Teen Depression
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Teen Depression - Boys
What is
Depression? Depression is a serious medical illness; it’s not something that you make up in your head. More than a feeling of being “down in the dumps” or “blue” for a few days, the symptoms of Depression are severe and debilitating. Depression is characterized by feeling “down,” “low” and “hopeless” for weeks at a time. Factors that can contribute to the onset of Depression include stress, poor nutrition, physical illness, personal loss, relationship difficulties and the presence of other physical disorders. Depression isn’t always easy to detect, and people with depressive conditions can experience different symptoms. It may be expressed through lack of appetite or overeating; insomnia or an unnatural desire to sleep; the abuse of drugs and alcohol; sexual promiscuity; or hostile, aggressive, or risk-taking behavior. Depression (major depressive disorder) is a common and serious medical illness that negatively affects how you feel, the way you think and how you act. Fortunately, it is also treatable. Depression causes feelings of sadness and/or a loss of interest in activities once enjoyed. It can lead to a variety of emotional and physical problems and can decrease a person’s ability to function at work and at home. Depression symptoms can vary from mild to severe and can include
Symptoms must last at least two weeks for a diagnosis of depression. Also, medical conditions (e.g., thyroid problems, a brain tumor or vitamin deficiency) can mimic symptoms of depression so it is important to rule out general medical causes. Depression affects an estimated one in 15 adults (6.7%) in any given year. And one in six people (16.6%) will experience depression at some time in their life. Depression can strike at any time, but on average, first appears during the late teens to mid-20s. Women are more likely than men to experience depression. Some studies show that one-third of women will experience a major depressive episode in their lifetime. Depression Is Different From Sadness or Grief/Bereavement The death of a loved one, loss of a job or the ending of a relationship are difficult experiences for a person to endure. It is normal for feelings of sadness or grief to develop in response to such situations. Those experiencing loss often might describe themselves as being “depressed.” But being sad is not the same as having depression. The grieving process is natural and unique to each individual and shares some of the same features of depression. Both grief and depression may involve intense sadness and withdrawal from usual activities. They are also different in important ways:
Risk Factors for Depression Depression can affect anyone—even a person who appears to live in relatively ideal circumstances. Several factors can play a role in depression:
How Is Depression Treated? Depression is among the most treatable of mental disorders. Between 80% and 90% of people with depression eventually respond well to treatment. Almost all patients gain some relief from their symptoms. Before a diagnosis or treatment, a health professional should conduct a thorough diagnostic evaluation, including an interview and possibly a physical examination. In some cases, a blood test might be done to make sure the depression is not due to a medical condition like a thyroid problem. The evaluation is to identify specific symptoms, medical and family history, cultural factors and environmental factors to arrive at a diagnosis and plan a course of action. Medication: Brain chemistry may contribute to an individual’s depression and may factor into their treatment. For this reason, antidepressants might be prescribed to help modify one’s brain chemistry. These medications are not sedatives, “uppers” or tranquilizers. They are not habit-forming. Generally antidepressant medications have no stimulating effect on people not experiencing depression. Antidepressants may produce some improvement within the first week or two of use. Full benefits may not be seen for two to three months. If a patient feels little or no improvement after several weeks, his or her psychiatrist can alter the dose of the medication or add or substitute another antidepressant. In some situations other psychotropic medications may be helpful. It is important to let your doctor know if a medication does not work or if you experience side effects. Psychiatrists usually recommend that patients continue to take medication for six or more months after symptoms have improved. Longer-term maintenance treatment may be suggested to decrease the risk of future episodes for certain people at high risk. Psychotherapy: Psychotherapy, or “talk therapy,” is sometimes used alone for treatment of mild depression; for moderate to severe depression, psychotherapy is often used in along with antidepressant medications. Cognitive behavioral therapy (CBT) has been found to be effective in treating depression. CBT is a form of therapy focused on the present and problem solving. CBT helps a person to recognize distorted thinking and then change behaviors and thinking. Psychotherapy may involve only the individual, but it can include others. For example, family or couples therapy can help address issues within these close relationships. Group therapy involves people with similar illnesses. Depending on the severity of the depression, treatment can take a few weeks or much longer. In many cases, significant improvement can be made in 10 to 15 sessions. Electroconvulsive Therapy (ECT) is a medical treatment most commonly used for patients with severe major depression or bipolar disorder who have not responded to other treatments. It involves a brief electrical stimulation of the brain while the patient is under anesthesia. A patient typically receives ECT two to three times a week for a total of six to 12 treatments. ECT has been used since the 1940s, and many years of research have led to major improvements. It is usually managed by a team of trained medical professionals including a psychiatrist, an anesthesiologist and a nurse or physician assistant. Self-help and Coping There are a number of things people can do to help reduce the symptoms of depression. For many people, regular exercise helps create positive feeling and improve mood. Getting enough quality sleep on a regular basis, eating a healthy diet and avoiding alcohol (a depressant) can also help reduce symptoms of depression. Depression is a real illness and help is available. With proper diagnosis and treatment, the vast majority of people with depression will overcome it. If you are experiencing symptoms of depression, a first step is to see your family physician or psychiatrist. Talk about your concerns and request a thorough evaluation. This is a start to addressing mental health needs. Related Conditions
References American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Fifth edition. 2013. National Institute of Mental Health. (Data from 2013 National Survey on Drug Use and Health.) Kessler, RC, et al. Lifetime
Prevalence and Age-of-Onset Distributions of DSM-IV
Disorders in the National Comorbidity Survey Replication.
Arch Gen Psychiatry. 2005;62(6):593602. According to the 5 th edition of the DSM, a person must exhibit at least five of the following characteristics to be diagnosed with a depressive disorder:
The above represent a "major
depressive episode". The other two criteria as stated by
DSM-5 is that "the occurrence of the major depressive
episode is not better explained by schizoaffective disorder,
schizophrenia, schizophreniform disorder, delusional
disorder, or other specified and unspecified schizophrenia
spectrum and other psychotic disorders" and there has never
been "a manic episode or a hypomanic episode." What are the
symptoms of Depression? • Loss of energy and
interest. Think you might be suffering from
depression? Try one of these free online quizes:
Depression-screening.org
10 Ways to Help When
Your Child is Depressed 1. Recognize that clinical depression is a disease. Internalizing this fact will help your child in two ways. One, it will hopefully keep you from blaming yourself or your child. This is no one’s fault. Second, if you think of depression as a disease instead of a choice your child is making, you won’t say anything thoughtless like, “Why don’t you just pull yourself together,” or “Stop feeling sorry for yourself.” 2. Don’t freak out. This will definitely not help your child. Clinical depression can be successfully treated more than 80% of the time. As long as your child has a good doctor and supportive parents, he or she has a very good chance of recovering. Notice that last part – while everyone with depression really needs a good doctor, supportive parents are absolutely critical for a child with depression. 3. Do your homework. Read up about depression – symptoms, causes and treatment. The more you know, especially about treatment options, the more effectively you can advocate for your child in the health care system and at school. 4. Let your child know that it’s okay to be depressed. Children tend to hide things from parents that they think will upset them. Make it clear to your child that nothing they could say is as upsetting to you as being unable to help them because they’re afraid to hurt you. 5. Talk to your child frequently. This sounds like a tall order. Any parent who’s ever asked, “How was school?” and got the response, “Fine” knows that children can be reticent. And when someone’s depressed, talking is often the last thing they want to do. Provide some low-stress, low-distraction opportunities, like taking a walk or preparing a meal together, for your child to talk to you. 6. Be your child’s advocate in the health care system. Make sure that their doctor is knowledgeable, caring and someone who really listens. Take charge your child’s treatment. Ensure that your child keep appointments and takes the prescribed medication. You may have to be tough and persistent, but treatment, either medication or therapy or both, is the only thing that will make any difference. 7. Don’t be afraid of the “S” word. You may be afraid to ask your child if they are having suicidal thoughts, assuming that you will put the idea in their head. Don’t worry. Either they are already having suicidal thoughts, in which case it may be a big relief to talk about it. If they haven’t, talking about it openly will allow them to bring the subject up again if this changes. And please note that even children younger than 12 do commit suicide. 8. Encourage your child to socialize. Even though someone who’s depressed may shun gatherings, be persistent. Contact with friends and family provides a support system that is essential to someone with depression. 9. Encourage your child to enter therapy. Talk therapy, especially Cognitive Behavioral Therapy, can help your child break out of negative and self-hating thought patterns that are generated by depression. 10. Be patient. This won’t turn around overnight.
If you feel like you need help coping with the situation,
you might want to try individual therapy or family
counseling. Tips for Parents
Who Want to Talk to Children About Depression If you decide to talk about depression with your child, you may be concerned about saying the "right" thing. However, just having an open and honest discussion with your child can provide her with much-needed support. With a few tips, concerned parents and caregivers can confidently talk about depression with their children. Keep the Talk Age Appropriate You want to make sure that your child understands what you are saying and is not confused or bored by the discussion. Make sure that you are using words that your child can understand. Words such as "depression" or "emotional reaction" are probably too complex for a younger child but may be appropriate for an older child or adolescent. Try comparing her depression to something that your child is already familiar with --- like another illness that your child has had experience with (e.g., flu, ear infection, etc.) Keep the Conversation Positive Keeping your depression discussion positive does not mean that you should sugar-coat it. Depression is a serious illness that causes emotional and physical pain, and it can have serious consequences. However, if you maintain a positive and hopeful outlook in your discussions, you will avoid unnecessarily alarming your child. Be Honest In talking about depression, do not make promises you cannot keep or go into detail about topics that you are not certain of. Instead, tell your child what you do know, and make a list of questions to discuss with your child's mental health professional. Be Compassionate Your child needs to know that you recognize and respect his feelings. Even if you do not quite understand his thoughts, avoid quipping, "What do you have to be depressed about?" or "Don't be ridiculous." Comments like these just cause a child to keep his feelings to himself or become defensive. Be a Good Listener Allow your child to talk openly and express his opinions and thoughts. Avoid interrupting, judging or punishing him for his feelings. Knowing that he has someone he can confide in help to sort out his feelings. While talking to your child about his depression can be a very important part of his recovery, it does not replace the need for professional treatment. If your child is depressed or you suspect depression, consult with his pediatrician or other mental health professionals for accurate diagnosis and treatment. Sources: Feelings Need Check Ups Too. American Academy of Pediatrics. Communicating
With Your Child. American Academy of
Pediatrics.
Stress
in America: Talking With Your Children About
Stress. Unexpected
Symptoms of Teen Depression What does depression in teens look like? Adults expect teen depression to show up as a pervasive sense of sadness and withdrawal, and sometimes it does. But what most adults don't know is that in teens, depression is more likely to show up as angry or irritable behavior. A teen who is yelling at others, grumpy, easily frustrated, defiant or quick to snap at a parents' benign comments may in fact be suffering from depression. In addition to anger and irritability, teens suffering from depression may also exhibit the following symptoms: 1. Health problems such as a chronic headache or stomachache. Unexplained health problems are often a sign of depression in teens, who are likely to experience sadness as a physical sensation. Other complaints include feeling dizzy or nauseated. If your teen has such complaints, have them initially checked out by an MD. In cases where no physical illness is detected, depression may be the reason for these symptoms. 2. A change in social interactions or patterns. Depressed adults tend to withdraw from others, but this is less likely to happen with teens, who build their lives around interactions with peers. Sudden or significant changes in a teen's participation with others can signal depression. This can include changing friends, spending less time in activities with peers or being alone more often. 3. Very low self-esteem. Depressed teens are likely to react badly to any negative event, perceiving failure or apparent criticism of them. A seemingly small failure may be perceived as substantial and reinforce their sense of negativity and poor self-worth. A benign comment may be blown out of proportion by the teen. Teen depression can manifest in many different ways and therefore the presence of depression should always be considered as part of the assessment and treatment of a teen who is exhibiting troubling behaviors. Quick Link: Parent's
Guide to Teen Depression
Depression
Symptoms and Warning Signs Feeling down from time to time is a normal part of life, but when emotions such as hopelessness and despair take hold and just won't go away, you may have depression. Depression makes it tough to function and enjoy life like you once did. Just getting through the day can be overwhelming. But no matter how hopeless you feel, you can get better. Learning about depression—and the many things you can do to help yourself—is the first step to overcoming the problem. How do you experience depression? While some people describe depression as “living in a black hole” or having a feeling of impending doom, others feel lifeless, empty, and apathetic. Men in particular may even feel angry and restless. No matter how you experience it, depression is different from normal sadness in that it engulfs your day-to-day life, interfering with your ability to work, study, eat, sleep, and have fun. Some people feel like nothing will ever change. But it’s important to remember that feelings of helplessness and hopelessness are symptoms of depression—not the reality of your situation. You can do things today to start feeling better. What are the symptoms of depression? Depression varies from person to person, but there are some common signs and symptoms. It’s important to remember that these symptoms can be part of life’s normal lows. But the more symptoms you have, the stronger they are, and the longer they’ve lasted—the more likely it is that you’re dealing with depression. Symptoms of depression include:
Is it depression or bipolar disorder? Bipolar disorder, also known as manic depression, involves serious shifts in moods, energy, thinking, and behavior. Because it looks so similar to depression when in the low phase, it is often overlooked and misdiagnosed. This is a problem, because antidepressants for bipolar depression can make the condition worse. If you’ve ever gone through phases where you experienced excessive feelings of euphoria, a decreased need for sleep, racing thoughts, and impulsive behavior, consider getting evaluated for bipolar disorder. See: Bipolar Disorder Signs and Symptoms. Depression and suicide risk Depression is a major risk factor for suicide. The deep despair and hopelessness that goes along with depression can make suicide feel like the only way to escape the pain. If you have a loved one with depression, take any suicidal talk or behavior seriously and watch for the warning signs:
If you think a friend or family member is considering suicide, express your concern and seek help immediately. Talking openly about suicidal thoughts and feelings can save a life. The symptoms of depression can vary with gender and age Depression often varies according to age and gender, with symptoms differing between men and women, or young people and older adults. Depression in men. Depressed men are less likely to acknowledge feelings of self-loathing and hopelessness. Instead, they tend to complain about fatigue, irritability, sleep problems, and loss of interest in work and hobbies. They’re also more likely to experience symptoms such as anger, aggression, reckless behavior, and substance abuse. Types of depression Depression comes in many shapes and forms. Knowing what type of depression you have can help you manage your symptoms and get the most effective treatment. Major depression Depression causes and risk factors While some illnesses have a specific medical cause, making treatment straightforward, depression is more complicated. Depression is not just the result of a chemical imbalance in the brain that can be simply cured with medication. It’s caused by a combination of biological, psychological, and social factors. In other words, your lifestyle choices, relationships, and coping skills matter just as much—if not more so—than genetics. Risk factors that make you more vulnerable to depression include:
The cause of your depression helps determine the treatment Understanding the underlying cause of your depression may help you overcome the problem. For example, if you are depressed because of a dead end job, the best treatment might be finding a more satisfying career, not taking an antidepressant. If you are new to an area and feeling lonely and sad, finding new friends will probably give you more of a mood boost than going to therapy. In such cases, the depression is remedied by changing the situation. What you can do to feel better When you’re depressed, it can feel like there’s no light at the end of the tunnel. But there are many things you can do to lift and stabilize your mood. The key is to start with a few small goals and slowly build from there, trying to do a little more each day. Feeling better takes time, but you can get there by making positive choices for yourself. What you can do Reach out to other people. Isolation fuels depression, so reach out to friends and loved ones, even if you feel like being alone or don’t want to be a burden to others. The simple act of talking to someone face-to-face about how you feel can be an enormous help. The person you talk to doesn’t have to be able to fix you. He or she just needs to be a good listener—someone who’ll listen attentively without being distracted or judging you. Get moving. When you’re depressed, just getting out of bed can seem daunting, let alone exercising. But regular exercise can be as effective as antidepressant medication in countering the symptoms of depression. Take a short walk or put some music on and dance around. Start with small activities and build up from there. Eat a mood boosting diet. Reduce your intake of foods that can adversely affect your mood, such as caffeine, alcohol, trans fats, sugar, and refined carbs. And increase mood-enhancing nutrients such as Omega-3 fatty acids. Find ways to engage again with the world. Spend some time in nature, care for a pet, volunteer, pick up a hobby you used to enjoy (or take up a new one). You won’t feel like it at first, but as you participate in the world again, you will start to feel better. 10 tips for reaching out and staying connected
For more information, see:
Coping
with Depression
When to seek professional help If support from family and friends and positive lifestyle changes aren’t enough, find a therapist who can help you heal. Therapy can help you understand your depression and motivate you to take the action necessary to prevent it from coming back. Medication may be imperative if you’re feeling suicidal or violent. But while it can help relieve symptoms of depression in some people, it isn’t a cure and is not usually a long-term solution. It also comes with side effects and other drawbacks so it’s important to learn all the facts to make an informed decision. Related HelpGuide articles
Resources and references Signs and symptoms of depression Signs and Symptoms of Mood Disorders – Lists the common signs and symptoms of depression and bipolar disorder. (Depression and Bipolar Support Alliance) Types of depression The Different Faces of Depression – Discussion of the different subtypes of depression, including atypical depression, melancholic depression, and psychotic depression. (Psychology Today) Depression causes and risk factors What Causes Depression? Page 1 & Page 2 – Learn about the many potential causes of depression, including genes, temperament, stressful life events, and medical issues. (Harvard Health Publications) Source: www.helpguide.org/articles/depression/depression-signs-and-symptoms.htm
Facts and Warning
Signs for Suicidal Thoughts in Children Depression Knowing youth suicide facts is especially important for parents of children with depression. For parents, suicidal thoughts and behaviors are one of the most alarming concerns of childhood depression. According to the Centers for Disease Control (CDC), death by suicide is the fourth leading cause of death among 10- to 14-year-olds, and many more children attempt but do not complete suicide. At What Age Can Suicidal Thoughts Happen? According to the CDC's Web-based Injury Statistics Query and Reporting System (WISQRS), there were no deaths by suicide in the United States among children under age 5 between 2000 and 2007. However, rates of suicide deaths increased 0.02% for 5- to 9-year-olds, and 1.22% for 10- to 14-year-olds in that same time period. Typically, rates of suicide increase with age, peaking in late adolescence. Girls more often attempt suicide, but boys more frequently follow through to completion. Suicidal Thoughts and Depression According to Dr. David C.R. Kerr, who published a study of youth suicide in The Journal of Suicide and Life-Threatening Behavior in 2008, suicidal thoughts are linked to a worse course of depression, the symptoms of which include earlier onset, longer duration and shorter intervals of remission. It is important to know that not all depressed children will have suicidal thoughts or behavior. In fact, it is one of the least common symptoms of childhood depression. Also, not all children with suicidal thoughts and behavior are depressed. Perhaps most comforting to know, not all children who have suicidal thoughts will attempt suicide. However, it is a good predictor for future attempts, and these children always need to be evaluated by a professional. Warning Signs of Suicide Some important warning signs of suicidal behavior in children are:
Risk Factors Some risk factors that may contribute to a child's risk of suicidal thoughts and behavior include:
How to Help Your Child Be aware. While rare in young children, suicide is possible. Know the warning signs and risk factors that may increase your child's risk of suicide. Talk to your child. Talking about suicide will not give your child the idea to attempt suicide. If a friend or other loved one has died, committed suicide or is extremely ill, talk to your child about it and address her feelings. Tell others. If your child exhibits suicidal thoughts or behaviors, tell your child's other caretakers and faculty members at her school so they can closely monitor your child when you are not around. Keep weapons locked up. Common sense tells you to keep weapons, medications, alcohol and poisons safely away from children, but this is especially important for children at risk for suicide. Get your child treatment. If your child is depressed, at high risk for depression or other mental illness, it is essential to get her treatment. When to Get Immediate Help It's better to be safe than sorry when it comes to your child's well-being. If you think that your child is in crisis and has had a previous suicide attempt, is threatening to harm herself, or you just have a "gut feeling," get your child help immediately. Do not wait. If needed, take your child to a pediatric emergency room. Having a child who is depressed or is suicidal does not make you a bad parent or mean that you did anything to cause her pain. The best thing you can do is to get your child help and support her in her recovery. *If your child or someone else you know is having thoughts of suicide, contact the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255). Sources: David C. R. Kerr, Ph.D., Lee D. Owen, B.S., Katherine C. Pears, Ph.D., and Deborah M. Capaldi, Ph.D. Prevalence of Suicidal Ideation Among Boys and Men Assessed Annually from Ages 9 to 29 Years. Suicide and Life-Threatening Behavior. August 2008 38(4): 390-401. Injury Prevention & Control: Data & Statistics (WISQARS). Centers for Disease Control. Knowing The Warning Signs. American Association of Suicidology. Suicide Prevention for Children. American Academy of Pediatrics: HealthyChildren.org. Suicide Prevention: Youth Suicide. Centers for Disease
Control. Parent's Guide to
Teen Depression What are the signs and symptoms of depression in teens? Unlike adults, who have the ability to seek assistance on their own, teenagers rely on parents, teachers, or other caregivers to recognize their suffering and get them the help they need. So if you have an adolescent in your life, it’s important to learn what teen depression looks like and what to do if you spot the warning signs. While it might seem that recognizing depression is easy, the signs aren’t always obvious. For one, teens with depression don’t necessarily appear sad. Irritability, anger, and agitation may be the most prominent symptoms. Signs and symptoms of depression in teens
Is it depression or teenage “growing pains”? A certain amount of moodiness and acting out is par for the course with teens. But persistent changes in personality, mood, or behavior are red flags of a deeper problem. If you’re unsure if your child is depressed or just “being a teenager,” consider how long the symptoms have been going on, how severe they are, and how different your child is acting from his or her usual self. Hormones and stress can explain the occasional bout of teenage angst—but not continuous and unrelenting unhappiness lethargy, or irritability. Suicide warning signs in teenagers Seriously depressed teens often think
about, speak of, or make "attention-getting" attempts at
suicide. But an alarming and increasing number of teenage
suicide attempts are successful, so suicidal
thoughts or behaviors should always be taken very
seriously.
For the overwhelming majority of suicidal teens, depression or another psychological disorder plays a primary role. In depressed teens who also abuse alcohol or drugs, the risk of suicide is even greater. Because of the very real danger of suicide, teenagers who are depressed should be watched closely for any signs of suicidal thoughts or behavior. Suicide warning signs to watch for
Don’t ignore the problem Depression is very damaging when left untreated, so don’t wait and hope that worrisome symptoms will go away. If you suspect that your child is depressed, bring up your concerns in a loving, non-judgmental way. Even if you’re unsure that depression is the issue, the troublesome behaviors and emotions you’re seeing are signs of a problem that should be addressed. Open up a dialogue by letting your teen know what specific signs of depression you’ve noticed and why they worry you. Then ask your child to share what he or she is going through—and be ready and willing to truly listen. Hold back from asking a lot of questions (teenagers don’t like to feel patronized or crowded), but make it clear that you’re ready and willing to provide whatever support they need. Tips for communicating with a depressed teen Focus on listening, not lecturing. Resist any urge to criticize or pass judgment once your teenager begins to talk. The important thing is that your child is communicating. You’ll do the most good by simply letting your teen know that you’re there for them, fully and unconditionally. Encourage social connection Depressed teens tend to withdraw from their friends and the activities they used to enjoy. But isolation only makes depression worse, so do what you can to help your teen reconnect. Make face time a priority. Set aside time each day to talk—time when you’re focused totally on your teen (no distractions or multi-tasking). The simple act of connecting face to face can play a big role in reducing your teen’s depression. Combat social isolation. Do what you can to keep your teen connected to others. Encourage them to go out with friends or invite friends over. Participate in activities that involve other families and give your child an opportunity to meet and connect with other kids. Make physical health a priority Physical and mental health are inextricably connected. Depression is exacerbated by inactivity, inadequate sleep, and poor nutrition. Unfortunately, teens are known for their unhealthy habits: staying up late, eating junk food, and spending hours up hours on their phones and devices. But as a parent, you can combat these behaviors by establishing a healthy, supportive home environment. Get your teen moving! Exercise is absolutely essential to mental health, so get your teen active—whatever it takes. Ideally, teens should be getting at least an hour of physical activity a day, but it needn’t be boring or miserable. Think outside the box: walking the dog, dancing, shooting hoops, going for a hike, riding bikes, skateboarding—as long as they’re moving, it’s beneficial. Know when to seek professional help Support and healthy lifestyle changes can make a world of difference for depressed teens, but it’s not always enough. When depression is severe, don’t hesitate to seek professional help from a psychologist or psychiatrist. A mental health professional with advanced training and a strong background treating teens is the best bet for your child’s care. Involve your child in treatment choices When choosing a specialist or pursuing treatment options, always get your teen’s input. If you want your teen to be motivated and engaged in their treatment, don’t ignore their preferences or make unilateral decisions. No one therapist is a miracle worker, and no one treatment works for everyone. If your child feels uncomfortable or is just not ’connecting’ with the psychologist or psychiatrist, seek out a better fit. Explore your options Expect a discussion with the specialist you’ve chosen about depression treatment options for your son or daughter. Talk therapy is often a good initial treatment for mild to moderate cases of depression. Over the course of therapy, your teen’s depression may resolve. If it doesn’t, medication may be warranted. Unfortunately, some parents feel pushed into choosing antidepressant medication over other treatments that may be cost-prohibitive or time-intensive. However, unless your child is acting out dangerously or at risk for suicide (in which case medication and/or constant observation may be necessary), you have time to carefully weigh your options before committing to any one treatment. In all cases, antidepressants are most effective when part of a broader treatment plan. Medication comes with risks Antidepressants were designed and tested on adults, so their impact on young, developing brains is not yet understood. Some researchers are concerned that exposure to drugs such as Prozac may interfere with normal brain development—particularly the way the brain manages stress and regulates emotion. Antidepressants also come with risks and side effects of their own, including a number of safety concerns specific to children and young adults. They are also known to increase the risk of suicidal thinking and behavior in some teenagers and young adults. Teens with bipolar disorder, a family history of bipolar disorder, or a history of previous suicide attempts are particularly vulnerable. The risk of suicide is highest during the first two months of antidepressant treatment. Teenagers on antidepressants should be closely monitored for any sign that the depression is getting worse.
Take care of yourself (and the rest of the family) As a parent dealing with teen depression, you may find yourself focusing all your energy and attention on your depressed child. Meanwhile, you may be neglecting your own needs and the needs of other family members. However, it’s extremely important that you continue to take care of yourself during this difficult time. Above all, this means reaching out for much needed support. You can’t do everything on your own. Trying is only a recipe for burnout. As the saying goes: “It takes a village.” Enlist the help of family and friends. Having your own support system in place will help you stay healthy and positive as you work to help your teen. Don’t bottle up your emotions. It’s okay to feel overwhelmed, frustrated, helpless, or angry. Reach out to friends, join a support group, or see a therapist of your own. Talking about how you’re feeling will help defuse the intensity. Related HelpGuide articles
Resources and references General information about teen depression Depression Teen depression and suicide About Teen Suicide Teenage depression and violence Warning Signs of Youth Violence Treatment for teen depression Treatment of Children with Mental Illness Antidepressants for teens Antidepressant Medications for Children and Adolescents: Source: www.helpguide.org/articles/depression/teen-depression-signs-help.htm
I Knew I had
a Good/Bad Psychiatrist/Therapist When… We’ll start out with my experiences… My first experience with treatment was at the mental health clinic at the local hospital. I was fairly indifferent toward the first psychiatrist I had there, but I was unpleasantly jarred to find out that he was leaving after six months. Apparently they were on some sort of rotation. When I walked into the new psychiatrist’s office, I immediately got a bad feeling. It looked like he felt this was a temporary situation, as the office was completely bare except for the desk and two chairs. The reason for my visit was to ask him to raise my medication, as I was feeling the familiar signs of depression after being fairly stable for a year. He never even looked at me, and only asked me one question to determine whether I was depressed again or not, “Do you have thoughts of harming yourself or others?” I said, “Well, no, but I never have, so that’s not really an indication for me.” He ignored all the signs of depression I was recounting and refused to raise my medication. I absolutely hated him, and wouldn’t go back until he was gone six months later. This time when I walked into the new psychiatrist’s office I was very wary, but the difference he had made in that cold office was amazing. I’m a little fuzzy on the specifics, but I immediately noticed that the place smelled great. He had air fresheners in the office that made you want to inhale when you walked in. He had prints on the walls and (I’m pretty sure) healthy plants. I may be just remembering the plants because he was such a nurturing person. He also had a photo of himself with a child on his bulletin board, which I took as a good sign. He was very accessible, listened to me, and ordered a blood test to find out the level of meds in my blood, which indeed was too low. He stayed longer than six months before moving on, and I was very sorry to see him go. I had trouble with severe mood swings for years and my condition was getting worse. Upon finding out that several close relatives were bipolar, I did some research and found that without a doubt I had the symptoms. I took my information and family history to a local psychiatrist. He stated with sarcasm, “If you went out and bought five Corvettes I’d believe you were bipolar, but you’re not.” I believed him, left and did not seek any further treatment as I descended deeper into a horrible depression. Finally I went to a local clinic, and talked to a nurse practitioner who believed me enough to give me a trial of lithium. Literally within days I rounded a corner. The medication literally saved my life. The moral of the story for me is; if at first you don’t get listened to, keep looking until you do. Also, I’d rather talk to a nurse who listens than an MD who doesn’t. – Kate from Idaho OK, finally…I put off suicide until I could at least get in to see the psychiatrist. The Paxil that my GI put me on isn’t working. I’m slipping down a drain. I had 1 1/2 hours of sleep last night and in another 2 hours I have to go to work. But….I went to the shrink today like I promised. Told him of my plans to end it. Told him how close I came. Told him I was already dead inside. Told him I had 2 hours of sleep and had to work again. I told him I can hardly get through a day anymore. He said “increase the paxil to 1 1/2 tabs and come back in a month”. Oh well. I didn’t deserve the help anyway. – angelica About six years ago I was suffering from incredible depression. (I have since been diagnosed w/Borderline Personality Disorder, and depression comprises only a part of this). At any rate, because I was cutting myself, wanting to die, and locking myself in my apartment for weeks at a time (where I would sleep for days on end), my employer (who happened to be my church–I was a church secretary) demanded that I see the licensed family therapist they had on staff. I went. He looked like a dish of spumoni–he wore mixed pastels (polyester), and a horrifyingly bad toupee. On top of everything else, he told me (I am quoting here), that I was evil, that God was protecting other people from me, and that he felt sorry for anyone who knew me because I really was a bad person. This, said to a severely depressed person by a supposed professional, is BAD. I quit seeing him, obviously. Here’s the REALLY juicy part: he then attempted to blackmail me with my patient records, which he said (I’m quoting again) that he would keep for his own protection, in case I said anything unflattering about him. He said he would make those records public if anything bad I said got back to him. I have since found out that in my state, ANYBODY can be a “licensed family therapist”, just by paying a fee for the license. Scary, huh? (NOTE: this loser has since been taken off the church staff, and I have long since gotten some QUALIFIED help. And I had a Government agency confiscate my records from his office–with my permission, because I work for a defense contractor and had to obtain a security clearance. I have no idea how many other people this pig damaged, though.) – Anita from Alabama After reading your story, I started to think about my psych, he’s from India, he thinks I’m really off my rocker. He tells me to do other things from what my therapist tells me, and I think he uses me for his guinea pig. He’s been trying to start me on some of the strangest meds, and all I want to do was to get my Effexor refilled. Then he gave me a 2-week supply, but this medicine takes effect in about 30 days. When I go back and see him, what does he do, he prescribes me something else. I’m going to find another psych and keep my therapist. She’s more understanding of my problem. – Tom Even though I had had depression for years and mild mania, I started off with a psychologist who did not refer me to a psychiatrist until it got so bad I had to be hospitalized. Thankfully, the psychiatrist knew what he was doing (actually at that point it had become quite obvious). So he became my doctor for the last 6 years and was great. Except in October he was too close to a tree that got hit by lightning and he had to stop practicing while they evaluated him. The doctor he left as a back-up was “too busy” for any sessions. I had to go out and interview doctors. That was fun. Finally, my doctor’s office called me and told me to call this other doctor, that he would see me. Well, he started off the conversation stating he was a “mood expert” and started diagnosing me over the phone. He tells me I have to increase my medications and I have to be totally reevaluated and maybe hospitalized (a week before the holidays). I told him that I had no problem raising the medication and that he would find that I took my medications as I was told. He actually said “That’s an oxymoron.” After that experience, I did the incredible. I actually called the insurance company and asked them to find me a doctor. They did, he was nice and he took care of me until my old doctor came back. No, I never did make my appointment with the “mood expert”. You should always interview a “doctor” before actually going into their office. In this state, a doctor has the power to hospitalize you if they think you are in danger or a danger to others. – Lourdes from Miami I knew I had a bad shrink when he called me at home on Saturday morning to ask me my advice for how he should deal with his problems with his girlfriend. — Eee-gads! – Meg It was my first experience with a psychiatrist, but I knew it was a mess when one of his assistants/office staff/next door neighbors/whatever kept walking into the office. On the second visit, the doctor spent most of his time on the phone with apparently his stock broker as they were talking all about money, selling this, buying that, etc. Needless to say, I did not go back, and shortly after that he was arrested for DWI and essentially run out of town on a rail. (Turns out I was not the only person that he’d “ignored” in favor of his stock broker.) Current primary care doctor wants me to see a psychiatrist again, and after one bad experience, I’m not sure this is a good idea. I called the insurance company just to clarify what the benefits were. Turns out that they really don’t want you to use their “mental health services.” I can’t use any doctor in the plan, nope, it has to be one who is also in their “merit services” program (which probably means money in one way or another). My other doctors (primary care doctor, orthopod, etc.) are located at the biggest hospital in the area — but none of their “merit services” people are, and they could only give me two names of anyone in town that I could *maybe* see! Needless to say, I won’t be seeing a psychiatrist, and I’m not terribly upset about that! – Laurie When I first met Dr. X I had an almost unwelcome feeling. I felt like I should be paying for his services and only then he would treat me like I worthy of his therapy. Anyway, I told him that I wanted some sort of psychotherapy rather than drugs because of sideffects, etc. Although he listened to me he decided that drugs would be most useful in this case. Well I didn’t take them, but I did continue to see him. Being a psychology student I am sure my beliefs about drugs were emanating from my psyche. With time, however, I gained respect for this person with a British accent and snotty attitude. When he started sharing some of his personal history and I found that we had a bit of history in common I began to trust him. I guess trust was a real issue for me. I began taking the meds and gradually became healthier. We developed a bit of a friendship which was in the end briskly cut off by him. I guess because he didn’t want me to become too dependent on this one and only friendship. Anyway I still hear his voice once in while and find comfort in knowing that he knew me enough to get me to help myself. – Anonymous I have been having a hell of a time, lately, with psychiatrists (i.e., finding one and keeping one) during this last bout of depression. My heart sinks when I walk into a practitioner’s office and it barely looks as if they write scripts there. We probably just can’t help it, but women are probably more sensitive to this. The past two pdocs I’ve seen (and didn’t go back to when I couldn’t take it anymore) hardly looked at me, either, except to say “these are the rules” type statements and ask me if was suicidal. Funny thing – it made no difference in their reaction if I said I was suicidal or swore I wasn’t. Not really very humorous. The psychiatrist I saw previously was (is!) a real human being, who listened, empathized, and did his damnedest to help me feel that I too, am a human being, defects and all. He had an office with “real” furniture, old worn oriental carpets, real works of art, including that of friends of mine. Offices of both my current individual therapist and someone my husband and I see occasionally are warm, inviting, not fancy, but with pictures of both their kids and “artwork” done by the same. In other words, if they see themselves as human beings, perhaps they can give us the same courtesy. I resolve to walk right out of the “robot” practitioner’s offices as soon as I walk in from now on! Our instincts may be all we have left…. – Robin I have been to untold numbers of these people over the last 5 years that I have been suffering from depression. One told me that I could blame it all on my parents and that I should let them know. (Thank God that I did not do so). The next one would give me a depression test every week that I saw him. He placed me on different drugs over the years, all with the same results, but at least the data was of use. I then found a good man who showed me how to use my brain to help control the pain in my left arm. Two years of little depression. Then he had a stroke. Depression back. Back to other psychiatrist, still more drugs. Then last year a breakdown in public; result pending police charges (a man with one good arm with two assault police charges), depression deeper, placed in a psych hospital; depression even deeper. Then my good man came to my rescue, got me out of the hospital and he now treats me (at no charge), ring or visit him at any time. – Anonymous I refer to the first 3 psychiatrists I saw as quacks #1, #2, and #3. I suffer from severe, chronic clinical depression and have tried nearly every psychiatric medicine known with no permanent success. I was referred to the psychiatrists I saw by an EAP. It turns out that the only requirement to get on the EAP’s list was that these providers apply and send in copies of their licenses. Quack #1 was relatively innocuous. She prescribed a combination of two tricyclics which gave me severe anxiety attacks. Every other doctor I have seen wonders why she combined those two drugs as no one seems to have ever heard of using them together. She left the area before doing any more damage. Quack #2 apparently did not believe in taking blood levels. I wound up in the hospital (not once, but twice) with toxic blood levels at therapeutic dosages of the antidepressant I was taking. I later found out that that was not unheard of for those particular drugs. Quack #3 used to fall asleep in therapy sessions and would tell me it was because my monotone voice put him to sleep. When I finally got angry enough to fire him, he told me I was leaving because we were finally getting to the root of my problems and I was afraid to address my issues. When I asked him what those issues were, he said that I needed to discover them myself. – Gal I think I know she’s a good therapist because, when friends/family ask how my session went or what my therapist thinks of me, I can’t really give them a pat answer. In other words, she isn’t authoritative or didactic. She listens, responds non-verbally, and then when I’m finished with my latest spiel, she asks me questions about how what I’ve just said relates to past sessions, relationships, my experiences growing up, etc. It feels as if she is quite solidly on my side, no matter what, and I trust her. I’ve described our sessions as my weekly anchor to sanity (no advice from well-meaning friends, no belligerent orders to stop my behaviors, no fear or frenzy for one hour a week…). I used to be very suspicious of therapy, I think, because of the bad press it gets in our culture. I assimilated this and thought of myself as a spoiled white female who couldn’t solve her petty problems and who wanted to run to therapy (even though she wasn’t “bad enough” to deserve treatment) so someone else could run her life. So I raged and screamed to get attention from my parents (alcoholic father, shy and enabling mother), fell into deep depressions at my lack of perfection, and cut my arm repeatedly to put my anger and pain into a place I could focus on. Now I feel as if my life is my own and I don’t want to spend another second feeling bitter or loathing myself. I just want new tools and perspectives so I can keep searching. I take 50 to 100mg of zoloft daily (I also take short breaks from it as I see fit–my therapist and psychiatrist both accept my need to control my medication and don’t view my treatment as a power play). I still cut my arm occasionally, but we discuss it and don’t treat it as some terrible backslide. I feel very lucky. I look at my chronic depression and realize that, given my life’s circumstances, much of it was a sane response to insane situations. I feel that I’ve been easy to treat, but had I had a series of “nightmare” therapists, I’d be so much worse off. I’m very grateful to susan for her support. – Laura I think the thing that amazes me the most about some of the doctors I’ve seen for my episodic depression is that they’ve been so cruel. I wouldn’t say some of the things they’ve said to me to my dog. The first time I got depressed, I was terrified. Therapy was urgent, because of my strong anxiety and complete inability to cope. Naturally, I was referred (by my kind, gentle therapist) to a psychiatrist, which was scary. Was I really that sick? I was highly resistant to the idea of meds, but she didn’t try to allay my fears. “What makes you think you don’t need medication?” she barked, “I think you do.” She convinced me, and I’m glad she did although I’ll never forgive her for treating a suicidal but intelligent teenager like an imbecile. Other doctors I saw were nicer, but there was one last year who was pure evil. I’ll always remember the disgust in her eyes when, in response to the question, “Can you tell me something about this drug I’m taking?” she said, “Don’t you want to have children someday? You are going to harm your children, destroy their lives, if you don’t fix your problems.” Ugh. I think the reason antidepressants take so long to work is that it takes you a month to get over your appointments with your psychiatrist. – Wendy from New Jersey My first therapist was a social worker (MSW) whom my college roommate (also an MSW) recommended to me. I felt very comfortable with her, but after less than a year, I felt my therapy was at an impasse. (she had suggested meds, which petrified me) and I shut down after that. I thought I could get along without a therapist but after a few months I realized it was not the case. The next therapist was a social worker too, with training in Freudian analysis, which I have since read is not very good for depression. She was not very empathetic. When I was worried about my parents’ finances because my mother has depression, she said don’t worry about it, they have health insurance and then tried to change the subject, despite the fact that I was worried because their insurance wasn’t paying for some very expensive x-rays. And she wanted to know why I was so upset to find out my mother has lung cancer. (Depressives tend to get overly upset at things, but really, she’s my MOTHER!) After being with her for almost a year, I realized I needed to do something or I would end up dead. I went to my primary care physician for a referral to a psychiatrist. He asked me a few questions, and a few minutes later he wrote a prescription for Paxil and told me to come back in 6 months. Well, after that, I called my health insurance, got names of some psychologists. Our first session was an interview, I followed some suggestions from one of my books and asked her a lot of questions — how often she treats depression, etc., etc. I began seeing her and saw a psychiatrist that she recommended. It’s been a hard time finding meds for me (PAXIL was a bad choice for me and it’s taking a while to wean me off.) But all in all I am comfortable with both my psychologist and psychiatrist. – Susan from NYC I recently had a panic attack. I went to the local clinic and was given Paxil. I found a shrink in the yellow pages, it’s a small town and there was only a choice of two. The one just worked on state cases. I choose shrink number two. I just got his bill for three sessions. Are you ready for this…$890. My first session I asked his charges. He said $125 for a 50 minute hour, and the first session would go longer, getting background etc. My second session lasted over two hours until I finally said, hey doc, I gotta go. I’m thinking, hey it’s a small town, he’s not busy, maybe he’s interested in my case. Session number three was going into two hours and I just excused myself, never thinking he has got the clock running. To sum up, I’ve written the state
board of medicine and spoken to their ombudsman, whose first
comment was “Jesus”. I’ve flushed the dope
down the toilet, and I feel much better thank you very much.
– Rodger Tips for Parents Who Want to Talk
to Children About Depression If you decide to talk about depression with your child, you may be concerned about saying the "right" thing. However, just having an open and honest discussion with your child can provide her with much-needed support. With a few tips, concerned parents and caregivers can confidently talk about depression with their children. Keep the Talk Age Appropriate You want to make sure that your child understands what you are saying and is not confused or bored by the discussion. Make sure that you are using words that your child can understand. Words such as "depression" or "emotional reaction" are probably too complex for a younger child but may be appropriate for an older child or adolescent. Try comparing her depression to something that your child is already familiar with --- like another illness that your child has had experience with (e.g., flu, ear infection, etc.) Keep the Conversation Positive Keeping your depression discussion positive does not mean that you should sugar-coat it. Depression is a serious illness that causes emotional and physical pain, and it can have serious consequences. However, if you maintain a positive and hopeful outlook in your discussions, you will avoid unnecessarily alarming your child.
Be Honest In talking about depression, do not make promises you cannot keep or go into detail about topics that you are not certain of. Instead, tell your child what you do know, and make a list of questions to discuss with your child's mental health professional. Be Compassionate Your child needs to know that you recognize and respect his feelings. Even if you do not quite understand his thoughts, avoid quipping, "What do you have to be depressed about?" or "Don't be ridiculous." Comments like these just cause a child to keep his feelings to himself or become defensive. Be a Good Listener Allow your child to talk openly and express his opinions and thoughts. Avoid interrupting, judging or punishing him for his feelings. Knowing that he has someone he can confide in help to sort out his feelings. While talking to your child about his depression can be a very important part of his recovery, it does not replace the need for professional treatment. If your child is depressed or you suspect depression, consult with his pediatrician or other mental health professionals for accurate diagnosis and treatment. Sources: Feelings Need Check Ups Too. American Academy of Pediatrics. Communicating
With Your Child. American Academy of
Pediatrics. Stress
in America: Talking With Your Children About
Stress. How
Parents Can Talk to Teens About Depression When talking with your teen about depression, you will want to consider where she is developmentally and what is currently important to her. An older child or adolescent naturally begins to pull away from her family and identify with her peers. She is striving to find her identity and working to establish independence from her parents. So, when having a conversation about depression, you will want to address these factors. Some research has shown that children of parents who take an active role in their child's treatment are more likely to comply with treatment, which increases the likelihood of remission. Explaining Depression to Your Teen Comparing depression to another medical illness that your child is familiar with may allow her to understand depression as an illness, her symptoms, the importance of treatment and avoid feeling abnormal. Older children and adolescents are especially sensitive to feeling different or out of place. For Example: "Depression is a special kind of illness called a mental illness. It is similar to other illnesses like the flu in the way that it can make you feel tired or have a headache. Depression also affects your mood and feelings. It can make you feel sad, lonely, frustrated, angry or scared. What questions do you have about depression?" Talking About Treatment With Your Teen Your teenager is more likely to comply with treatment if she understands what it is for, knows what to expect and can have a say in it. Of course, it is not always practical to allow your child to plan her own treatment, but if you can allow her to even make a small decision (like setting up her next appointment), it may make a big difference in allowing her to feel in control. For Example: "You will need to take medicine every day and go to therapy once a week so you feel better. In therapy, you will talk to Dr. Smith privately about your feelings and activities, and ask questions. At first, you may have some side effects from the medicine, like feeling extra tired or dizzy, but it should go away soon. That is why you will see the doctor once a month. He will ask about how the medicine is making you feel and will make sure that it is helping you. What do you think of this treatment plan so far?" Encouraging Supportive Relationships Even though older children identify more with their peers, depression can cause a child to withdraw from everyone. Having supportive relationships is important for everyone, but it may be especially important for depressed children who already feel lonely or isolated. Having just one friend or supportive adult to talk to can provide a huge benefit to your child. Declare your support and availability to your child, and encourage her to connect or re-connect with friends and share her feelings. For Example: "I am always here to talk to you about anything. You may want to think about talking to some of your friends about your feelings too. Having supportive and encouraging people to lean on is important. Talking about your feelings can make a difficult time a little bit easier. Which of your friends do you think you might be able to talk to?" Addressing Myths Older children may be familiar with the social stigma of mental illness or have heard others say derogatory things about the mentally ill. You may want to address this with your child so that she does not feel like she has to hide or be ashamed of her depression diagnosis. For Example: "You may have heard people say hurtful or inaccurate things about people with mental illness or depression. Occasionally, when people don't know about things, they will say something hurtful or make incorrect judgments. You should not feel embarrassed or like you have to hide it, but you should make the decision to tell others about depression if and when you want to." It is mistakenly thought that talking about suicide may plant ideas in a child. In fact, addressing the topic can help her to know what to do if she has suicidal thoughts or behaviors. Remember, though, it is important that you seek urgent medical care if your child is having suicidal thoughts or behaviors. For Example: "If you are ever feeling like you want to hurt yourself or like you don't want to live, please tell me, or call your doctor immediately. Sometimes feelings can be overwhelming, and you feel like it might never get better. Suicide is permanent and feelings are not. We can help you to work through your feelings. Are you currently having any feelings of wanting to hurt yourself?" It is hard not to worry about saying the "right" thing to your child about her depression -- but just letting her know that you love and support her speaks volumes. Sources: Communicating
With Your Child.
Feelings Need Check Ups Too. American Academy of Pediatrics. Accessed: June 15, 2010. Willansky-Traynor, P. Manassis, K., Monga, S. et al. "Cognitive Behavioural Therapy for Depressed Youth: Predictors of Attendance in a Pilot Study." Journal of the Canadian Academy of Child and Adolescent Psychiatry May 2, 2010, 19. Stress
in America: Talking With Your Children About
Stress. Suicide
Prevention: Youth Suicide.
Teen
Depression - Boys They're young, they're often highly visible—and they're in deep trouble. America's adolescent boys may look strong as they swagger down the street, but in reality they are the population at highest risk today for all kinds of serious problems. Rates of anxiety
Adolescent males find themselves
facing a set of unique pressures. Shifting gender
Then too, the boys, as well as their
sisters, belong to the first generation of divorce. And today's boys are facing unprecedented stresses from many directions. While there is less certainty about the outcome of the college race, there is no let up in expectations for male success. There is more career confusion, and paths seem less clear. Given the disquietude,
substance
abuse
But perhaps the biggest problem with today's young males is that they often have mild to moderate alexithymia—they are unable to identify their own (and others') feelings and thus unable to communicate about them. They never learned how from absent or overworked fathers. However, the ability to communicate feelings is an increasingly important survival skill. It is certainly required for stable interpersonal relationships throughout life—at school, at work, and in the families most expect eventually to create. For adolescent boys as for anyone, resolving the pressures in one's life involves figuring out how you feel. Alexithymia is like having a padlock on your tongue. There is an immediate need to take action. If not, our sons face life-threatening consequences—drug and/or alcohol addiction, self-destructive behavior and accidents, suicide, and violence towards others. Such problems are already rampant.
Then impart emotional management
skills
Source: www.psychologytoday.com/articles/200207/teen-depression-boys
Teen
Depression - Girls It's clear that many kids are breaking down in college. But most of the issues affecting them are at play well before they get to college age. If you wish to understand what is happening with young adults, it's wise to focus on teenagers. We have all heard about the male loner who suddenly blows people up, like the pipe bomber or the Columbine kids. We are learning about the girls who are as aggressive as the boys but who are indirect in their aggression, the so-called mean girls syndrome. They are the most visible symbols of some disturbing trends. By any measure, our young people are in trouble. Rates of depression and anxiety are soaring—and getting worse. Possibly one out of three teens will end up with significant clinical depression needing treatment. Their suicide rates have tripled. We need to take action. If you are the parent or sibling of a teenager, or come in contact with them on a regular basis, there is information you need to have and strategies to adopt. I want to focus this article on teenage girls.
One of the best sources of information is The Inside Story on Teen Girls, by Alice Rubenstein, Ed.D., and Karen Zager, Ph.D. The book was published by the American Psychological Association.
You have to mobilize your values and
realize that your exhaustion is not worth missing an
opportunity to connect. In the long run connection produces
more value than a night's sleep
There are many reasons why depression
is rampant in young people. They face unprecedented
pressures to succeed. The college race is harder and more
uncertain than ever. As the pressure has increased, so has
anxiety, because adults aren't there to teach kids how to
handle it. It's exploding in eating
disorders
This is the first generation of
divorce
Today's teens face more pressure for sexual activity earlier, a situation that can be very depressing for those who aren't ready or don't know what to do. There is an epidemic of low
self-esteem
It's critical to go after depression
in the young. We now know that there is a kindling effect:
the younger you are when you get your first depression, the
more at risk you are for serious adult depressions with more
frequency. The faster anyone can pick up on depression and
its signs in young people, the quicker they can be
helped. How to Help
Someone with Depression When a family member or friend suffers from depression, your support and encouragement can play an important role in his or her recovery. However, depression can also wear you down if you neglect your own needs. These guidelines can help you support a depressed person while maintaining your own emotional equilibrium. Helping a depressed friend or family member Depression is a serious but treatable disorder that affects millions of people, from young to old and from all walks of life. It gets in the way of everyday life, causing tremendous pain, hurting not just those suffering from it, but also impacting everyone around them. If someone you love is depressed, you may be experiencing any number of difficult emotions, including helplessness, frustration, anger, fear, guilt, and sadness. These feelings are all normal. It’s not easy dealing with a friend or family member’s depression. And if you don’t take care of yourself, it can become overwhelming. That said, there are steps you can take to help your loved one. Start by learning about depression and how to talk about it with your friend or family member. But as you reach out, don’t forget to look after your own emotional health. Thinking about your own needs is not an act of selfishness—it’s a necessity. Your emotional strength will allow you to provide the ongoing support your depressed friend or family member needs. Understanding depression in a friend or family member Depression is a serious condition. Don’t underestimate the seriousness of depression. Depression drains a person’s energy, optimism, and motivation. Your depressed loved one can’t just “snap out of it” by sheer force of will. Is my friend or loved one depressed? Family and friends are often the first line of defense in the fight against depression. That’s why it’s important to understand the signs and symptoms of depression. You may notice the problem in a depressed loved one before he or she does, and your influence and concern can motivate that person to seek help. Be concerned if your loved one... Doesn’t seem to care about anything anymore. Has lost interest in work, sex, hobbies, and other pleasurable activities. Has withdrawn from friends, family, and other social activities. How to talk to a loved one about depression Sometimes it is hard to know what to say when speaking to a loved one about depression. You might fear that if you bring up your worries he or she will get angry, feel insulted, or ignore your concerns. You may be unsure what questions to ask or how to be supportive. If you don’t know where to start, the following suggestions may help. But remember that being a compassionate listener is much more important than giving advice. You don’t have to try to “fix” the person; you just have to be a good listener. Often, the simple act of talking to someone face to face can be an enormous help to someone suffering from depression. Encourage the depressed person to talk about his or her feelings, and be willing to listen without judgment. Don’t expect a single conversation to be the end of it. Depressed people tend to withdraw from others and isolate themselves. You may need to express your concern and willingness to listen over and over again. Be gentle, yet persistent. Ways to start the conversation: "I have been feeling concerned about you lately." Questions you can ask: "When did you begin feeling like this?" Remember, being supportive involves offering encouragement and hope. Very often, this is a matter of talking to the person in language that he or she will understand and respond to while in a depressed mind frame. What you CAN say that helps:
Source: The Depression and Bipolar Support Alliance Taking care of yourself There’s a natural impulse to want to fix the problems of people we love, but you can’t control a loved one’s depression. You can, however, control how well you take care of yourself. It’s just as important for you to stay healthy as it is for the depressed person to get treatment, so make your own well-being a priority. Remember the advice of airline flight attendants: put on your own oxygen mask before you assist anyone else. In other words, make sure your own health and happiness are solid before you try to help someone who is depressed. You won’t do your friend or family member any good if you collapse under the pressure of trying to help. When your own needs are taken care of, you’ll have the energy you need to lend a helping hand. Tips for taking care of yourself Think of this challenging time like a marathon; you need extra sustenance to keep yourself going. The following ideas will help you keep your strength up as you support your loved one through depression treatment and recovery. Speak up for yourself. You may be hesitant to speak out when the depressed person in your life upsets you or lets you down. However, honest communication will actually help the relationship in the long run. If you’re suffering in silence and letting resentment build, your loved one will pick up on these negative emotions and feel even worse. Gently talk about how you’re feeling before pent-up emotions make it too hard to communicate with sensitivity. Set boundaries. Of course you want to help, but you can only do so much. Your own health will suffer if you let your life be controlled by your loved one’s depression. You can’t be a caretaker round the clock without paying a psychological price. To avoid burnout and resentment, set clear limits on what you are willing and able to do. You are not your loved one’s therapist, so don’t take on that responsibility. Stay on track with your own life. While some changes in your daily routine may be unavoidable while caring for your friend or relative, do your best to keep appointments and plans with friends. If your depressed loved one is unable to go on an outing or trip you had planned, ask a friend to join you instead. Seek support. You are NOT betraying your depressed relative or friend by turning to others for support. Joining a support group, talking to a counselor or clergyman, or confiding in a trusted friend will help you get through this tough time. You don’t need to go into detail about your loved one’s depression or betray confidences; instead focus on your emotions and what you are feeling. Make sure you can be totally honest with the person you turn to—no judging your emotions! Encouraging your loved one to get help
While you can't control someone else’s recovery from depression, you can start by encouraging the depressed person to seek help. Getting a depressed person into treatment can be difficult. Depression saps energy and motivation, so even the act of making an appointment or finding a doctor can seem daunting. Depression also involves negative ways of thinking. The depressed person may believe that the situation is hopeless and treatment pointless. Because of these obstacles, getting your loved one to admit to the problem—and helping him or her see that it can be solved—is an essential step in depression recovery. If your loved one resists getting help: Suggest a general check-up with a physician. Your loved one may be less anxious about seeing a family doctor than a mental health professional. A regular doctor’s visit is actually a great option, since the doctor can rule out medical causes of depression. If the doctor diagnoses depression, he or she can refer your loved one to a psychiatrist or psychologist. Sometimes, this “professional” opinion makes all the difference. Supporting your loved one's treatment One of the most important things you can do to help a friend or relative with depression is to give your unconditional love and support throughout the treatment process. This involves being compassionate and patient, which is not always easy when dealing with the negativity, hostility, and moodiness that go hand in hand with depression. Provide whatever assistance the person needs (and is willing to accept). Help your loved one make and keep appointments, research treatment options, and stay on schedule with any treatment prescribed. The risk of suicide is real
It may be hard to believe that the person you know and love would ever consider something as drastic as suicide, but a depressed person may not see any other way out. Depression clouds judgment and distorts thinking, causing a normally rational person to believe that death is the only way to end the pain he or she is feeling. When someone is depressed, suicide is a very real danger. It’s important to know the warning signs:
If you think a friend or family member might be considering suicide, talk to him or her about your concerns as soon as possible. Many people feel uncomfortable bringing up the topic but it is one of the best things you can do for someone who is thinking about suicide. Talking openly about suicidal thoughts and feelings can save a person’s life, so speak up if you're concerned and seek professional help immediately! Related HelpGuide articles
Resources and references Helping a depressed person Helping Someone with a Mood Disorder – Covers how to support a loved one through depression treatment and recovery. (Depression and Bipolar Support Alliance) Helping Someone Receive Treatment – What to do (and not to do) when trying to help a loved one get help for depression. (Families for Depression Awareness) Helping a Friend or Family Member with Depression or Bipolar Disorder – How to help your loved one while also taking care of yourself. (Depression and Bipolar Support Alliance) What is the role of the family caregiver? – Tips on how families can work together to manage depression treatment. (Families for Depression Awareness) Helping a suicidal person How to Help Someone in Crisis – Advice on how to deal with a depression crisis, including situations where hospitalization is necessary. (Depression and Bipolar Support Alliance) Suicidal helplines National
Suicide Prevention Lifeline
Crisis
Text Line
Samaritans
UK
Lifeline
Australia
Crisis
Centers Across Canada
IASP
International
Suicide Hotlines Source: www.helpguide.org/articles/depression/helping-a-depressed-person.htm
What to do if
you are depressed?
For more information: National
Institute of Mental Health www.nimh.nih.gov/publicat/depression.cfm#ptdep5
Where can I get
more information about Depression? National Alliance for the Mentally
Ill (NAMI), Colonial Place Three , 2107 Wilson Blvd.,
Suite 300 , Arlington, VA 22201, 800.950NAMI (6264) or
703.524.7600 or www.nami.org
A support and advocacy organization of
consumers, families, and friends of people with severe
mental illness-over 1,200 state and local affiliates. Local
affiliates often give guidance to finding treatment. Depression & Bipolar Support
Alliance (DBSA), 730 N. Franklin St., Suite #501,
Chicago, IL 60610-7204, 312.988.1150, Fax: .312.642.7243 or
www.DBSAlliance.org
Purpose is to educate patients,
families, and the public concerning the nature of depressive
illnesses. Maintains an extensive catalog of helpful
books. National Foundation for Depressive
Illness, P.O. Box 2257, New York, NY 10116,
212.268.4260; 800.239.1265 or www.depression.org
A foundation that informs the public
about depressive illness and its treatability and promotes
programs of research, education, and treatment. National Mental Health
Association (NMHA), 2001 N. Beauregard Street, 12th
Floor, Alexandria, VA 22311, 800.969.6942 or 703.684.7722,
TTY 800.443.5959, www.nmha.org
An association that works with 340 affiliates to promote mental health through advocacy, education, research, and services. Source: www.facetheissue.com/depression.html
Who
Young People Turn to for Help  Over half of
teachers report kids feel anxiety now that Trump is
president The problem is the most prevalent among Muslims, immigrants, and children of immigrants. Local therapist Anita Gandhia-Smith says kids take on their parents’ anxiety. What can you do? It's best to talk to your child openly and honestly. They are likely hearing rumors and gossip in school. Ghandia-Smith suggests reassuring your kids and telling them that it is going to be ok. "There is an element of having basic trust in the system and in the universe," said Ghandia -Smith. "Help your children understand that the system has worked for a long time. There are lots of checks and balances." Mayor Muriel Bowser and other mayors all over the country, have come out and said that D.C. will continue to protect immigrants. Madeline Albright is the latest prominent figure to come out and say she will register as Muslim if there is a Muslim registry, so Muslims do not feel alone. If your child is struggling with anxiety, here are a few resources that can help: If you want to contact Dr. Anita
Gandhia-Smith: www.fromaddictiontorecovery.com/
A comic that
accurately sums up depression and anxiety — and the
uphill battle of living with them Depression and anxiety disorders are real illnesses. Mental illnesses are not "in someone's head," they're not something a person can "just get over," and they affect so many of us — over 40 million people in the U.S. alone. Despite how common they are, it's still really difficult to explain to people who may have never experienced a mental illness. Enter: cute, clever illustrations that get the job done. Nick Seluk, who creates the amazing comics at The Awkward Yeti, heard from reader Sarah Flanigan. She shared her story of depression and anxiety with him. If it could help even one person, she said, it would be worth it. Nick turned her story into a fantastic comic that perfectly captures the reality of living with depression and anxiety. (Go to the web site to see the actual cartoon.) "The hardest part of living with depression and anxiety for me is feeling like I have to hide it," Sarah said. "I've always been known as the happy one in my group of friends. Everyone's always so shocked when I tell them I have depression or they see the self-harm scars." "It's much harder than it should be to say, 'Hey, I have depression and I've been struggling with self-harm since I was 10 and I just really need your support to get me through tonight,'" Sarah explained. Let's all keep working to make it easier for our friends, family members, and ourselves to get support. Let's keep talking about it. About These comics were created by Nick Seluk of The Awkward Yeti, published on Tapastic. I'm sharing them with Nick's express permission. He's a really cool guy who has an entire "Medical Tales Retold" series that, until recently, focused on physical conditions. He covers a lot there and makes the difficult reality of living with certain conditions a little lighter. You can follow him on Facebook, Twitter, Tumblr, and Instagram. Huge props to Sarah for bravely
sharing her story with Nick and, in turn, thousands and
thousands of people. She was hoping for just one person to
see the comic and know they weren't fighting the battle
alone. She more than accomplished that, and we're all better
for it! Depression
Hotline Many people who have depression turn to drugs and alcohol to make them feel better or to numb themselves from their feelings—estimates state that approximately 10.2 million adults live with a co-occurring mental health and addiction disorder.3 This relationship between mental health and addiction is dangerous, particularly because substance abuse can worsen depressive symptoms. But there are many ways to find help, including calling a depression hotline for information about treatment centers and 12-step programs. The connection between depression and substance abuse can place you at a higher risk for self-harm, injury, and suicide, so having a 24-hour depression hotline crucial for many people who are in crisis. You can be assured that all calls are private and confidential and that you will speak to a person with experience in helping people with similar issues. Depression is a significantly debilitating mental health condition that can prevent you from living life to your fullest potential because you feel hopeless, sad, and tired. Additionally:1
There are effective ways to manage depression; calling a hotline can help you or a loved one begin your search for treatment. What Questions Should I Ask? When you call a 24-hour depression hotline, it is important that you share as much information as possible with the person on the other end of the line so they can better gauge your situation and provide relevant treatment information. Before you call a depression helpline, you may want to write down questions you have, which might include:
If you are concerned about a family member, significant other, friend, classmate, or colleague, it can take an emotional toll on you. When calling a depression helpline, you can ask:
When you call, you may be asked your first name as well as your age, which helps the counselors figure out what types of programs you are eligible for. You may also be asked any of the following questions when you call:
Should I Call a Hotline? Most people experience periods of sadness in their lives after major events, such as a job loss, a divorce, or the death of a loved one. However, clinical depression is different than regular sadness or a period of grief. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), depression is diagnosed when you have 5 or more of the following symptoms in a 2-week period:4
Mental Health Information If you have depression and a substance abuse disorder, it can be very difficult to pick up the phone and ask for help. If you feel nervous and aren’t sure you can talk to someone on the phone, you can always try another time. Because all calls are confidential, you can feel safe about being open and honest—the person you speak to has experience and training and understands what you need. If you want information about mental health in general, these resources can help:
Other Depression Hotlines For many people, depression is an extremely lonely experience. Calling a hotline gives you the opportunity to talk to a caring person who can help you work through whatever negative thoughts or feelings you have. If this is an emergency and you need immediate assistance, please call 911.
Sources 1. World Health
Organization. (2017). Depression.
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