Adolescent Depression:
"Not Something They Can Just Snap Out Of"

The adolescent and teenage years can be awkward times. But major depression is not a normal part of teenage "growing pains." Depression is a serious - and treatable - illness.

"I think it's really hard because what we may think of as the typical developmental difficulties of adolescence sometimes overlap with depression, so you have to be very careful," says Dr. Diane Treadwell-Deering, medical director of the Pediatric Psychopharmacology Clinic at Texas Children's Hospital.

The symptoms of a depressive disorder include irritability, sensitivity, a depressed mood, and tearfulness. To be classified as depression, the symptoms must last for at least two weeks. "We're not talking about feeling depressed for a day after making a bad grade on a test," she says.

Many adolescents or teens with a major depressive disorder may exhibit signs of disinterest in things that used to be pleasurable to them. Dr. Treadwell-Deering notes an important distinction in this area. It may be typical for a teen to favor doing something with his or her friends rather than going to dinner with the family, even though it is something they used to enjoy doing, she says. When the teen ceases to show interest in being with friends or participating in extracurricular activities because he or she lacks the energy, motivation or no longer feels it is worth it, they could be showing signs of a depressive disorder.

Depression also takes its toll on school performance. "Depression makes you feel like there's no point in doing things, so you don't," says Dr. Treadwell-Deering, assistant professor of psychiatry and behavioral sciences at Baylor College of Medicine.

Changes in eating and sleeping patterns can be part of normal teenage behavior, but they can also be signs of depression. Parents may have difficulty determining if the behavior is appropriate as their teen becomes more independent.

"It's hard because teenagers often stay up very late at night and then have trouble getting up for school. Or they may eat pizza at 2 a.m. with buddies and not eat breakfast the next morning," Dr. Treadwell-Deering says. "A typical parent may not know a lot about those habits because teens have more autonomy."

If the young person has trouble going to sleep or wakes up frequently throughout the night, it could be a sign that something is wrong. Likewise, if a teen loses interest in eating, it may be a symptom of depression.

Research shows that a genetic component does exist in cases of depression, however, the exact cause is still unknown. Those young people with family members who have suffered from depression are at a greater risk for the illness.

"Depression is a very serious disorder," says Dr. Treadwell-Deering. "Major depression is not something people can just snap out of. Believe me, if they could, they would."

The depression may become so severe that the young person begins to have thoughts of dying. Suicide is the second leading cause of death in adolescents after accidents, and accounts for 12 percent of mortality in this population. According to statistics, suicide rates have tripled from 1950 to 1980, from 2.7 per 100,000 to 8.5 per 100,000.

"Having a major depressive episode increases your risk for suicide," she says. "This is another reason why this disorder should be taken seriously." Other contributing factors to teen suicide include substance use or abuse, alcohol, other psychiatric disorders, history of physical or sexual abuse, school failure and an unsupportive family environment.

Fortunately, depression is a treatable disease. In cases of major depression, anti-depressant medication may be used to treat the illness. "It's oftentimes very frightening for some people to use medication in a youngster to deal with problems regarding their feelings and emotions," says Dr. Treadwell-Deering. "But if someone needed insulin for juvenile diabetes, you wouldn't want them to go without it. That's the same way I feel about major depressive episodes."

Behavioral cognitive therapy is also an option and may be part of the treatment plan for less severe depression. Depending on the individual, psychotherapy, school intervention and social skills training may be other avenues taken to address the depression.

"One of the things we've learned is that having repeated episodes of depression worsens your prognosis, so it's very important to recognize this disorder and treat it," she says.

---

©2006 Texas Medical Center

---

E-Mail: tmc-info@tmc.edu
URL: http://www.tmc.edu/tmcnews/01_15_99/page_08.html