Jewish World Review June 4, 2004/ 15 Sivan 5764
Depressed and dosed in the absence of time
The smarter we get, the dumber we are.
Consider the celebratory tone of two stories that ran in Wednesday's New York Times. One announced that anti-depressants such as Prozac work better on adolescent depression than "talk therapy."
The other good-news story floated rainbow balloons around the latest fad for the busy set: restaurants with nannies.
No longer do chardonnay-sipping parents have to put up with whiny children demanding attention. Now parents can plunk down a few extra bucks for their kids to hang with other stranger-children in a segregated "play" area while parents indulge in uninterrupted, adult musings.
And we wonder why kids are depressed?
A quote in the anti-depressant article aptly summed up what both stories are really about. Commenting on the pill report, a psychiatry professor declared it good news "because it's hard to get people into cognitive (talk) therapy anymore. They just don't want to take the time."
Eight words - they just don't want to take the time - pretty much covers it. Parents, exhausted from work and eager for their own playtime, don't want to take the time to engage their children. Better to let a stranger in another part of the restaurant baby-sit the little rage incubators.
Who will be taking Prozac one day soon?
Not necessarily, obviously. But we might pause for a moment (if one has time) to consider the possibility that the trends that make nanny restaurants a lucrative market niche are the same ones that lead to increasing diagnoses of childhood and adolescent depression.
As a friend succinctly put it: "It's depressing when your parents don't care about you."
The anti-depressant story, though reported as a high-five moment in psychiatric circles, suggested something else for those reading between the lines. The study - which spanned 36 weeks and included 439 youths between the ages of 12 and 17 suffering moderate to severe depression - divided the kids into four groups that received either (1) Prozac only; (2) talk therapy only; (3) placebo pills; (4) Prozac and talk.
Although information has been analyzed only for the first 12 weeks, early reports conclude that those in the fourth group did best, while those receiving only Prozac did better than those receiving only talk therapy.
Oddly, the study also found that all four groups were effective in reducing the risk for teen suicide. All four? Even the placebo group? Might it be that the kids taking placebos felt better because they were getting some caring attention? Just a thought.
It's not surprising that a pill that changes brain chemistry would show quicker, "better" results than an approach that is, alas, time-consuming. But to assume that a pill is, therefore, a better approach to curing depression seems weirdly shortsighted.
Anyone who has ever participated in analysis knows that it can take months to years for a trusting therapist-client relationship to develop and for results to evolve. A pill might produce immediate chemical improvement, but talking - articulating feelings - is the way to understanding. Clarity isn't a quick fix; it's a process.
The cure for severe depression may include doctor-dispensed medicine, but the cure for what ails the growing number of "depressed" children in America more likely has to do with our objectification of children, who increasingly are vehicles for adult self-fulfillment.
It's all about Moi.
The problem of course is that Me-ness is the natural and age-appropriate view of children, not parents. In both the Prozac and restaurant-nanny stories, the common thread is adult convenience at children's expense. We embrace and celebrate the pill fix because it suits us, not because it's really good news for kids who are depressed because no one has time for them.
The cure merely reiterates the source of the problem. You don't have to be a shrink to know these things. You just have to have raised a child or two. Or spent time in a child-care center, or been a nanny. The caregivers know.
Yes, parents deserve a night out without the little darlings, though we might not delude ourselves into thinking that dumping kids with restaurant nannies makes us more virtuous than leaving them at home with a sitter.
And yes, some children suffer severe depression that may require urgent medical treatment. But there's something wrong when millions of children are taking anti-depressants, and the answer is likely in those eight little words: People just don't want to take the time.
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