What Is Depression?
Depression is a serious illness, not a harmless part of life. It is a complex disorder with a variety of causes. It is never caused by just one thing. It may be the result of a mix of factors, including genetic, chemical, physical, and sociological causes. It is also influenced by behavior patterns learned in the family and by cognitive distortions. Depression is not just an adult disorder; it affects as many as 5 percent of children in this country. It is always troubling, and for some children it can be disabling. Depression is more than just sadness or “the blues.” It can have an impact on nearly every aspect of a child’s or adolescent’s life. Children who suffer from depression may experience feelings of despair and worthlessness, and these can have an enormous impact on the child’s relationships. Several factors may cause depression in children and adolescents, and there are many different strategies for preventing it.
When a child or adolescent suffers from depression, it can affect every part of his or her life, including the physical body and behavior, thought processes, and mood. It also affects the child’s ability to relate to others.
What Are The Symptoms of Depression in Teens?
Depression in children and adolescents appears somewhat different from how it looks in adults. Children who are diagnosed with clinical depression have a combination of symptoms from the following list:
- Feeling sad, crying
- Isolating oneself from others
- Feeling hopeless, like a failure
- Anger, irritability, hostility
- Having a hard time getting along with others
- Fatigue, low energy
- Restlessness, boredom
- Greatly reduced interest or pleasure in most regular activities
- Low self-esteem, feeling worthless
- Excessive or inappropriate guilt
- Thinking distorted thoughts
- Feeling sick much of the time; headaches and stomachaches
- Change in appetite
- Change in sleeping patterns
- Excessive school absences
- Reduced ability to think or concentrate
- Doing poorly in school
- Running away from home
- Recurrent thoughts of death
- Suicidal thoughts
- A specific plan for committing suicide
- A suicide attempt
When a child or teen is suffering from depression, these symptoms cause significant distress or impairment in every important area of functioning. This means that the patient’s family and social relationships and work life are impaired. A child who once enjoyed playing with friends and participating in activities may become isolated and disinterested in almost everything. Adolescents are generally more verbal and may talk about death and suicide, while a younger child does not. Adolescents may also self-medicate by abusing alcohol and drugs. The symptoms may be more hostile than sad. If a child begins having problems getting along with others and gets into trouble frequently, it may be a sign of depression.
When a child or adolescent is suffering from depression, symptoms such as these are not the result of a chronic psychotic disorder, substance abuse, a general medical condition, or bereavement. Depression may include feelings of sadness, but it is not the same as sadness. Depression lasts much longer than sadness. While depression involves a loss of self-esteem, grief, disappointment, and sadness do not. Children or adolescents who are depressed function less productively. Kids who are sad or disappointed continue to function.
Who Becomes Depressed?
Depression strikes people in families of all ethnic groups, educational levels, and income. Some researchers believe that depression strikes more often in females who have a history of emotional and sexual abuse, economic deprivation, or are dependent on others. It also affects children who are experiencing stress and those with other emotional and learning disorders.
Depression tends to run in families, so it is more common among the parents, children, and siblings of people who are diagnosed with depression. The average age at the onset of a depressive episode is the mid-twenties. However, children and adolescents born more recently are being diagnosed at a younger age.
What Are The Physical Causes of Depression?
Many physicians believe that depression results from a chemical imbalance in the brain. They often prescribe antidepressant medication, and many patients find relief as a result. However, there is no reliable test to identify such a chemical imbalance. It is unknown whether life experiences cause mood changes, which create changes in brain chemistry; or whether the process works in reverse. Depression may be associated with physical events such as other diseases, physical trauma, and hormonal changes. A child or adolescent who is depressed should always have a physical examination as part of the assessment process to determine the role of physical causes.
What Is The Treatment For Depression?
It is important to get help as early as possible for a teen who shows signs of depression. Depression can be very serious and dangerous, and professional help is often needed. There are three basic ways to treat depression in children: individual psychotherapy, family therapy, and medication. Many children and adolescents respond best with a combination of two or more methods:
- Individual psychotherapy. A competent therapist can help the child recover from depression. With children, this may be done with the use of games and art therapy. It is important to consult a mental health professional who specializes in working with children or adolescents.
- Family therapy. Since the entire family is affected when a child or adolescent is depressed, everyone will benefit from treatment. An experienced therapist who specializes in working with families can help the family get through the crisis.
- Medication. One’s brain chemistry can be altered by taking antidepressant medication. A physician may recommend medication when the child’s depression is severe, if the child has been depressed before, and if there is a family history of depression. Four types of antidepressant medication are available today:
- Tricyclic antidepressants (TCAs)
- Monoamine oxidase inhibitors (MAOIs)
- Selective serotonin reuptake inhibitors (SSRIs)
- Structurally unrelated compounds
The TCAs and MAOIs have been used for decades. The SSRIs (such as Prozac) and structurally unrelated compounds are newer and are being prescribed more and more frequently today. They have fewer and less pronounced side effects than the TCAs and MAOIs.
When Is Professional Treatment Needed?
If a teen is depressed and exhibits any of the following signs, it is extremely important to seek the assistance of a medical or mental health professional:
- Thoughts about death or suicide. This is always dangerous. The patient should see a professional therapist immediately.
- Symptoms of depression continue for a long time. When this occurs, the patient may need professional help. Acute responses to events are normal, but they should not last beyond a reasonable time.
- The child’s ability to function is impaired by depression. Seek help before the patient’s life situation deteriorates to a serious level.
- The child or adolescent has become severely isolated. An isolated child has no one with whom to reality test. Advise that the patient seek someone out to share thoughts and feelings with. This could be a mental health professional, clergy member, teacher, or friend.
- Depressive symptoms have become severe.
How Can Depression Be Prevented?
Depression can often be prevented. It is especially important to take or more of the following preventive actions if a child or adolescent has predisposing factors such as those identified earlier:
- Help your child learn to manage stress. Kids can learn proven techniques for calming and relaxing themselves. They can learn these techniques by working with a therapist, taking a stress management class, or listening to relaxation tapes.
- Help your child learn problem-solving skills. Many kids and adolescents who develop depression need to learn better problem-solving skills. They need to develop the ability to view problems from many viewpoints and look for a variety of solutions.
- Help your child focus on the future. Depressed people tend to be focused on the past. People who set goals and focus on the future tend to be more positive about life.
- Show your teen how to strengthen emotional boundaries and set limits. Boundaries define a person’s role in a social situation. They determine how one will and will not behave in given circumstances. Having clear, strong boundaries is empowering, while boundary violations make people feel victimized and helpless. Setting limits means having and enforcing rules for what behavior one expects in a relationship.
- Help your child build positive and healthy relationships. Encourage your child to think about what you need from others in relationships. Teach him or her to learn to read people and trust his or her instincts about whether or not they are positive influences.
- Help your child avoid isolation. Encourage your child to talk to you and others about what’s going on inside. If a person keeps his or her thoughts private, he or she may be unaware that they are distorted. Sharing thoughts with another person helps your teen become more objective.