Depression and teens

Not too long ago I was asked to medically clear a 17 year old teenager who had threatened to commit suicide earlier that day. What immediately struck me was how sad she looked and how “normal” her family was by anyone’s standards. What was really heartbreaking was that success in school, sports and music, and what appeared to be a very loving and supportive home, she never felt happy. Her parents thought she was “serious” and just being a teen - burning the candle from both ends and feeling some college application pressure. For some reason that day she woke up deciding that the world would be better without her and it scarred her so much she told her teacher. Initially, her parents and teachers were shocked but after a while started to put together small things that had been off for a while all leading to that point. Did she keep it well hidden or did they miss the cues?

With the holidays fast approaching, talking about depression in kids, particularly teens, is very timely – this is a very high risk season for people with depression and for teens it is even more precarious. In a depressed person’s eyes, being around all that happiness and cheer is literally painful. And, what makes teenage depression so challenging is the very essense of being a teenager – their impulsivity. Too many teens die each year that way – acting on an impulse as opposed to a more thought out plan.

So, how do we decide if our child is “clinically” depressed or just having a tough time or bad day? Keep in mind that most teens, despite their reputation as a group, do listen to adults and follow the rules. Remember, a busy teen is a happy teen – at least most of the time. And, while teens can be melodramatic the episodes are short lived. The red flag starts to wave when these basic rules are all encompassing – when the down moods and melodrama seem to be the rule not the exception.

www.aboutourkids.org has a list of screening questions that can help you decide whether you may need to seek professional help for your child. Keep in mind that a “screening” test picks up kids who MIGHT have a problem – kids you want to have someone else look at – but it may not mean that there is a HUGE problem.

1. Does your child feel sad, blue, or tearful?
2. Is your child often angry or picks fights at school or at home?
3. Does your child no longer care about favorite activities?
4. Has your child lost or gained a lot of weight?
5. Does your child have trouble sleeping or sleeps too much?
6. Does your child have trouble sitting still or appears very slowed down?
7. Does your child always look tired or is “too tired to play”?
8. Does your child feel hopeless or tell you, “I’m no good?”
9. Does your child have trouble concentrating or making small decisions?
10. Does your child talk about how life is not worth living, death, or suicide?
11. Have you noticed these symptoms have been present for almost every day for a 2 week period?
12. Do these problems get in the way of activities at home, in school, or with friends?

If your teen is clinically depressed, you will have a large peak to climb - but don’t let that deter you. There will be peaks and valleys as you help your teen battle this but keep the ultimate peak, the gold ring in mind to keep you focused: the smile on your child’s face that you’ve likely not seen in all too long a time.

© 2005 Pediatrics Now.
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