Depression is Serious and Treatable

Being a teen is tough enough when you’re healthy, but it can be unbearable for teens with depression.

Depression in Youth

People often interpret the symptoms of depression as normal teen behavior. But depression isn’t “typical” or “just a phase” and teens can’t handle it alone. For some, depression may lead to thoughts of suicide.

Experts believe that at least 95% of people who die by suicide have depression or a related depressive illness. Suicide is the second leading cause of death for people 10 to 25 years old. Treating depression is the most effective way to prevent suicide.

Depression is a recognizable and treatable illness.

Depression is an illness of the brain that affects moods, thoughts, feelings, behavior and physical health. Unlike the “blues.” depression lasts longer than a couple of weeks. It won’t go away with positive thinking or determination.

Anyone can have depression

Depression is an illness that can happen at any time, even when a person’s life seems to be going well. For some teens, stressful situations can trigger depression, such as dealing with pressure to fit it, adjusting to the break-up of a relationship, doing poorly in school, or not feeling wanted at home.

It’s important to remember that anyone can suffer from depression. Seek treatment because everyone deserves to be healthy.

Symptoms of Depression

• Feeling sad, empty and numb.

• Feeling tired all the time.

• Feeling hopeless, helpless or worthless.

• Feeling angry or moody, excessive crying.

• Sleeping more or less than usual.

• Avoiding friends; feeling alone when with friends.

• Loss of interest in things that used to be fun

• Difficulty concentrating or remembering.

• Eating less or eating more than usual.

• Recurring headaches, backaches or stomachaches.

• Alcohol or drug use.

• Thinking about, planning or attempting suicide.

Warning Signs of Suicide

• Talking, reading or writing about suicide or death.

• Talking about feeling worthless or helpless.

• Saying things like: “I’m gonna kill myself,” “I wish I were never born;” or “I shouldn’t have been born.”

• Visiting or calling people to say goodbye.

• Giving things away; returning borrowed items.

• Organizing or cleaning bedroom for the last time.

• Self-destructive behavior like self-cutting.

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Five ways to help if your child seems down

If you notice troublesome behavior in your child, such as agitation, anxiety, or lethargy, there are steps you can take even before seeking professional help. Here are some suggestions from Dr. Kerns and Neal Ryan, M.D., associate professor of psychiatry at the University of Pittsburgh School of Medicine.

1. Talk to your child, but don’t overreact—the blues are not depression. Express concerns about her feelings. Sometimes just paying attention is helpful. If you have a "difficult" baby, don’t assume she’ll become a depressed child. Babies usually outgrow troublesome symptoms.
2. Listen. Avoid jumping in with advice. Pay attention and ask him if he has any thoughts about what might help.
3. Share your feelings. Tell your child about your disappointments and how you handled them.
4. Boost your child’s self-esteem. Discuss her talents and things she does well.
5. Correct negative thinking. If a best friend fails to call as planned and your child says, "I don’t think he cares about me," suggest, "Maybe his mother said he has to do homework."

Is Your Child Moody or Depressed?   by Gloria Hochman

As recently as 15 years ago, mental health experts regarded depression as an adult affliction. Childhood was seen as stress-free, and it was unthinkable that children could be depressed. Experts believed that children’s psyches were not sufficiently developed to allow them to experience depression.

Today, however, studies show that as many as six million children and adolescents in the United States are depressed. Mental health researchers and practitioners now know that even infants and toddlers can show signs of depression, ranging from a handful of troubling symptoms to a full-fledged depressive or manic-depressive episode.

"Not only are we more alert to the existence of depression in children," says Theodore A. Petti, M.D., a professor of child psychiatry at Indiana University School of Medicine in Indianapolis, "but we’re seeing an increase, probably because of the shift in social structures, the breakdown of the family, and more financial and emotional stress.

"Childhood depression is genuine, not a phenomenon created by neurotic parents who read too many pop psychology books," adds Dr. Petti. "It cuts across all social and economic classes and affects all races and ethnic groups."

There is good news, however. While it is painful for parents to acknowledge depression in their children, early diagnosis can lead to effective treatment and may prevent problems that affect later growth and development.

Diagnosing depression

It’s not easy to diagnose depression in a child. There’s no definitive lab test, no x-ray to confirm its existence. And unlike adults who can say, "I have no energy," or "I feel worthless," kids can’t always express the way they feel. Adults must deduce what children are experiencing largely from their behavior, which is frequently inconsistent.

If your child has any of the following symptoms, consult your pediatrician, who may treat him or refer you to a psychiatrist or therapist.

Depressed babies tend to:
 

• withdraw
• eat poorly
• have trouble sleeping

They may appear:

• listless
• smile little
• turn away from people who attempt to engage them.

They are:

•  negative in mood
• slow to adapt to different environments  

Of course, not every child with these symptoms is depressed, but these behaviors are frequently implicated in the onset of depression.

Depressed toddlers often:

• won’t make eye contact with adults
• stare into space
• may be delayed in standing, walking, or talking.

"Sometimes we’ll see self-destructive behavior such as head banging or self-biting," says Lawrence L. Kerns, M.D., associate clinical professor of psychiatry at the University of Illinois in Chicago and co-author of Helping Your Depressed Child.

Play and art therapy may provide clues that aid in diagnosis. The former was painfully revealing with Jenny Lane, almost 3, the youngest child ever diagnosed by Javad Kashani, M.D., professor of psychiatry and pediatrics at the University of Missouri in Columbia. When he showed her a picture of a baby elephant showering and asked what she saw, she said, "The elephant is crying." When he showed her a doll family, she said they were crying and added, "They’re all dead."

Depressed preschool and school-age children are often neither sad nor withdrawn. The two most salient symptoms, says John Sargent, M.D., associate professor of psychiatry and pediatrics at the University of Pennsylvania School of Medicine in Philadelphia, "are irritability and inability to concentrate. The child may be upset by small things. He is usually disagreeable. He knows that he’s behaving badly and is frustrated because he can’t stop himself. So, he feels worse about himself and becomes even more depressed."

Unfortunately, parents, teachers, and coaches may worsen the child’s condition. "They may not recognize the symptoms of depression," says Dr. Sargent. "So parents may berate children for being irritable and uncooperative. Teachers may label them as lazy, and coaches may call them unmotivated. The child, as a result, sees himself as a failure and is helpless to do anything. He becomes even more depressed."

Why kids get depressed

Depression often accompanies other common disorders such as learning disabilities, conduct disorders, or Attention Deficit Disorder. "Depression is always associated with stress," says Michael Silver, M.D., associate medical director of the Philadelphia Child Guidance Center. Sometimes the stressor relates to a child’s body chemistry.

A doctor needs to study family history meticulously because it often contains vital clues. "Many studies show that children with a depressed parent stand a 25 percent chance of becoming depressed themselves in their lives," says Dr. Kerns. "When both parents are depressed, the risk soars to 50 percent."

Sometimes the depression is termed "adjustment disorder" because the cause is environmental. A doctor’s job is to identify a child’s sources of stress and help the child and family cope. The doctor should examine a child’s school performance, both academically and socially, as well as his environment: Is there an alcoholic parent? Has the child changed schools? Are the parents divorced? A physical examination is necessary to rule out medical conditions such as head injury, brain tumor, or anemia.

"It’s not the parents’ behavior that causes depression in the children," says Dr. Silver. "But if a parent is emotionally disengaged from a child for any reason, the child is not getting the attention and nurturance he needs and is more likely to become depressed."

This article is reprinted from "Reaching Out," published by the Catholic Charities, Foster Care Service Group, 651 West Lake St., Chicago, IL 60661. It originally appeared in Child Magazine, February 1995, pp. 58-61.