC Pattern Activities- great for differentiating instruction!

Maze activities for counting by 2's, 5's, & 10's. I've also included answer keys for each sheet.

Counting down to the New Year!

There is also a sheet with traceable numbers for kids who need the added practice.

Celebration Time!

I've included matching cards to go along with this activity sheet.

Here's the whole sha-bang!

If you're still with me, I have a freebie just for you: 

{Click image to download}

 There are 10 sequencing activities to choose from. Colored images as well as black/white images are provided. I hope it's something you can use with your little ones. 

Here's a sample of one we did last year:

If you're looking for more New Year's activities, you must check out this pinboard:

It's brought to you by some of the most fabulous people I know! There are tons of DIY projects for your classroom, kid tested and approved products, arts & crafts, math and literacy centers & activities, tips for organizing, and the list goes on!! There are also links to many teaching strategies in action, video clips, and professional articles and books.

The contributors of the pinboard also have a blog!! Click on the image to check it out! 

And if you want even more freebies, then you definitely have to hop on over to my friend Shuna's blog at Pocket Full of Kinders. Shuna along with 16 other bloggers have teamed up to bring you a super fun facebook blog fans scavenger hunt!! There are a TON of freebies to be won so head on over there for all the details. 

 

Thanks for sticking with me friends ~ I'm off to savor every last second of my break! :)

New Years Resolution: Technology Linky

Another day, another linky! lol! Today I am linking up with Kathleen from Growing Kinders to bring you my technology resolutions.

I've been hopping from blog to blog reading about all the cool things everyone does in their class and I must say, I am one of the unfortunate ones. BOO! No smartboards or class sets of ipads here. I would definitely love to try and write a grant if someone could steer me in the right direction (wink). A few years ago each one of us received three computers for our classrooms- but there was no money left for maintenance. Crazy huh?! So, needless to say how many years later almost half of those computers are now sitting in a storage room broken or left with no anti-virus. Out of my three, only one is still alive today. I do have an old laptop that I let my kids use and on Friday's I bring in my ipad as an incentive, but one ipad and 19 little 5 year-olds sometimes creates more chaos then fun :(

I have a multimedia projector that I use to showcase short stories and fun songs from youtube and teachertube.com. I also recently projected images of polar bears from nationalgeographickids.com and my kids just had the most fun. I think they just like it when the lights turn off. They say they feel like they're at the movies...lol! 

my videos are taking forever to upload so here are the links:

http://www.youtube.com/watch?v=nUubMSfIs-U
http://www.youtube.com/watch?v=-0icbq
http://www.youtube.com/watch?v=A-V4zzXzpT8
http://www.youtube.com/watch?v=xPWZu4LDmQM

Two of my favorite sites filled with a plethora of technology information, as well as TONS of other information are:

 

and

{click images to go to websites}

These websites offer a lot of articles on recommended apps, websites, technology trends, educational social networds (twiducate...have you heard of that?), using apps to create study guides, & MORE! There is even an article on edudemic on how to know if you're correctly integrating technology! Click here to read more.

Have you heard of this website? It's similar to pinterest but for educators!!

You must check it out!

A few of my favorite websites & apps for my kiddos are:

Starfall.com

I spy fun from scholastic.com

madlibs.com

  

Flow Free- a fun app where you have to connect matching colors with a pipe creating a "flow". Pipes break if they overlap or cross so be careful! 

 

Harper Collins for tons of games & printable pages

crayola.com (great ideas/ lesson plans for teachers too)

Banana Math App (Drill Math Word Problems)

More Images

 

Online Storytime by Barnes & Noble

There are 16 popular children's books posted so far- my kids absolutely love this! 

Whew! If you're still with me, here are my resolutions:

1. To be more consistent

2. To have a better plan/ schedule for my kids to use the one ipad that I have.

3. To show my kids how to type their name using Word.

I'm not sure if I can call the third one a resolution since one of our standards is to teach students the parts of a computer as well as get them acquainted with the keyboard. They don't have to know where specific keys are but they need to understand that if I press a key a letter/number/object will be projected onto the screen. I always have fun teaching this because my little ones that aren't exposed to computers are always so fascinated.

Okay, enough of my ramblings...head on over to Kathleen's blog & join the fun!