Do Antidepressants Work for Kids?I am a clinician who grew up surrounded by alcoholism.  I grew up in the house that Jack built.  Jack was my father, and although he didn’t construct our house board by board, his alcoholism framed it in toxicity. The atmosphere in our small house brimming with children was chilly at best.  My mother, five brothers and I remained on high alert, never knowing if dad would come home for dinner intoxicated or if he would return at all. If the family function is an art form, ours looked more like the disjointed parts of a Picasso—everyone was hurting.

We didn’t know what we didn’t know, and we had no language for what was happening. The no-talk rule so common in alcoholic/addicted households held fast in our fear-based system.  Days without tension days were the odd ones; on calm days, things just felt off.

A child growing up in an alcoholic or addicted home will become overly familiar with intense feeling states, particularly anger, fear and anxiety. Children need words. They need a safe harbor, a channel to understand their world, a way to navigate their emotions, lest they begin to plow them underground.

The emotions cushioning my Lost Child role were hard to shake: anxiety, fear of failure, sense of over responsibility, floating guilt and that all-encompassing shame.

I finally fell like Humpty from the wall of safe, flat places, and it was time to risk breaking camp and begin my healing work. It took a village—a therapist, journaling groups, expressive arts groups, Al-Anon circles and a Master’s degree in Alcoholism and Drug Abuse Ministry to bring forth a new framework for living, loving and leading others.

Fast forward to the current addiction crisis. Consider all the family members impacted, and particularly the children—so many kids raised in houses built around the illness of addiction. My father’s alcoholism took years to manifest into full-blown, out-of-control addiction. Opiate and heroin addiction creates family dysfunction on speed dial. While we’re batting an eye or scratching our heads, a four-year-old is watching his mother die with a needle in her arm. A six-year-old is left in the back seat of a car or in the restroom of a discount store while parents tend to their drug habits.

Yes, there’s an epidemic. Yes, addicts need help. Yes, we need to create more and different treatment options. Yes, Naloxone can bring a user back from the brink of death.  But what about the children nestled inside a parent’s opiate addiction? How do we pull them back from the brink of fear/anxiety/confusion/anger?

Costs to the Children

Dr. Nora Volkow, director of National Institute on Drug Abuse, discusses children in her 2016 blog  She cites how early intervention in a child’s life where family instability is the norm, helps stabilize a child’s ability to self-regulate later on. Early stabilization decreases their risk of abusing alcohol/drugs. While substance abuse costs to our society are difficult to swallow—2013 statistics regarding costs, including tobacco, alcohol, illicit drugs were cited as $740 billion annually. Those costs include health care, lost productivity, and crime. July 25. NIDA. (2017, April 24). Trends & Statistics.

Although costs to the children of addicts are not so easy to gather, clinicians can rest assured there is some degree of negative impact on a child’s emotional world. So many will have issues with trust, love and self-worth.  And how many will become addicts or alcoholics? Shame is the tie that will bind them unless supportive programs can offer hugs and age appropriate language to help them understand the family illness and pain. When pain is minimized or denied, it will slide sideways and find a way out through maladaptive behaviors.

I recently found a copy of a poem by Rainer Maria Rilke tucked between the pages of a meditation book from my early recovery days:

Destiny itself is like a wonderful wide tapestry in which every thread is guided

by an unspeakable tender hand, placed beside another thread, and held and

carried by a hundred others.

Children of addicts and alcoholics need the “unspeakable tender hand of a hundred others.”  Part of a clinician’s responsibility during these heightened days of concern needs be to the little ones. They deserve advocacy.  They need be a part of the family healing.

For clinicians working directly with those addicted adults–ask them about their kids:

  • Have you talked to your kids about addiction?  What do they know?
  • What kind of acting out behaviors have you witnessed in them?
  • What are you willing to do to get your children the age-appropriate help they need?
  • Provide material to families concerning outreach in your communities regarding play therapy, Alateen or Alatot groups.
  • Provide a list of reading material, suggestions include:

Wishes and Worries: Coping With A Parent Who Drinks Too Much Alcohol,” by Centre for Addiction and Mental Health, Lars Rudebjar

“An Elephant In the Living Room, The Children’s Book,” by Jill M. Hastings and Marion H. Typpo

Up And Down the Mountain: Helping Children Cope With Parental Alcoholism,” by Pamela Leib Higgins

“My Dad Loves Me; My Dad Has A Disease. A Child’s View: Living With Addiction,” by Claudia Black

Understanding Addiction and Recovery Through A Child’s Eyes: Hope, Help and Healing for Families,” by Jerry Moe

Let us not forget that little ones growing up in homes framed by addiction need tender hands to guide and words to help them understand.

 

Candace Hartzler, MA, LIDC,  worked in the field of chemical dependency counseling for 28 years, retiring from The Ohio State University, Wexner Medical Center, Talbot Hall Addictions Treatment Unit until three years ago. She was a presenter in 2012 at the National Conference on Addiction Disorders held in Washington D.C. and is currently working on a book entitled, “Learning to Love Differently: family addiction as spiritual gateway.” She maintains a small private practice, working with families of addicts, and working part-time at Wellness Driver Intervention Program in Columbus, Ohio.