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more articles by Duplan, Auguste L. , MD  |  author's bio

Teenagers and Depression

Teenagers and Depression

By Auguste Duplan, M.D.

The thinking around teenage depression has changed significantly in recent years. The prevalent opinion used to be that children and adolescents simply did not suffer from depression. However, now we understand that young people can and do suffer from depression and that this illness is common among adolescents.

The symptoms of adolescent depression differ in some ways from adult symptoms. Also, if we think about human beings on a continuum, then we understand that the capacity to express depression changes as people mature. Young people cannot always communicate depression in the same language that adults use.

What are the common symptoms of adolescent depression?

Sometimes it is easiest to understand the symptoms if we draw a comparison. An adult with depression meets specific criteria, the most common of which include a sad and depressed mood, recurrent thoughts of death, loss of interest in activities that were previously enjoyable, changes in sleep habits and appetite, decrease in level of energy, libido, attention and concentration and feelings of guilt, worthlessness, hopelessness, and helplessness for at least a two-week period.

Adolescents, on the other hand, do not always feel sad; rather, they feel irritable. They sense that something is not right, but they typically resist seeking help. Their feelings of irritability and unease often lead to self-medication in the form of substance abuse and alcohol. It is not uncommon for their anger to lead to self-mutilation, and to behavioral problems. As the condition worsens, their performance in school often deteriorates and they begin a downward spiral of self-defeating behavior, such as cutting classes.

Is adolescent depression on the rise?

Since mental health professionals have opened themselves up to the possibility, depression in children and in adolescents is more often recognized and diagnosed than a decade ago. The fall season can be especially difficult for teenagers as they begin classes. The adjustment to school can be very stressful, particularly for someone who is already struggling with depression. Deterioration in school performance is often one of the overt signals of this illness.

What should I do if I think my teenager is suffering from depression?

If you think your teenager is suffering from depression, the first thing you should do is talk with your teen. Express your concerns about the changes you see. Tell your teen that you want him or her to see a professional and be evaluated. This can be a tough sell because teenagers feel they are invincible, but it is important to pursue it nevertheless.

Evaluation by a professional is valuable because depression can be caused by medical conditions that are correctable. Thyroid problems, for example, can cause depression. We never assume that the problem is psychiatric in nature until we rule out other possible causes.

You can also enlist help from guidance counselors and teachers. Some parents are initially alerted to the problems depressed teens experience in school from a guidance counselor or school social worker or psychologist. In fact, schools are doing a lot of outreach and education about adolescent depression these days.

What if my son or daughter is afraid of what others will think?

Depression left untreated can lead to a bad outcome. If you suspect your child is depressed, don't wait for the downward spiral to continue: get your child help. The risks of not dealing with depression are far worse than the risks associated with getting treatment. If your child is worried about the stigma that some people associate with psychiatric illness, a support group of peers can help overcome those worries. Depression among teens is quite common; we treat many patients with severe depression in the Adolescent Behavioral Services Unit at Cayuga Medical Center.

Can depression be cured?

Adolescents with depression typically respond well to therapy that includes medication and talking therapy. We have very good drugs today for treating depression. Through talking therapy, teens can examine what is stressing them and, with the help of a therapist, can begin to think differently about those stressors.

Depression often recurs. We encourage people to develop a support system of family, friends, and school contacts. We also try to help them see the value of engaging that system when things start to go bad, and not to wait until the situation feels intolerable.

Dr. Duplan is the attending child and adolescent psychiatrist in the Behavioral Services Unit at Cayuga Medical Center. He did his fellowship training in child and adolescent psychiatry at New York Presbyterian Hospital-Weill Medical College of Cornell University, where he remains a clinical instructor. He completed a residency in adult psychiatry at Albert Einstein College of Medicine at Bronx-Lebanon Hospital, following an internship in internal medicine at the State University of Haiti University Hospital.

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