It's not easy
American teens are stressed and depressed. As a pediatrician, I see the suicide attempts, the overdoses, and all the new methods that teens are finding to intentionally hurt themselves — to somehow dull the pain.
It’s getting worse. According to recent results from the Stress in America Study, teens are now more stressed out than adults:
• 40% feel irritable or angry
• 36% feel nervous or anxious
• 31% felt overwhelmed due to stress in the past month
•36% feel fatigued or tired, and
•Almost 30% feel depressed or sad
I’m not surprised. Here’s what teen stress and depression look like in my ER, and what parents can do to help:
Prescription drug seeking
Here’s the classic story—teen comes in with perfect story for kidney stones. He’s rolling on the waiting room floor in pain. We put in an IV and give morphine. He feels better. After thousands of dollars of tests and the radiation of a CAT scan, we find no evidence of a stone or any other illness. We were duped. Then he has the nerve to ask for a prescription for Percocet “in case the pain comes back after the morphine wears off.” I tell him the morphine wore off about 2 hours ago. Oops.
I also see kids whose parents are using them as drug seekers. One child sat through about six hours of blood tests and imaging, but we couldn’t find anything wrong with him. He continually rated his pain as “8 or 9” on a scale from 1-10. No matter how much pain medicine we gave him, he didn’t feel better. Then the charge nurse figured out his mother was on our list of patients with a history of drug seeking behavior…
ADHD drug abuse
Nearly 1 in 10 U.S. children have been diagnosed with ADHD. Although it is counter-intuitive to give a hyperactive child a stimulant, stimulants are one of the most effective and most heavily researched treatments for ADHD. Accordingly, more than 4 million Americans take prescription amphetamines, and US amphetamine production more than quadrupled over the past decade. It’s no surprise that so many teens turn to amphetamine abuse to manage stress and depression.
ADHD meds are a quick fix to help you stay up late to finish school work, concentrate during an exam, or get a quick high when you’re feeling down. And it’s not hard to get ADHD for them: Most kids can find some in their own medicine cabinet, usually prescribed for a sibling. No one notices until that child ends up short for a few months in a row. Any teen on ADHD meds knows they can sell their meds whenever they need extra cash. I see these patients when they come to the ER with a racing heartbeat, or when they overdose on all the meds they can find.
Suicide attempts—with a gun
A few times a year I see teens brought to the ER after they were caught holding a gun to their head. I never see the ones who pulled the trigger. Teens who attempt suicide with a gun are the most likely to be successful. I’m a moderate on gun control, but wherever you stand on this issue please get rid of the guns in your home if you have a teen with depression or other mental illness. Every parent whose child attempts suicide tells me a story about why they thought the gun and/or bullets were secure.
Salt and ice burns
It’s a trend on YouTube. “Salt and ice” burns occur when you put salt on ice then hold the ice on your skin for as long as you can stand it. The problem is that the burns keep getting worse, even after the salt and ice are removed. They come in screaming, trying not to cry. The pain is horrific. Sometimes it starts as a dare, but I’ve also seen salt and ice burns as a form of masochism in depressed patients. At first the area is just very red and painful, often requiring narcotics for pain control. Later the burns can blister, and, if not treated appropriately, become infected.
Fad diets taken to the extreme
The Stress in America study also showed that teens aren’t managing their stress well—they aren’t eating well, exercising and getting enough sleep. And our children are getting fatter. According to the National Health and Nutrition Examination Survey (NHANES):
• 31.9% of children and adolescents were overweight (BMI at or above the 85th percentile)
• 16.3% were obese (BMI at or above 95th percentile).