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Depression in Teenagers: Now What Can We Do?
No doubt you have seen the recent news headlines about a federal panel that recommended to the FDA that anti-depressant medications carry the strongest possible warning label for use in children and teenagers. This recommendation to the FDA shook the medical community, especially those who work with depressed young people. The biggest problem from the treatment community's point of view was not the recommendation for the warning label, but the way that the media protrayed the panel's recommendation. The panel reported that 2% to 4% of children and teens who were given anti-depressants for the treatment of depression became suicidal, that is they had suicidal thoughts, or made suicidal attempts of one kind or another. None of the 4,000 children and teens studied committed suicide. What the media did not report well is the fact that 15% of children and teens with depression who receive no treatment will commit suicide. These 15% will not just think about it, but will actually kill themselves. So what are we to do? If the media had their way it seems that no teens with depression would receive anti-depressants. As a result the suicide rate for those who could be using the medication would rise from nearly zero percent to about fifteen percent. But at least we wouldn't have to be concerned about evil medications. Look, I understand that there actually are young people, even adults, who have become suicidal only after beginning treatment with an anti-depressant. Some have in fact gone on to take their own lives. This is absolutely tragic. But so is the fact that untreated depression is potentially a fatal disease. Fifteen out of one hundred young people with depression take their own lives. They should be allowed to receive a treatment that will lower the suicide rate dramatically, and without any stigma attached to it by the media. Recently we had a patient brought to our counseling center named John (not his real name). John was rebellious, angry, withdrawn, and in trouble often, and yet he was diagnosed and treated for depression. When we think of someone who is depressed, we usually picture a sad, tearful, lonesome person. But teenagers with depression don't look like adults with depression. Current studies show that there are about as many teenagers who are depressed as there are adults that are depressed. However, depression is exhibited far differently by teenagers than by adults. Teenagers do not commonly display gloom, self-depreciation, or talk about feeling hopeless like adults do. Teenagers with Major Depression are described in diagnostic manuals as often becoming negative and antisocial. Feelings of wanting to leave home, or of not being understoodand approved of increase. The teen often changes, and becomes more restless, grouchy, or aggressive. A reluctance to cooperate in family ventures, and withdrawal from social activities, with retreat to one's room are frequent. School difficulties are likely as concentration is affected. Sometimes there is inattention to personal appearance and increased emotionality. Often there is an increased sensitivity to rejection in love relationships as well. Teenage boys will often become aggressive, agitated, and get into trouble at home, at school, or with the law. Teenage girls will sometimes become preoccupied with themes of death or dying, and become decreasing concerned about how they look. Suicidal thoughts are common. Some studies suggest that 500,000 teens attempt suicide each year, and 5000 are successful. Increased use of alcohol or other drugs is common, along with other forms of "self-destructive behaviors." Poor self-esteem is common with teenagers, but especially with those who are depressed. Parents are often confused and frustrated when their teens begin to act like this. Sometimes parents become stern disciplinarians, or even put the teen down, which only serves to increase feelings of guilt and depression. Other times, parents feel helpless, and stand by waiting for adulthood to arrive. Of course neither course is the right one to take. If you know of a teen whose behaviors have changed to look like what has been described above, let the parents know that there is help available, and encourage the family to seek help from a professional. With proper diagnosis and treatment a depressed teen, or adult, can be greatly helped. If someone close to you is suffering from depression, first please understand that depression is a very emotionally painful condition. For some people with depression it turns into a "terminal illness" due to suicide. Please take the situation seriously. 1) Get a medical evaluation. Symptoms of depression can be the result of a wide assortment of illnesses, including thyroid problems, viral infections, and other factors. 2) Deprex is an amino acid and homeopathic medicine for the treatment of depression that we have seen work well with our patients. It may be worth trying as long as the situation is "stable" and there is no suicidal thinking on the part of the depressed person. 3) Medications such as Prozac can be very helpful for more difficult cases. Consult your doctor. These medications are often prescribed by Family Practice Doctors, but in most cases ought to be monitored by Psychiatrists. 4) Increase intake of Protein somewhat. Use a protein powder supplement, just like a weight lifter. 5) Exercise daily. Just get out and walk for about 15 minutes. 6) Seek out counseling from someone who is good at treating depression. This can do a world of good for you. However, always use great wisdom and common sense when choosing a therapist. Some are good, and some are not, so choose wisely. Douglas Cowan, Psy.D., is a family therapist who has been working with ADHD children and their families since 1986. He is the clinical director of the ADHD Information Library's family of seven web sites, including http://www.newideas.net, helping over 350,000 parents and teachers learn more about ADHD each year. Dr. Cowan also serves on the Medical Advisory Board of VAXA International of Tampa, FL., is President of the Board of Directors for KAXL 88.3 FM in central California, and is President of NewIdeas.net Incorporated.
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