Question:
Does your child get headaches or stomachaches whenever it's time to go to school? Or is she a well-behaved, straight-A student - who never plays with other kids? Each of these two very different children may suffer from depression, but how would their parents know for sure? A new paper attempts to
shed light on this dark subject.
Answer:
This is a place for teens to come together and talk about
depression. I have made this page because I have not found
another page that focuses on teenage depression although it is a
real problem. I myself am 14 years old and depressed. I have put
a message board in which we can all post and help each other.
Please feel free to post on it. Also feel free to e-mail me,
there is a link to email me with to the left.
http://www.geocities.com/pood_72581/
Every parent worries about the future of his or
her child. Parents of a depressed teen-ager are likely to be even
more concerned -- and they should be, according to new research.
"Having a depressive episode as a teen more than doubled the risk
of having another depressive episode in young adulthood," says
Ian H. Gotlib, PhD, co-author of the study. The study also found
that only about one in four people who had been diagnosed with
depression as teens said they remained free of psychiatric
illness in early adulthood.
"As a general rule of thumb, depression in adolescence seems to
be underdiagnosed and underappreciated," says Robert L. Findling,
MD, of Case Western Reserve University in Cleveland, who
commented on the study for WebMD. "We are quite aware that this
is a malignant and potentially lethal disorder. The leading cause
of death in young people is suicide. But the earlier the disorder
is caught, the less malignant it is, just like any disorder in
medicine.
"There's a lack of appreciation that depression is a
dysregulation of mood, just as diabetes is a dysregulation of
blood sugar," Findling says. "We see youngsters with profound
disturbances in function who suffer needlessly because parents or
other well-meaning adults say it's part of being a teen-ager or
it's just a phase."
Depression should be distinguished from common sadness, says
Gotlib: "Some warning signs are loss of interest, sadness,
fatigue, concentration difficulties, sleep disturbances, and
appetite problems that last for at least two weeks." But, he
cautions, "it's important not to overreact if you see sadness for
a few days in an adolescent."
For more than 10 years, doctors have been studying a group of
1,700 Oregon teen-agers, aged 14 to 18, who were randomly
selected from nine high schools. The doctors originally wanted to
find out how common depression and other mental disorders were in
this group of "normal" teen-agers. In this study, published in
the American Journal of Psychiatry, they focused on teens who
originally were found to be depressed but had recovered when
questioned again a year later to see what happened to them as
they got older. These subjects were interviewed by phone around
the time of their 24th birthdays.
Of the 274 formerly depressed patients, only about 30% said they
were free of psychiatric disorders, while about 45% said they had
had at least one recurrence of depression. According to Gotlib,
the risk of having had a depressive episode at age 24 for people
who did not have depression as teens is 18%.
The authors also analyzed a host of factors to try to determine
what contributes to an increased risk of having depression
return.
"As you might expect, we found having multiple episodes during
adolescence increased risk," Gotlib says. Other things that
increased the risk were having a family member with recurrent
major depression, being female, having some antisocial or
abnormal personality characteristics, emotional dependency, and
family conflict.
"Conflict with parents is not uncommon in families in which
there's a depressed parent or adolescent. This is not the
mopiness or withdrawal that we think about when we think about
depression. It's often irritability, anger, and conflict on the
part of the adolescent and/or the parent," Gotlib says. He urges
parents to recognize their own psychological limitations and to
be aware that their personal histories may make their children
more vulnerable to depression.
Gotlib says that depressed teens who may have some of the risk
factors for recurrence should be seen by a doctor every six
months or so to make sure things are going OK.
Findling adds that parents should find a mental health
professional who is proficient in caring for depressed
adolescents. "We're fortunate in Cleveland to have a center of
experts in pediatric mood disorders," he says. "But every
community is different. Even if there is no specific program
available, your doctor can probably tell you who is good at
seeing young people with depression within your community."
Almost half of the group of formerly depressed teens developed
another type of problem, such as substance abuse or anxiety,
between the time they were 19 and 23 years old.
Preventing new problems is another reason to treat depression
early, the doctors say. "The earlier the disorder is caught, the
less malignant it is, like any disorder in medicine," Findling
says. "Because a disturbance in mood can affect a youngster's ...
social, academic, and [family] functioning ... we know the longer
we let the disorder go on, the more the 'tumor' grows. I wish I
had a dime for every parent who said, 'I wish we had done this
[gone for treatment] sooner.'"
Findling says he knows some parents are reluctant to bring their
children in for treatment because of possible side effects of
medications or uncertainty that the treatments will work. "There
may be risks of treatment, and there may be some knowledge gaps,"
he says. "But more important is the fact that we know there are
profound and pronounced risks associated with depression that
should never go unaddressed. ... You need to find an expert who's
comfortable and familiar and expert at this to assure the best
for your youngster." Serious, scientific examinations of childhood depression have
been rare until relatively recently, says Jeffrey T. Kirchner,
DO, director of the family practice residency program at
Lancaster General Hospital in Lancaster, Pa. Kirchner and some
colleagues gathered together what literature exists on the
subject, and published a review of it in the Nov. 15 issue of the
journal American Family Physician.
That review confirms that children and adolescents indeed
experience a spectrum of mood disorders, says Kirchner, who also
teaches medicine at Temple University in Philadelphia. But even
though childhood depression is now acknowledged to be a
significant problem, "It's something that's still not talked
about much, something that many people -- even physicians -- are
not either aware of or tuned into," he tells WebMD.
As with adults, genes may play a part in a child's depression,
says Kirchner. However, by school age, children are also
vulnerable to life stressors like family conflict, divorce,
criticism, school troubles, and confusion about sexual
orientation.
"They don't have the same coping mechanisms that an adult or even
an adolescent would have to process and deal with the change,"
Kirchner tells WebMD. The result can be general sadness, anxiety,
low self-esteem, excessive guilt, and depression. Sometimes
children get involved in drug abuse as a way of dealing with
their feelings, he says.
In some children, such feelings are translated into headaches,
stomachaches, worry, and irritability, says Kirchner. "It may be
a reason kids don't want to go to school."
Poor academic performance can be a signal of depression in some
children, says Kirchner, but in others, depressive feelings and
low self-esteem may trigger a need to overcompensate. "They work
hard to please and be accepted by others, to get the best
grades," he says. "But because they are well behaved and doing
well in school, no one even suspects they may be depressed."
It's a confusing phenomenon, he admits.
"Parents should look at how their children are interacting
outside of school," says Kirchner. "They may be getting all A's,
but if there's no interest in outside activities, playing with
other children, doing things with siblings, eating, there may be
depression."
Ninety percent of children with major depressive disorder will
get better by themselves, within a year and a half to two years,
he says. But untreated children often are left with poor
self-esteem, problems with relationships, and symptoms of
depression -- and they often wind up taking increasing risks,
leading to smoking, drug abuse, and pregnancy.
And left untreated, ...
