Antidepressant prescriptions for teenage girls up significantly since beginning of school year in Quebec

Antidepressant use on the rise in girls Child psychiatrist warns that rise in antidepressant use by girls means they need better help

MONTREAL — The use of antidepressant medication increased about 17 per cent during the second half of the pandemic in Quebec among girls under the age of 18.

The concerning trend began in mid-summer, and intensified at the beginning of the school year, according to data provided by the government’s health insurance board (RAMQ).

From September through December 2020, the records show young female patients received double the number of prescriptions for antidepressants than the general population (8.6 per cent) and nearly triple what’s being prescribed to boys (5.4 per cent).

Dr. Cecile Rousseau, a child psychiatrist at the Montreal Children’s Hospital, is not surprised about the disparity between the sexes since “girls are more vocal about their anxiety and depression,” but adds “this is worrisome news.”

Compared to the same period in 2019, girls were 11 per cent more likely to receive antidepressant drugs this past September and nearly 21 per cent more likely in December 2020, compared to 2019.

To Rousseau, it signals that the level of distress among adolescents is very high as they deal with curfews and confinement. This age group needs less isolation and more contact with friends, she said.

“It’s not that they’re spoiled. They need that [contact] in order to develop as young adults. They can endure that for one month, two months, but it’s been a year now, and Rousseau said it’s taking a toll on their mental health.

Even more worrisome, however, is that doctors are responding to this kind of distress with prescriptions, said Rousseau.

It’s not that antidepressants aren’t needed and useful in certain cases, and some of the antidepressants could have been prescribed for reasons other than depression and anxiety.

But Rousseau said “we know that antidepressants don’t help stress-related disorders. They do not help when life hurts. That’s not a good answer.”

She said accessing services is difficult now and doctors “are well-intentioned and doing their best.”

But children’s mental health has become the collateral damage of this pandemic, she said, arguing that the government’s virtual self-help tools “are very adult-oriented,” and don’t address teenagers’ needs.

DOCTOR’S ADVICE

Youths and parents need to seek medical advice if a mental health issue becomes serious or dangerous. Emergency room physicians are prepared to help.

However, families can also employ some strategies to try and prevent the stress from taking over.

Adolescents “need a bit less isolation, a bit more going outside, and a bit less screen time,” said Rousseau, who is also a researcher in the division of social and transcultural psychiatry at McGill University.

The key to helping teens is to give them tools and ideas that can address their boredom and frustration, she said.

She acknowledged that is easier said than done, as a result of the government’s restrictive public health measures, but she suggests parents interpret the rules in a healthy way.

“Of course we do not want youth to party, but having a bubble with one or two close friends, always the same, to be able to go outside and chill is something which is essential for youths’ mental health,” the child psychiatrist said.

Even if it doesn’t follow the guidelines exactly, Rousseau said “it’s much less dangerous than being sent to the emergency room with suicidal ideation.”

The idea is to balance the developmental needs of the children, offer a sense of freedom and a way for them to express their individuality and feelings - while encouraging sound decisions.

Parents can also encourage their teens to take up hobbies and activities, like art projects, music and sports - running and cycling - for example.

The Montreal Children’s Hospital has been providing some ready-made art kits to children who can’t afford to purchase supplies on their own.

QUEBECERS NOW LIVING WITH CHRONIC STRESS

Stress doesn’t affect all people and all age groups in the same way, said Rousseau. Some will perform and do even better than before, even if they’re still hurting.

“Others will go down the drain, lose their capacity to function normally, will be conflictual, depressed and anxious - a normal response to stress,” she said.

But after more than one year living in pandemic conditions, the type of stress people are suffering has shifted from acute, to chronic stress, the specialist said.

Some experts think the impact of chronic stress will be long lasting but as someone who works with refugees and victims of torture, Rousseau thinks it could also be “transformative.”

“If you look at the generation who survived the Second World War, you look at the communities that have been struck most...I’m thinking of the Jewish community, they are doing well and not just in spite of the trauma, but because it has a steeling effect.”

It doesn’t mean that trauma is good, of course.

“That would be horrendous to say, but collective adversity like the ice storm, like the pandemic, have a collective transformative,” and strengthening effect for many, including young people - girls and boys, she said.

Rousseau said this experience is “certainly transforming their brains, and how to be in the world and we’ll have to discover how. The idea, though, is that humans are incredibly resilient.”