Focus on Pediatrics - Not all signs of depression typical in teens
Routine screenings identify depressed teens
It is estimated that one in eight adolescents are depressed, although their level of depression is not all the same. Some have a mild depression they have lived with for so long they don't realize that they are supposed to feel any other way. At the other extreme, depression renders the teen nonfunctional or suicidal, says Lindy Garnett, MSW, director of Child and Family Mental Health Services at the National Mental Health Association in Alexandria, VA.
More than 'moody'
Teen depression often goes undiagnosed, because kids that age have an image of being sullen and moody. "What we may be seeing is the one-in-eight teen-ager with depression rather than that being a typical teenage mood. I am not sure that in the extreme that is typical of teen-agers, and there is a lot of missed depression," says Garnett.
It is important for counselors, teachers, coaches, parents, and others who interact with teens to be aware of the signs of depression. In that way, they can quickly identify any changes in a teen's behavior, because they know what his or her typical behavior is like vs. the way they are currently acting.
Symptoms include: hopelessness, a loss of interest in the activities they have previously been interested in, sleeping a lot or not sleeping, overeating or not eating, low energy, lack of enthusiasm, lowered academic performance, and missed school.
"There are also some signs that don't look like typical adult depression. For example, adolescent males that are depressed can appear very irritable and act out. They show irritability and agitation," says Garnett. Risk-taking behavior also is a sign of depression because the teen's feelings are blunted and he or she is trying to conjure up some kind of feeling by thrill seeking. Drug and alcohol use can also be a sign of depression.
If signs point to depression, a teen should be assessed for the illness. There are simple questionnaires that can be used to screen for depression. "Teens tend not to talk to their parents about what they are feeling. In fact, they tend not to talk about their feelings, period. They put them down on paper much better when asked about them," says Garnett.
Depression deters development
Identification and treatment of depression is very important in teens because there are many levels of development they need to conquer in order to grow into a successful, functioning adult. "If I am not functioning well, I don't have the energy to participate in my own life and develop the skills I need to be developing," explains Garnett.
Depressed teens who are irritable and agitated often act out in ways that put them in contact with law enforcement. Spending time in juvenile hall can have a detrimental effect on a teen's future. Poor school performance also impacts teens' lives by preventing them from being accepted at a good college, obtaining their career goals, or landing a good job. Depression also hampers relationship building. "One of the things adolescents do is build relationships and test their role in relationships. If they miss that because they have withdrawn, that makes those relationships in adulthood that much more difficult," says Garnett.
Depression can't be 'overcome'
It is important to remember that depression is a medical issue and doesn't just go away if overlooked. Teens don't grow out of depression, have circumstances in their lives change that makes them OK, or muster enough energy to pull themselves up by their bootstraps. "Most research indicates that the combination of counseling and medication for a pretty severe depression is best," says Garnett.
Factors contribute to disease
A variety of factors cause depression, biological and environmental. Teens whose parents suffer from depression or other mental illnesses are at greater risk than their peers who do not have a family history of depression.
A higher rate of depression also is found in teens who have experienced a traumatic event, have suffered a great loss, or must deal with difficult issues, such as a severe learning disability. "The general thinking is there is always some composite of these factors that all come together for a teen to truly end up with depression," says Garnett.
Routine screening is key
The best scenario for catching depression early and treating it would be for all middle-school and high-school students to be screened routinely for depression, says Garnett. Health care systems frequently conduct screenings for high-blood pressure, diabetes, and other health problems at various locations throughout the community, and could easily conduct depression screenings at schools, as well. "The assessment could weed out the teens who need a closer look. If the numbers are correct that one in eight teen-agers are depressed that is a lot of kids. In an average classroom, that would be about three to four kids," says Garnett.
Source
For more information on teen depression, contact
• Lindy Garnett, MSW, Director, Child and Family Mental Health Services, National Mental Health Association, 1021 Prince St., Alexandria, VA 22314-2971. Telephone: (800) 969-6642 or (703) 684-7722. Fax: (703) 684-5968.
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