For children and parents alike, adolescence is a time of transition and self-discovery. Many of us look back on our adolescence and literally cringe at certain memories. For me, there are a number of “AHA!” moments as I look back on my middle and high school years, as I can literally see the formation of some of my adult behaviors. Adolescence is always challenging, as teens struggle to gain independence and handle the increased responsibilities that come along with it, all the while trying to adjust to a host of physiological changes that occur. While adolescence can be traumatic, most kids will adapt to these curves in the road with time and patience.
Some kids, however, will develop symptoms of clinical depression during adolescence, which parents and educators may dismiss as normal adolescent behavior. It’s important to understand the signs and symptoms of clinical depression in this age group, as it may manifest differently than in adults.
Depression and Adolescents
Clinical or major depression can affect people of all ages, including teens. Depression affects a person’s thoughts, feelings, behavior, and physical health. In adolescents, depression left untreated may lead to school failure, alcohol or drug use, destructive behavior, and even suicide. While the exact cause of depression is hard to pinpoint, it is most likely a combination of genetic, biologic, and environmental factors. So how can parents and guardians tell the difference between normal adolescent stress or sadness and major
Dr. Louise Thurman is a board certified psychiatrist and is the CEO and Medical Director of IPS Research Company. Her primary focus is clinical research in mental illness, and one area of particular interest is childhood and adolescent depression. “Most of us recognize depression as sadness, loss of interest in things, maybe trouble sleeping, and feelings of hopelessness. In adolescents, it is not uncommon to see kids that feel very overwhelmed, appear irritable, and have a ‘bad’ attitude toward things they used to love, all the while denying that they feel sad or down.”
While many adolescents go through periods in which they feel overwhelmed, depression is much more than that. “Kids with depression often lose interest in everything, including their friends and their usual activities. They tend to take on a brooding, angry mood.” Dr. Thurman acknowledges that some teens that will display symptoms similar to those common in adults. “The challenge is looking at things over time. Is this a short mood swing associated with the trauma of going through adolescence, or is this something more pervasive?”
The pressures of adolescence can be intense. Not only are these kids trying to figure out who they are and what they want to do in life, they are more aware than ever before of how they appear to others. According to Dr. Thurman, brief periods of mood swings, tearfulness, and irritability are not unusual, but if changes are really dramatic or last longer than two weeks at a time, it may signal a bigger problem. For a teen struggling with depression, “Things seem ten times harder,” says Dr. Thurman. “Even simple things like getting dressed in the morning or organizing your things for school.”
Parents need to be especially aware of the risk of suicide in teens. “Sometimes kids will get so frustrated or overwhelmed that they may take an overdose of something just to avoid an unpleasant consequence or emotional conflict. They think they’ll just sleep for awhile, and they don’t really understand how lethal an overdose can be. It’s important to take any suicide threat or behavior seriously in teens.”
In fact, Dr. Thurman notes that approximately 15 percent of people diagnosed with major depression commit suicide. There are a number of resources available in our community, including HeartLine. “Just dial 211. They have a 24-hour cell service and can refer people to get the help they need.”
Treating Depression in Adolescents
According to Dr. Thurman, “The first step to good treatment is finding out what a person wants to happen as a result of them getting some help. Then you work with them to help them get there.” While there are a number of different types of talk therapy that may be effective, Dr. Thurman finds cognitive-behavioral therapy to be particularly effective with teens. “It teaches you to think about situations in more helpful and healthy ways, and helps you find new ways to behave that produce the results you want. Teens like this because it is more focused on results than hashing out details of why you think you are the way you are. Gaining insight is helpful, but you have to know what to do with it once you have it.”
In addition to counseling, antidepressants may be prescribed for children and adolescents diagnosed with severe depression. “These medications have been found to be safe and effective in teens. It’s important to work closely with your doctor during the first couple of months of treatment, so you can report any problems. There are different types of medications available, and some work well for one person and not at all for another, which is another reason for frequent follow-up.”
Keys to Understanding Adolescent Depression
Dr. Thurman cautions parents, educators, and teens alike, “Do not underestimate how serious depression can be.” In addition to the elevated suicide risk, mental health problems are the leading cause of days off from work, loss of income, and early mortality. “Depression is not having a bad day, or feeling sorry for yourself, or eating a pint of ice cream because your boyfriend broke up with you. It’s a serious illness that prevents people from doing what they need to do to take care of themselves and their families.”
Still, the best news is that in most cases, treatments really do work. Dr. Thurman notes that “By partnering with a doctor and therapist who can develop a good treatment plan, teens can recover and get back to living.”
Shannon Fields is a freelance writer and a Certified Pharmacy Technician at Innovative Pharmacy Solutions.