Dr. Hal Pickett's Thoughts on Adolescent Depression

While we as a society are learning more and more about adolescent depression, it doesn't seem to be much help in decreasing rates of depression among teens.

Adolescent mental health, including depression, is getting a lot of attention in the media these days. New studies, new guidelines and greater awareness of teen depression are great, but won't decrease rates until we actually address symptoms in their own teens.

Many parents and professionals ask me whether depression is being over-diagnosed and if kids are just using it as an excuse. Maybe. I don't know for sure. But what I do know is that depression is very different than being deeply sad about something, grieving about a loss or low motivation. I usually tell parents and adolescents that sometimes depression feels very similar to the flu, but the treatment is different.

The signs of adolescent depression are fairly common to all: a drop in grades despite spending seemingly adequate time trying to get homework completed; being tired all the time despite sleeping enough; deciding that being with friends takes too much energy; seeming spaced-out or overly sensitive to minor irritations.

One tell-tale symptom of a depressed teen is a sad or irritable mood  - they don't appear angry at the world, but more overwhelmed with a tendency to react to simple stressors.  It is kind of like a cornering a vulnerable animal; they act aggressively to defend themselves from what is interpreted as an attack.

Other symptoms include hopelessness and helplessness. There may be a loss of appetite that looks more like hunger just does not emerge to remind them to eat. Or there can be overeating which looks more like mindless eating, not necessarily because the adolescent is overly hungry. The adolescent may want to sleep all the time or they may try, and not be able to sleep. They may have passive hopeless kind of thoughts like "why do anything;  why am I alive" or very active thoughts of self harm or suicide.

Luckily, some of the most effective treatments for depression are fairly simple: exercise, healthy eating, healthy sleep hygiene, being socially active. Research has shown that therapy helps adolescent depression as well, but your adolescent must connect with his or her therapist for it to be effective.

Medication also can be helpful for some. But it in this case, it is important to work with a physician or Child and Adolescent Psychiatrist who is comfortable treating depression and understands that  sometimes the first try at an antidepressant is not the right one for your adolescent   Unfortunately, treating depression with medication is not like treating an infection. There is some trial and error in finding the medication that will work with, not against, their brain chemistry.

The most important thing is to not let your depressed adolescent "check out." That tends to make the depression worse. And help them get the appropriate treatment they need, whether it's changing lifestyle, therapy or meds - or some combination of the three.  Untreated, depression can result in "self medication" with drugs and alcohol, missing important academic and developmental milestones, becoming an adolescent who never rises to their full potential, or the most serious -- self-injury or suicide.

So ask for help for your adolescent. Find someone they can connect with, someone they trust,  like a school counselor, pastor or teacher who can help immediately, or connect them to more intensive treatment if necessary. But do not ignore the signs and symptoms, because they can be deadly. 

For more information about how Headway can help your teen and family, click here.