Even though mental health is just as important as physical health to our overall well-being, there’s still a lot of stigma surrounding mental health care, especially medication. But the truth is that medication can be a crucial tool for people of all ages who are struggling with anxiety and/or depression — and, yes, that includes kids and teens.
So, if your little one is experiencing anxiety, you might wonder whether or not medication could benefit them, either as a short-term, situational bridge or as a long-term treatment option. Even if your child’s doctor recommends meds, you could have some understandable questions: Are they safe? Are there potential side effects? Are they addictive?
We chatted with a psychiatric nurse practitioner, who answered every concern you might have about anxiety meds and kids. And the TL;DR here is: There’s no shame in seeking care for your child, whatever it might look like.
Are meds right for my kid?
As with so many parenting questions, there truly is no one-size-fits-all answer to mental health care, as Keith Carter, DNP, PMHNP-BC, points out. Carter, who works with patients 5 years old and up at Relief Mental Health, notes that starting medication can be a “complex” decision for parents, no matter the specific scenario or child at hand.
“It’s important to pay attention to certain signs that may indicate issues with anxiety,” he says. “If you notice that your child is consistently experiencing intense worry, restlessness, irritability, or difficulty concentrating — and these symptoms are significantly impacting their daily life and relationships — it might be an indication that medication could be beneficial.”
Carter adds that it’s “crucial to consider the duration and severity of the anxiety symptoms. If they persist over time and interfere with your child’s ability to engage in normal activities or socialize with peers, it might be worth exploring additional options for support.”
What should we expect?
For kids and teens, non-pharmacological options like therapy will be explored first, but “if ineffective, medication may be part of a comprehensive plan,” says Carter. “Keep open communication with healthcare providers, discuss potential benefits and risks, and actively participate in decisions about your child’s well-being.” Generally speaking, mental health care is a marathon and not a sprint, so it’s never as simple as taking a single pill and having all anxiety dissipate forever.
Carter says that “medication might be considered for children as early as age 6 and beyond, particularly when anxiety symptoms significantly impair their functioning and well-being and other interventions have been tried (e.g., therapy, counseling, lifestyle adjustments). Younger children may receive behavioral interventions and therapy as a first-line approach. However, each case is unique, and decisions regarding medication should be made on an individual basis.”
Parents, caregivers, and the child will all closely collaborate with healthcare providers, so listening and supporting your kiddo every step of the way is so important.
OK, gimme the nitty-gritty.
Several types of meds can help support kids struggling with anxiety, says Carter. The two most common types are SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors), both of which work by increasing mood-boosting neurotransmitters in the brain.
SSRIs that are commonly prescribed for anxiety in children and teenagers include:
- Zoloft (sertraline)
- Prozac (fluoxetine)
- Luvox (fluvoxamine)
- Paxil (paroxetine)
- Celexa (citalopram)
- Lexapro (escitalopram)
SNRIs that are commonly prescribed for child and adolescent anxiety include:
- Effexor XR (venlafaxine ER)
- Cymbalta (duloxetine)
Carter adds that buspirone, another type of anxiety medication that helps balance neurotransmitters in the brain, is also sometimes prescribed for kids and teens.
“While these medications can effectively manage anxiety, safety considerations are paramount,” he adds. “Potential side effects like nausea, dizziness, insomnia, and appetite changes need monitoring. Regular assessments and adjustments to the medication may be needed. Open communication between parents and healthcare providers is crucial to address concerns and ensure the child’s mental health is well-monitored throughout the treatment process.”
Though side effects are common (and can be unpleasant), Carter says that frequently, they’ll dissipate over time, “usually within the first few weeks.” Additionally, “there is a potential risk of increased suicidal thoughts, particularly when starting or adjusting the dosage, necessitating close monitoring, especially in younger individuals.” Parents and caregivers will need to communicate any concerning side effects with their child’s provider ASAP, no matter how big or small they might seem.
Are meds a lifelong treatment option?
As with anything else, per Carter, each child’s needs will vary. “Medication is often part of a comprehensive approach, providing immediate relief while addressing underlying issues,” he says. “Once symptoms are managed for a particular amount of time, typically 6-12 months, healthcare providers may consider trialing without the medication. Medication may be replaced with other supports like therapy or the child’s ability to utilize coping tools to manage anxiety.”
“For some children with chronic anxiety, long-term use might be considered, but regular assessments ensure the ongoing necessity of medication,” he continues. “The decision involves collaboration between healthcare providers, parents, and the child, ensuring the treatment plan adapts to their evolving needs.”
What happens before meds?
Medications are typically a last-line treatment option for kids and teens, so what non-pharmacological steps can help minimize anxiety when your kiddo is struggling? Carter suggests:
- “Creating a supportive and open family environment is crucial. Parents can actively listen to their child’s concerns, validate their feelings, and work together on problem-solving. Establishing a predictable and structured daily routine can provide a sense of security for children, reducing uncertainty and anxiety.”
- “Prioritizing sleep hygiene, limiting screen time, maintaining a balanced diet, and fostering positive social connections contribute to overall well-being.”
- “Collaborating with schools for a nurturing environment is essential. This may include accommodations, support groups, or additional resources.”
- “Cognitive behavioral therapy (CBT) has proven effective, helping children identify and modify negative thought patterns associated with anxiety.”
- “Mindfulness techniques, including meditation and deep breathing exercises, promote emotional regulation.”
- Regular physical activity, such as sports or yoga, can positively impact mood and anxiety.
All these lifestyle adjustments and techniques constitute a “holistic and individualized approach to a child’s mental health,” per Carter, which will set them up for a lifetime of knowing how to care for themselves and their needs.
With or without medication, helping your child develop an arsenal of tools in their mental health toolkit is an incredible path forward for them and for you. The less shame, stigma, and secrecy surrounding mental health, the better for all of us.