Sunday, March 8, 2009

Sue Scheff: Teenage Depression

“Just this gloom was like hanging over my head and I knew something wasn’t right but I wasn’t exactly sure what it was.”

– Amy, 16 years old

New research from Columbia University finds that nearly 50 percent of teens suffer from some form of depression, anxiety, or a number of other psychiatric disorders.

“A lot of people I know get depressed all the time about lots of stuff,” says 15-year-old Meagan.

“It’s like everything’s all on your shoulders and you have to take everything at once,” says Meredith, 14.

Sixteen-year-old Amy agrees, “Just this gloom was like hanging over my head and I knew something wasn’t right but I wasn’t exactly sure what it was.”

“My parents went through an awful divorce my ninth grade year and I was devastated, worse than my heart could ever imagine,” says 18-year-old Brittany, “and it hurts a lot, and I still hurt to this day and I’m a senior in H.S.”

The symptoms vary: some kids may be lethargic and withdrawn; others may show agitation and frustration, even aggression. Often, there is a drop in grades.

And sometimes these symptoms can cause parents to punish the child, instead of providing treatment.

“Rather than thinking of children’s misbehaviors as discipline problems or misbehaviors as deliberate,” says psychologist Sunaina Jain, Ph.D., “it’s important to see them as communications from the child.”

Experts say lots of kids experience depression or anxiety, often mild and temporary, but not always. And that’s why parents need to constantly check their child’s emotional pulse.

“You know it doesn’t take hours and hours. Even a few minutes of checking in with each other every day is a great way of saying you know I’m here, I’m interested in you,” says Jain.

Tips for Parents

All teens experience ups and downs. Every day poses a new test of their emotional stability – fighting with a friend, feeling peer pressure to “fit in” with a particular crowd or experiencing anxiety over a failed quiz – all of which can lead to normal feelings of sadness or grief. These feelings are usually brief and subside with time, unlike depression, which is more than feeling blue, sad or down in the dumps once in a while.

According to the Nemours Foundation, depression is a strong mood involving sadness, discouragement, despair or hopelessness that lasts for weeks, months or even longer. It also interferes with a person’s ability to participate in normal activities. Often, depression in teens is overlooked because parents and teachers feel that unhappiness or “moodiness” is typical in young people. They blame hormones or other factors for teens’ feelings of sadness or grief, which leaves many teens undiagnosed and untreated for their illness.

The Mayo Clinic reports that sometimes a stressful life event triggers depression. Other times, it seems to occur spontaneously, with no identifiable specific cause. However, certain risk factors may be associated with developing the disorder. Johns Hopkins University cites the following risk factors for becoming depressed:

Children under stress who have experienced loss or who suffer attention, learning or conduct disorders are more susceptible to depression.
Girls are more likely than boys to develop depression.
Youth, particularly younger children, who develop depression are likely to have a family history of the disorder.

Possible Symptoms:

Prolonged sadness or unexplained crying spells
Significant changes in appetite and sleep patterns
Irritability, anger, worry, agitation or anxiety
Pessimism or indifference
Loss of energy or persistent lethargy
Feelings of guilt and worthlessness
Inability to concentrate and indecisiveness
Inability to take pleasure in former interests or social withdrawal
Unexplained aches and pains
Recurring thoughts of death or suicide

It is important to acknowledge that teens may experiment with drugs or alcohol or become sexually promiscuous to avoid feelings of depression. According to the National Mental Health Association, teens may also express their depression through other hostile, aggressive, risk-taking behaviors. These behaviors will only lead to new problems, deeper levels of depression and destroyed relationships with friends and family, as well as difficulties with law enforcement or school officials.

The development of newer antidepressant medications and mood-stabilizing drugs in the last 20 years has revolutionized the treatment of depression. According to the Mayo Clinic, medication can relieve the symptoms of depression, and it has become the first line of treatment for most types of the disorder. Psychotherapy may also help teens cope with ongoing problems that trigger or contribute to their depression. A combination of medications and a brief course of psychotherapy are usually effective if a teen suffers from mild to moderate depression. For severely depressed teens, initial treatment usually includes medications. Once they improve, psychotherapy can be more effective.

Immediate treatment of your teen’s depression is crucial. Adolescents and children suffering from depression may turn to suicide if they do not receive proper treatment. Suicide is the third leading cause of death for Americans aged 10-24. The National Association of School Psychologists suggests looking for the following warning signs that may indicate your depressed teen if contemplating suicide:

Suicide notes: Notes or journal entries are a very real sign of danger and should be taken seriously.

Threats: Threats may be direct statements (“I want to die.” “I am going to kill myself”) or indirect comments (“The world would be better without me.” “Nobody will miss me anyway”). Among teens, indirect clues could be offered through joking or through comments in school assignments, particularly creative writing or artwork.

Previous attempts: If your child or teen has attempted suicide in the past, a greater likelihood that he or she will try again exists. Be very observant of any friends who have tried suicide before.

Depression (helplessness/hopelessness): When symptoms of depression include strong thoughts of helplessness and hopelessness, your teen is possibly at greater risk for suicide. Watch out for behaviors or comments that indicate your teen is feeling overwhelmed by sadness or pessimistic views of his or her future.

“Masked” depression: Sometimes risk-taking behaviors can include acts of aggression, gunplay and alcohol or substance abuse. While this behavior may not appear to be depression, in fact it may suggest that your teen is not concerned about his or her own safety.

Final arrangements: This behavior may take many forms. In adolescents, it might be giving away prized possessions, such as jewelry, clothing, journals or pictures.

Efforts to hurt himself or herself: Self-injury behaviors are warning signs for young children as well as teens. Common self-destructive behaviors include running into traffic; jumping from heights; and scratching, cutting or marking his or her body.

Changes in physical habits and appearance: Changes include inability to sleep or sleeping all the time, sudden weight gain or loss and lack of interest in appearance or hygiene.

Sudden changes in personality, friends or behaviors: Changes can include withdrawing from friends and family, skipping school or classes, loss of involvement in activities that were once important and avoiding friends.

Plan/method/access: A suicidal child or adolescent may show an increased interest in guns and other weapons, may seem to have increased access to guns, pills, etc., and/or may talk about or hint at a suicide plan. The greater the planning, the greater the potential for suicide.

Death and suicidal themes: These themes might appear in classroom drawings, work samples, journals or homework.

If you suspect suicide, it is important to contact a medical professional immediately. A counselor or psychologist can also help offer additional support.

American Academy of Child and Adolescent Psychiatry
American Foundation for Suicidal Prevention
Columbia University
Johns Hopkins University
Mayo Clinic
National Association of School Psychologists
National Depressive and Manic-Depressive Association
National Institute of Mental Health
National Mental Health Association
Nemours Foundation

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