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Adolescents and Depression

Introduction
Signs of Depression
Cause of Clinical Depression
Treatment
Who Can Help?

Introduction

Adolescence can be a roller coaster ride of extreme highs and lows. Teenage moodiness is so common that parents typically consider teenagers’ mood swings as a normal—although sometimes unpleasant—aspect of adolescence.

However, symptoms of depression should never be taken lightly. Depression is a debilitating illness that can adversely affect a teenager’s social and academic life, and an increasing number of adolescents are diagnosed with depression, and at younger ages.

In the United States, eight percent of teenagers are diagnosed with depression, but the actual number of adolescents suffering from depression is likely much higher. The Centers for Disease Control and Prevention found that in 2005, almost three in ten public high school students reported that they had symptoms of major depression in the past year.

Signs of Depression

Depression is typically diagnosed when teenagers demonstrate at least five of the following nine behaviors for at least two weeks:

  • Depressed or irritable mood nearly every day for most of the day
  • Markedly diminished interest or pleasure in previously enjoyed activities
  • Weight loss or gain
  • Changes in sleep pattern
  • Fatigue or loss of energy
  • Feelings of worthlessness or excessive, inappropriate guilt
  • Indecisiveness or diminished ability to concentrate
  • Recurrent thoughts of death

Compared with adults, adolescents’ symptoms tend to be directed outward rather than inward. Depression may be presented as irritability, frustration, disruptive behaviors, or outbursts of anger.

Cause of Clinical Depression

Clinical depression is caused by a chemical imbalance in the brain which regulates a person’s mood. Adolescent depression is also associated with a family history of mood disorders, inconsistent parenting, a history of child abuse or neglect, chronic illnesses, developmental disabilities, physical impairments, and stressful life experiences.

Between 40 percent and 90 percent of teenagers who have depression also have another illness or condition, such as anxiety, substance abuse disorder, or attention deficit hyperactivity disorder (ADHD). These conditions can complicate the diagnosis and treatment of depression.

Treatment

The good news is that depression responds well to treatment. Cognitive-behavioral therapy (CBT) is especially beneficial. CBT teaches teenagers how to manage sadness by changing thoughts and behavior.

When therapy alone is not adequate to alleviate depression, medication is usually considered. A new class of antidepressants, Selective Serotonin Reuptake Inhibitors (SSRIs), is the first drug of choice for teenagers and adults suffering from depression.

SSRIs have fewer side-effects than the antidepressants most prescribed previously. SSRIs include the medications Prozac, Zoloft, Paxil, Celexa, and Lexapro.

Unfortunately, from 20 to 60 percent of depressed teenagers relapse within one or two years. As many as 70 percent relapse within five years. However, the overall outlook in the treatment of adolescents is very good, especially when teens are treated with a combination of therapy and medication.

Who Can Help?

Parents can help their teenager by learning more about depression to better understand the illness. Depression cannot be overcome simply by force of will. People with depression often need medication to correct the chemical imbalance in the brain.

Parents can also work with physicians, social workers, and other health care providers to monitor and report any changes in their child’s behavior or mood. This is particularly important when a teenager begins taking a prescription medication for depression.

Since depression is a significant risk factor for suicide, parents should watch for signs of deepening depression, agitation, increased irritability, and self-injury. Report any changes to the teenager’s physician.

Depression can be incapacitating for teenagers and adults alike, but it is a treatable illness when diagnosed. Don’t assume that adolescent moodiness is a childhood phase. It could indicate that a child needs help.

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Source: “Are Dark Moods Normal Adolescent Development?” by Nic Dibble, MSW, CSSW, CISW, published in the National Association of Social Workers Specialty Practice Sections Annual Bulletin, Issue One – 2007.

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