Anxiety, school boredom, depression...... Psychological problems among adolescents are a growing concern. With the popularization of relevant knowledge, many parents no longer think that their children's psychological problems are emotional and hypocritical, but instead agree that they are a disease that needs to be treated. At the same time, some people have fallen into another misunderstanding, simply equating mental illness with physical illness, believing that "if you are sick and take medicine, you will get better", and rely excessively on drug means, resulting in drug abuse from time to time.
Over-reliance on medication
Recently, the Hunan Provincial Brain Hospital has treated hundreds of teenagers, most of whom are students, who have psychological problems such as school boredom, anxiety and even depression. Zeng Xianxiang, director of the sleep disorders department of Hunan Provincial Brain Hospital, said that among the teenagers treated, there were many students with excellent grades, some of whom had long-term insomnia, sleep rhythm disorders, and were plagued by anxiety and insomnia, and some students expressed extreme ideas.
Hunan Provincial Children's Hospital has opened a mental health clinic
Banyuetan reporters visited a number of hospitals and learned that the number of outpatient clinics in the psychiatric department of juvenile psychiatry and general hospitals has increased year by year. In 2023, the "Report on the Development of China's National Mental Health" released by the Institute of Psychology of the Chinese Academy of Sciences shows that about 14.8% of the surveyed adolescents have varying degrees of depression risk, of which 4% belong to the risk group of severe depression.
"Adolescent depression, anxiety and insomnia are closely related, and the more insomnia, the more likely it is to develop depression and anxiety, and eventually fall into a vicious circle." Zeng Xianxiang believes that rough parenting style, depressed family atmosphere, tense parent-child relationship, high academic pressure, interpersonal communication problems, and school bullying are the main reasons for adolescents' psychological problems.
When adolescents have psychological problems, the first choice of many parents is to seek help from medical institutions and let their children take prescription drugs prescribed by the outpatient clinic. Liu Juan, who works in Changsha, Hunan Province, told the Banyuetan reporter that her son, who was in high school, was tired of school, was unwilling to go to school, locked himself in his room, stayed up late to play with his mobile phone, threatened to jump off the building if his mobile phone was confiscated, and even had auditory hallucinations, saying that his classmates wanted to harm him.
"After a few simple questions, the doctor determined that the child was moderately depressed and prescribed sertraline and other drugs, and the whole diagnosis and treatment time was less than 3 minutes." Liu Juan said.
Dr. Zhou Xuhui, director of the Department of Psychiatry of Hunan Provincial Brain Hospital, believes that in order to face up to children's psychological problems, we must first distinguish between ordinary psychological problems and mental psychological disorders, and even for mental and psychological disorders, we must formulate treatment plans according to the severity of the condition.
"Generally speaking, for mild mental and psychological disorders, psychotherapy is chosen in principle. Taking depression as an example, for mild depressive episodes, psychotherapy is preferred in principle, and only when psychotherapy is not effective, drug therapy and physical therapy are considered. Zhou Xuhui said that for severe mental and psychological disorders, especially patients with high risk of suicide or violence, drug treatment is necessary.
Wang Yiquan, director of the Mental Health Center Affiliated to Zhejiang University School of Medicine (Hangzhou Seventh Hospital) and Hangzhou Child and Adolescent Mental Health Diagnosis and Treatment Center, said that in previous cases, there have been cases of blindly relying on drug treatment, and some children have aggravated their condition after taking medicine. Yu Bo, an intensive care physician at the Second Xiangya Hospital, once treated students who overused antidepressants because of serious psychological problems, and "took antidepressants and sleeping pills together, causing serious physical damage."
According to the interviewed experts, domestic and foreign treatment guidelines for various mental illnesses emphasize individualized treatment, and not all adolescents diagnosed with depression must use medication.
The service support is insufficient, and parents are eager to treat the disease
"At present, there is insufficient systematic research on adolescent mental illness." According to Wang Yiquan's analysis, there are differences in the performance of mental illnesses such as depression in adolescents and adults, and it is necessary to re-examine the characteristics of adolescent diseases, but insufficient research has made medical staff lack more targeted treatment methods in the face of adolescent mental illness.
Shi Yu, a member of the expert group of the National Center for Mental Health and Mental Health Prevention and Control, told Banyuetan reporters that there is currently a shortage of child and adolescent psychiatrists, and the outpatient consultation time has to be shortened when the number of patients increases. "The initial consultation usually takes more than half an hour to fully understand the child's condition and make a treatment plan, but the doctor only has 3 to 5 minutes or less." Shi Yu said.
The interviewed doctors pointed out that the treatment of mental illness is different from ordinary diseases, and only when the child and the doctor have sufficient communication and slowly build trust, it is possible to achieve better treatment results. It is difficult to build trust between children and doctors in the current mode of care.
Chen Wei, vice president of Quzhou Hospital of Traditional Chinese Medicine in Zhejiang Province, believes that at present, the role of early detection and early intervention in schools has not been effectively played. "All kinds of schools are equipped with full-time psychological teachers according to regulations, but most primary and secondary school teachers have only received short-term training, and their ability to identify and solve students' psychological problems is limited, resulting in teenagers with psychological problems having to flock to medical institutions." Chen Wei said.
Wang Yiquan told Banyuetan reporters that when their children have psychological problems, some parents think that "if you are sick and take medicine, you will get better", and as soon as they enter the hospital, they ask the doctor to prescribe some medicine, and they expect too much from the effect of the drug, rather than giving the child a space for psychological adaptation and rhythm adjustment.
Banyuetan reporter's investigation found that some teenagers received psychological treatment at the beginning, but due to the long course of psychological treatment, parents were eager to treat the disease, and listened to the words of informal psychological counseling on online platforms such as short videos, and tried to buy relevant psychotropic drugs for their children to take, causing secondary harm to children.
Strengthen the establishment of a mental health service system
In the face of this situation, the interviewees suggested that a more targeted adolescent mental health service system should be built.
The first is to raise the level of research on mental illness among adolescents. Zhou Xuhui suggested that according to the characteristics of adolescents, more targeted systematic treatment methods should be proposed, so as to get rid of excessive dependence on drug means and increase the proportion of psychotherapy. Strengthen follow-up surveys on adolescent mental health conditions, find out the development trend of adolescent psychology, and provide a scientific basis for the introduction and improvement of relevant policies.
The second is to strengthen the cultivation of professional talents. Chen Wei suggested that the introduction of policies and systems that favor psychiatrists and mental health teachers should be accelerated, the supply of specialized mental health services should be improved, and adolescent mental health specialties should be added according to specific needs.
The third is to strengthen the school's ability to detect and intervene early. Experts suggest that school mental health teachers should be provided with lectures, workshops, case studies and other forms of psychological supervision and hierarchical training, and mental health education should be carried out through individual counseling, group counseling, club activities, subject infiltration, campus culture infiltration, etc., so as to improve the application level of mental health education skills in subject teaching.
Fourth, promote effective multi-party collaboration. Zhou Yanan, director and deputy chief physician of the Department of Pediatric Psychology of Hunan Provincial Brain Hospital, suggested that parents should be guided to pay attention to the mental health of adolescents through multi-channel publicity and school parent classes, so as to relieve or reduce the excessive psychological burden and pressure of children as much as possible. At the same time, strengthen the popularization of mental health science and increase the correct understanding of mental health problems.
Half Moon Talk Reporter: Shuai Cai, Yu Chunsheng, Huang Xiao
*This article is the content of the 9th issue of "Half Moon Talk" in 2024
Original title: "Don't be overly dependent on drugs in the treatment of adolescent heart disease"