Getting your child or teenager into therapy is not a small thing. For most families, it takes months of noticing something is not quite as it should be, working up the courage to say it out loud, finding someone who is actually available and (hopefully) affordable, and then convincing your child or teen to walk through the door. By the time you get there, you’ve already done a lot, and you may feel a slight sense of relief.
So, when a therapist or provider, someone you’ve come to trust, someone who knows your child, suggests it might be time to talk to someone about medication, that overwhelmed feeling can creep in again. Even if you’ve known this conversation might come, it can feel less like a next step and more like another big shift in what you hoped was becoming solid ground. It is as if the situation somehow got more serious, or more permanent, or more real. I know that feeling well.
I want to be clear that I’m not a psychiatrist or a prescriber. I’m a parent who has been through this process with my own family. I have a research background that has taught me how to ask hard questions and push for real answers. What I want to offer here is not medical advice; it’s an honest conversation about the concerns that arose for me and often arise for other parents when the possibility of adding medication to support your child first comes up.
As with each step of this journey, I want you to remember that if medication is suggested for your child or teen, you don’t have to decide anything that day. And you’re allowed to ask questions.
The worries parents actually have
Like me, most parents I talk to don’t say outright, “I’m afraid of medication.” What they say sounds more like: I just want to make sure we’ve tried everything else first. Or: I don’t want my child to become dependent on something. Or: What if it changes them in some way?
None of those have easy answers, and they often are not adequately addressed in a 20-minute appointment with a new provider. So let’s go through them.
“What if it changes who my child is?”
This is probably the one I hear most, and it also tends to get dismissed too quickly, usually with something like “Don’t worry, it won’t change their personality.” That answer isn’t wrong, but it doesn’t actually address what parents are afraid of.
What parents are really asking is: Will they still feel like themselves? Will they feel like a numbed-out zombie on this?
Those are legitimate concerns, and it is highly dependent on what medication is being suggested. When medication is working well, what many parents describe is finally seeing the version of their child who isn’t fighting an uphill battle every single day. Still themselves, just with a little more breathing room.
But if you notice your child seems agitated, flat, unusually quiet, or as if something important to who your child is, is missing, you should raise that with your prescriber. It’s information, and it needs to go back to the prescriber. It likely means the medication or the dose isn’t the right fit. You’re allowed to say that directly: Something feels off, and I need you to take that seriously.
“I’m worried about dependency and addiction.”
The honest answer: Many psychiatric medications prescribed for children with things like anxiety or depression are not addictive in the way people usually mean when they use that word. They don’t create cravings. Needing a medication to function well is not the same thing as addiction. Some medications do need to be tapered slowly rather than stopped abruptly, but that’s about how the body adjusts, not dependence in a clinical sense.
There are a number of medications where prescribers pay closer attention to duration, dosing, and monitoring, which is exactly why follow-up appointments matter. They’re not optional check-ins. They’re part of how this process works, and if your provider suggests follow-up appointments, please make sure you go to them.
If you have concerns about a specific medication being recommended, ask directly: Is this a medication where dependency is a concern? What does monitoring look like? A good prescriber should walk through that with you.
“I don’t fully trust the process (or the prescriber).”
Finding a prescriber you trust is genuinely difficult right now. Child and adolescent psychiatrists are in short supply in most parts of the country, and wait times can stretch for months. Many families end up starting with their pediatrician, which can work for straightforward situations, but pediatricians vary a lot in their experience and comfort with psychiatric medications for kids.
One of my children had a significant reaction to a medication prescribed by their pediatrician. The pediatrician was well-meaning. They didn’t have the specialized knowledge to anticipate what happened. When we finally met with a pediatric psychiatrist, he offered genetic testing, something called pharmacogenomic testing, which looks at how your child’s body processes certain medications. It showed that a particular medication should never have been used for my child. I wish we had known to ask about that testing before we ever started. I want to note that not every prescriber will recommend this kind of testing, and the science around it is still evolving. But it’s a reasonable question to ask, especially if your child has a family history of bad reactions to medication
I’m not sharing that to frighten anyone. I’m sharing it because it’s the kind of thing you only learn after the fact. Reasonable questions to ask any prescriber before starting a medication include:
- How often do you prescribe this for children/teens?
- What side effects should I specifically watch for, and what should I do if I notice them?
- Is there any genetic testing or other testing we should consider before we start?
- At what point would you refer us to a specialist? (Especially if you are not talking directly with a psychiatrist).
Honestly, if you have a prescriber who is bothered by those questions, I would take that as a red flag. You want someone who takes the time to actually answer your questions, so you can feel better about working with them.
One practical note on finding a psychiatrist or someone who can prescribe and manage medication for your child: if your child is already working with a therapist or psychologist you trust, ask them directly for a referral. Therapists who regularly treat kids with anxiety or depression or other similar challenges usually have prescribers they work with, people they know, communicate with, and trust to handle the same kinds of cases. That referral is worth a lot more than a cold search. It’s also worth knowing that some pediatric practices have started bringing psychiatric nurse practitioners on staff specifically because the need has grown so much, and wait times for child psychiatrists can be so long.
Nobody really prepares you for how long this can take
I want to spend some time here because I think this is not discussed enough, and going in without realistic expectations made everything harder for our family.
I had the assumption, and I know others do too, that if medication is the right call, you’ll try it and it will help. What many families don’t realize is that finding the right medication, at the right dose, can take months. The first medication might not work. Or it works partially but comes with side effects that aren’t acceptable. Or it helps for a while and then seems to stop. This is not unusual, and it does not mean that there is nothing out there that will help. It just means that you have to try new medications, new schedules, or new doses. It is a process that can take longer than you want, but unfortunately, from what I have learned, there is no real way to speed it up.
Your prescriber might adjust the dose. They might switch to a different medication in the same class, or try something different entirely. Each step takes time to evaluate, because most psychiatric medications take weeks or months, not days, to show their full effect. Especially medications that you need to slowly raise or lower to prevent the body from reacting negatively.
This part is really hard, especially when your child is struggling, and you want something to improve. What helps is going in knowing that finding the right fit is the actual goal, and that every piece of information you gather along the way, including what doesn’t work, is part of getting there.
I strongly recommend keeping a simple log of what you’re observing at home. Your prescriber sees your child for maybe 20-30 minutes every few weeks. You see your child every day. Write down changes in mood, sleep, appetite, and energy. What seems better, what seems worse, what feels neutral. That information helps your prescriber make better decisions faster, and it also helps you feel less like you’re just waiting around hoping for something to shift. And just as a side note, I would encourage you not to constantly ask your child how they are feeling. They want this to work, too, and the constant barrage of questions will just increase the stress on them. It is okay to check in, but try to avoid a daily interrogation
What to do if you’re not ready to say yes to medication
You do not have to decide anything in the appointment where medication first comes up.
You can ask for time. You can come back with questions. If a provider is pushing a timeline without explaining why, you’re allowed to ask directly what makes this urgent.
One thing that helps: ask your provider for a reliable resource to read about each medication they’re recommending. Not a Google search, not a forum, something they would actually point you to. A good prescriber should be able to hand you something, or at least point you somewhere specific. Reading about a medication on your own terms, before you’ve agreed to anything, tends to surface the questions you didn’t know you had, and you can bring those questions back to your provider.
There are situations where medication is genuinely time-sensitive. Severe depression, for example, can make it nearly impossible for a child to engage meaningfully in therapy; in those cases, medication is what makes the therapy possible. But your provider should be able to explain their reasoning in a way that actually makes sense to you.
For most families navigating anxiety, mild to moderate depression, or similar challenges, there is usually room to gather information and make a decision you feel okay about.
If your child is a teenager, they have a stake in this decision too. Many teens push back on medication, sometimes hard. They may worry about what it means, what their friends will think, or they just don’t want to feel like something is wrong with them. These are big decisions, and they come with a lot of emotions and fears for your teen. A teen who feels like medication is being done to them rather than decided with them is a teen who may not take it consistently, or who carries resentment about it later. It doesn’t mean they get a veto, especially if the situation is serious, but it does mean that it is worth having a conversation. Including their therapist and prescriber in that discussion may help, so they can hear from the experts and not just their parents. Their concerns deserve the same honest answers yours do.
This is still the same process you’ve already been in
When medication enters the conversation, it’s easy to feel like you’ve crossed into different territory, like what may have been manageable just became something more serious. But most of the time, that’s not what’s actually happening. What’s happening is that the people supporting your child have enough information now to think about the next step. That’s the way the process is supposed to work, and it does not necessarily mean that the situation is getting worse.
Getting your child into therapy was a step. Working with a therapist long enough to understand what your child needs was a step. And considering whether medication might help is another step in that same process. It is not a verdict, nor a confirmation that something is more wrong than you thought.
Medication is a tool. For some kids, it’s the thing that makes some of the other work possible. For others, therapy alone is enough. You probably don’t know yet which will be true for your child, and that’s okay. What you can do is stay informed, keep asking questions, and make sure the people on your child’s team are actually listening to you.
You’ve already done hard things to get your child the support they need. This is just the next step in that process.
You’re not alone in this.
Laurie
Looking for information on therapist vs. psychologist vs. psychiatrist, and what each does, check out my earlier post.
If you want ideas on how to track information when your child starts medication, check out my posts on how to organize your child’s mental health information in one place and what information parents should track for their child’s mental health.
Parent. Founder of Together We Navigate. I spent years navigating support systems for my kids and built TWN so other parents don’t have to figure it out alone. PhD in Community Psychology.