The advent of modern antidepressant medication has been a lifesaver to many.

Recent research demonstrates that a combination of counselling and medication can provide the most effective treatment for youth suffering from depression. However, there is evidence to suggest that in the early stages of medication treatment, there is an elevated risk of suicidal thought, which for some persons may lead to suicidal behaviour. This is causing a great many people to reconsider their use of medication, even when indicated. This issue is determining which youth will benefit from one or the other or both treatments. To this end a good assessment will look for exogenous factors and endogenous factors. Exogenous factors are those things outside of the individual that may contribute to depression. These include; family dysfunction, abuse or neglect, parental separation, school related problems and relationship problems. If it can be determined that one or more of these kinds of factors are at play, then counselling alone may be sufficient to treat depression. Such counselling includes family therapy, or in the case of separated and fighting parents, mediation to help them resolve their conflict, so that the youth is no longer subject to their turmoil. If the youth is in a difficult interpersonal relationship, then counselling for the youth to address the difficulty may be in order. If the youth is abused or neglected, these issues must be addressed and the youth's safety must be attained. Endogenous factors generally relate to biological or neurobiochemical factors. If there is a history of depression in the family and there are no known endogenous factors, then medication alone may be the treatment of choice. Often though, with endogenous depression, the sufferer has difficulty controlling depressive thoughts and as such, in this situation a very specific form of counselling, CBT or Cognitive Behavioural Therapy, is also indicated. There are times of course when both endogenous and exogenous factors are at play. In these circumstances a combination of counselling and medication could be in order and should seriously be considered. Parents and youth are cautioned against making their decision solely on the basis of newspaper articles proclaiming the good or the bad about any treatment. Depression is a serious disorder, which left untreated can lead to suicidal thoughts, action, injury and death. If you or your child is depressed, obtain a good assessment by qualified professionals that will look at both endogenous and exogenous factors and devise a treatment plan accordingly. Further, the counsellor and the prescribing physician should be working hand-in-glove following the individual to manage safety issues and communicating regularly about progress. It is important to know that with antidepressant medication, it can take a good thirty days before the therapeutic effect is achieved. During this time, counselling may be of benefit to resolve other issues as listed above or to simply provide support until the medication reaches effectiveness. If you or your child is depressed, get help. It is often advisable to start with your family doctor or community clinic. A physician can make the diagnosis and direct you to treatment.

Teen Depression A GUIDE FOR PARENTS AND TEACHERS

and the development of a strong sense of self. but most teens balance the requisite angst with good friendships. teacher. Depression can destroy the very essence of a teenager’s personality. success in school or outside activities. despair. teen depression can lead to problems at home and school. there are many things you can do to help. self-loathing— even irreversible tragedy such as homicidal violence or suicide. the teen years are tough. Yes. . or friend. Fortunately. teenage depression can be treated. drug abuse. Occasional bad moods or acting out is to be expected. and as a concerned parent. or anger. causing an overwhelming sense of sadness. Depression is a serious problem that impacts every aspect of a teen’s life. Talking about the problem and offering support can go a long way toward getting your teenager back on track. In This Article: Understanding teen depression Signs and symptoms Effects of teen depression Suicide warning signs in teenagers Helping a depressed teenager Risks of teenage antidepressant use Supporting a teen through treatment Taking care of the whole family Related links Print Authors Text Size Understanding teen depression There are as many misconceptions about teen depression as there are about teenagers in general. You can start by learning the symptoms of depression and expressing concern when you spot warning signs. but depression is something different. Left untreated.Teenage depression isn’t just bad moods and occasional melancholy.

from the changes of puberty to questions about who they are and where they fit in. aggression. For Teens: If you’re a teenager struggling with depression or you’d like to learn how to help a depressed friend. it’s important to learn what teen depression looks like and what to do if you spot the warning signs. experts say only 20% of depressed teens ever receive help. teenagers usually must rely on parents. or hostility Tearfulness or frequent crying Withdrawal from friends and family Loss of interest in activities . SIGNS AND SYMPTOMS OF DEPRESSION IN TEENS Sadness or hopelessness Irritability. Signs and symptoms of teen depression Teenagers face a host of pressures. teachers. and rage are more prominent. the fact is that depression strikes teenagers far more often than most people think. Making things even more complicated. or other caregivers to recognize their suffering and get them the treatment they need. Unlike adults. For some depressed teens. The natural transition from child to adult can also bring parental conflict as teens start to assert their independence. who have the ability to seek assistance on their own.Whether the incidence of teen depression is actually increasing. anger. And although depression is highly treatable. it isn’t always easy to differentiate between depression and normal teenage moodiness. symptoms of irritability. So if you have an adolescent in your life. teens with depression do not necessarily appear sad. see Dealing with Teen Depression: Tips and Tools for Teens. or we’re just becoming more aware of it. With all this drama. nor do they always withdraw from others.

is often the predominant mood in depressed teens. dramatic. The following symptoms of depression are more common in teenagers than in their adult counterparts: Irritable or angry mood – As noted above. irritability. mood. While some “growing pains” are to be expected as teenagers grapple with the challenges of growing up. This is a particular problem for “over-achievers. A depressed teenager may be grumpy. easily frustrated. . these aches and pains may indicate depression. rather than sadness. teenagers usually keep up at least some friendships.Changes in eating and sleeping habits Restlessness and agitation Feelings of worthlessness and guilt Lack of enthusiasm and motivation Fatigue or lack of energy Difficulty concentrating Thoughts of death or suicide If you’re unsure if an adolescent in your life is depressed or just “being a teenager.” consider how long the symptoms have been present. and failure. and how different the teen is acting from his or her usual self. Extreme sensitivity to criticism – Depressed teens are plagued by feelings of worthlessness. making them extremely vulnerable to criticism. If a thorough physical exam does not reveal a medical cause. how severe they are. rejection. or behavior are red flags of a deeper problem. long-lasting changes in personality.” Withdrawing from some. hostile. or prone to angry outbursts. but not all people – While adults tend to isolate themselves when depressed. The difference between teenage and adult depression Depression in teens can look very different from depression in adults. Unexplained aches and pains – Depressed teens frequently complain about physical ailments such as headaches or stomachaches. However.

. Low self-esteem Depression can trigger and intensify feelings of ugliness. Effects of teen depression The negative effects of teenage depression go far beyond a melancholy mood. bulimia. failure. Such attempts are usually a cry for help. pull away from their parents. and yo-yo dieting are often signs of unrecognized depression. At school. binge eating. substance abuse only makes things worse. and unworthiness. or start hanging out with a different crowd. See the table below for some of the ways in which teens “act out” or “act in” in an attempt to cope with their emotional pain: Untreated Depression Can Lead to… Problems at school Depression can cause low energy and concentration difficulties. Eating disorders Anorexia. this may lead to poor attendance.teens with depression may socialize less than before. shame. or frustration with schoolwork in a formerly good student. Unfortunately. Running away Many depressed teens run away from home or talk about running away. a drop in grades. Many rebellious and unhealthy behaviors or attitudes in teenagers are actually indications of depression. Substance abuse Teens may use alcohol or drugs in an attempt to “self-medicate” their depression.

Self-injury Cutting. But excessive computer use only increases their isolation and makes them more depressed. As in the case of the Columbine school massacre. and other kinds of self-mutilation are almost always associated with depression. Reckless behavior Depressed teens may engage in dangerous or high-risk behaviors. speak. and unsafe sex. suicide is the third leading cause of death for 15 to 24-year-olds. the risk of suicide is even greater. burning. Violence Some depressed teens (usually boys who are the victims of bullying) become violent. To learn more. Suicide Teens who are seriously depressed often think.Internet addiction Teens may go online to escape from their problems. or make "attention-getting" attempts at suicide. According to the Centers for Disease Control and Prevention (CDC). out-of-control drinking. such as reckless driving. Suicidal thoughts or behaviors should always be taken very seriously. depression or another psychological disorder plays a primary role. self-hatred and a wish to die can erupt into violence and homicidal rage. For the overwhelming majority of suicidal teens. Suicide warning signs in teenagers An alarming and increasing number of teenagers attempt and succeed at suicide. see Helpguide’s Self-Injury. In depressed teens who also abuse alcohol or drugs. .

“I’d be better off dead. Seeking out weapons. so don’t wait and hope that the symptoms will go away. people might love me more”). and what to do in a crisis.” Speaking positively about death or romanticizing dying (“If I died. take immediate action! For 24hour suicide prevention and support. the troublesome behaviors and emotions you’re seeing in your teenager are signs of a problem.” or “There’s no way out. teenagers who are depressed should be watched closely for any signs of suicidal thoughts or behavior. If you suspect that a teenager you know is suicidal. Giving away prized possessions. warning signs. To learn more about suicide risk factors. Even if you’re unsure that depression is the issue. pills. Saying things like. or other ways to kill themselves. Writing stories and poems about death. The warning signs include: Talking or joking about committing suicide. take action right away. Helping a depressed teenager If you suspect that a teenager in your life is suffering from depression. Depression is very damaging when left untreated. call the National Suicide Prevention Lifeline at 1-800-273-TALK. Talk to your teen . Whether or not that problem turns out to be depression. Engaging in reckless behavior or having a lot of accidents resulting in injury.Because of the very real danger of suicide. see Helpguide’s Suicide Prevention: Understanding and Helping a Suicidal Person. Saying goodbye to friends and family as if for good. dying.” “I wish I could disappear forever. it still needs to be addressed—the sooner the better. or suicide.

Remember that denial is a strong emotion.The first thing you should do if you suspect depression is to talk to your teen about it. If you see depression’s warning signs. Hold back from asking a lot of questions (teenagers don’t like to feel patronized or crowded). but has no explanation for what is causing the depressed behavior. seek . If you don’t. Avoid offering unsolicited advice or ultimatums as well. Then encourage your child to open up about what he or she is going through. If your teen claims nothing is wrong. The important thing is that your child is communicating. but make it clear that you’re ready and willing to provide whatever support they need. even if their feelings or concerns appear silly or irrational to you. Validate feelings Don’t try to talk teens out of their depression. Listen without lecturing Resist any urge to criticize or pass judgment once your teenager begins to talk. In a loving and non-judgmental way. fully and unconditionally. Furthermore. you should trust your instincts. they will feel like you don’t take their emotions seriously. Simply acknowledge the pain and sadness they are feeling. Be respectful of your child’s comfort level while still emphasizing your concern and willingness to listen. Be gentle but persistent Don’t give up if your adolescent shuts you out at first. teenagers may not believe that what they’re experiencing is the result of depression. TIPS FOR TALKING TO A DEPRESSED TEEN Offer support Let depressed teenagers know that you’re there for them. Talking about depression can be very tough for teens. Let him or her know what specific signs of depression you’ve noticed and why they worry you. share your concerns with your teenager.

The doctor should also be told about any close relatives who have ever been diagnosed with depression or another mental health disorder. particularly when it comes to treatment options such as medication. . and medications (including birth control pills and diet pills). a lack of sleep. a poor diet (especially one low in iron). Depression in teens can be tricky. and any patterns you’ve noticed. In order to diagnose depression. including how long they’ve been present. how much they’re affecting your child’s daily life. Visit your family doctor Make an immediate appointment for your teen to see the family physician for a depression screening. The doctor will check for medical causes of the depression by giving your teenager a complete physical exam and running blood tests. the doctor will give your teenager a complete physical exam and take blood samples to check for medical causes of your child’s symptoms. including heavy alcohol and drug use. Seek out a specialist Finding help for your teen Click here to search for a psychiatrist who specializes in children and teens. The doctor may also ask your teen about other things that could be causing the symptoms. Neither you nor your teen is qualified to either diagnosis depression or rule it out. other possible causes of your teen’s symptoms must first be ruled out. ask your doctor to refer you to a psychologist or psychiatrist who specializes in children and adolescents.professional help. As part of the depression screening. A mental health professional with advanced training and a strong background treating adolescents is the best bet for your teenager’s best care. so see a doctor or psychologist who can. Source: American Academy of Child & Adolescent Psychiatry If there are no health problems that are causing your teenager’s depression. Be prepared to give your doctor specific information about your teen’s depression symptoms.

behavior management techniques. Explore the treatment options Expect a discussion with the specialist you’ve chosen about treatment possibilities for your son or daughter. Don't rely on medication alone When medication is used. However. as well as family therapy and other approaches should be considered. educational classes. it should not be the only strategy. it should be monitored and evaluated regularly. always get your child’s input. However. unless your child is considered to be high risk for suicide (in which case medication and/or constant observation may be necessary). There are a number of treatment options for depression in teenagers. If your child feels uncomfortable or is just not ’connecting’ with the psychologist or psychiatrist. If medication is prescribed. If it doesn’t. Family support services. Teenagers are dependent on you for making many of their health decisions. ask for a referral to another provider that may be better suited to your teenager. antidepressants should only be used as part of a broader treatment plan. your teen’s depression may resolve.When choosing a specialist. some parents feel pushed into choosing antidepressant medication over other treatments that may be cost-prohibitive or time-intensive. Source: National Institute of Mental Health Unfortunately. group or family therapy. including one-on-one talk therapy. so listen to what they’re telling you. No one therapist is a miracle worker and no one treatment works for everyone. you have time to carefully weigh your options before committing to any one treatment. Over the course of therapy. There are other services that you may want to investigate for your child. Risks of teenage antidepressant use . and medication. medication may be warranted. Talk therapy is often a good initial treatment for mild to moderate cases of depression.

and exposure to antidepressants may impact that development— particularly the way the brain manages stress and regulates emotions. developing brain is not yet completely understood. being angry. The human brain is developing rapidly in young adults. or violent Acting on dangerous impulses Being extremely hyperactive in actions and talking (hypomania or mania) . including a number of safety concerns specific to children and young adults. Antidepressants and the teenage brain Antidepressants were designed and tested on adults.In severe cases of depression. so their impact on the youthful. Antidepressant suicide warning for teens Teens on Antidepressants: Red Flags To Watch Out For Call a doctor if you notice… New or more thoughts of suicide Trying to commit suicide New or worse depression New or worse anxiety Feeling very agitated or restless Panic attacks Difficulty sleeping (insomnia) New or worse irritability Acting aggressive. They come with risks and side effects of their own. medication may help ease symptoms. Some researchers are concerned that the use of drugs such as Prozac in children and teens might interfere with normal brain development. However. It’s important to weigh the benefits against the risks before starting your teen on medication. antidepressants aren’t always the best treatment option.

Warning signs include new or worsening symptoms of agitation. or a history of previous suicide attempts. irritability. Certain young adults are at an even greater risk for suicide when taking antidepressants.S. Food and Drug Administration (FDA) to carry a “black box” warning label about this risk in children. Unusual changes in behavior are also red flags. a family history of bipolar disorder. including teens with bipolar disorder. According to FDA guidelines. your teenager should see their doctor: Once a week for four weeks Every 2 weeks for the next month At the end of their 12th week taking the drug More often if problems or questions arise . or anger. adolescents. The risk of suicide is highest during the first two months of antidepressant treatment.Other unusual changes in behavior Antidepressant medications may increase the risk of suicidal thinking and behavior in some teenagers. after starting an antidepressant or changing the dose. All antidepressants are required by the U. and young adults up to the age of 24. Teenagers on antidepressants should be closely monitored for any sign that the depression is getting worse.

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