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Ask Dr. Sue
TEENAGERS AND DEPRESSION
Dear Dr. Sue,
I am worried about my fifteen year old daughter.
She isn't acting like herself; sometimes she seems sad,
sometimes just very irritable, and she is spending a LOT
of time alone in her room. Could she be depressed?
I hate the thought of having her put on some strong
medicine for depression at her age, but I'm afraid of
some of the other possibilities if I ignore this
problem.
Concerned Mom
Dear Mom,
Your daughter's behavior certainly could fit a diagnosis
of depression, though there are many other
possibilities. You don't mention how long her
behavior has been different, and that would be a key
piece of information. Simple sadness about some
life event could change her behavior in this way, too.
Have you asked her what's going on in her life?
Maybe there are school or social stressors that you
don't know about. Please sit down and talk to her
immediately. At the very least she needs to
understand that you care about her and are available to
help her figure things out.
Drug or alcohol abuse can sometimes present this same
picture. Do you know your daughter's friends?
Does she spend a significant amount of time away from
home? Have you noticed any of the following signs:
bloodshot eyes, extremely dilated or pinpoint pupils,
loss of appetite, listlessness or unusual sleepiness, a
decrease in school performance, skipping school,
withdrawal from activities that she used to enjoy, an
unusual odor to her breath, a change in speech (slurred
or more rapid), or unsteadiness on her feet? Some
of those symptoms are also present with depression, as
you will see, but a cluster of them would raise concern
for drug use.
Depression is common in the childhood years, a fact that
was not well understood even a generation ago. It
is estimated that 8.3 percent of adolescents are
suffering from a true depression at any given moment
(and 2.5 percent of grade school children!)
Adolescent girls are twice as likely to be depressed
than boys. Children and teens who are depressed
don't always demonstrate it in the same way that an
adult would. They certainly may not be self-aware
enough to recognize that they have a fixable problem or
to actively seek help.
If any of the following signs are present along with the
behaviors you describe above, you should make an
appointment with your daughter's pediatrician right
away.
Signs of depressions in teens may include:
-
Frequent tearfulness. (or more subtle
evidence of sadness, including writing stories or
poems filled with hopelessness or listening only to
music with themes of death and hate.)
-
A loss of previous hygiene habits.
-
Dropping out of clubs, sports, or
other previously enjoyed activities, or avoiding
friends. (Some teens stop calling friends, or show
no interest in taking a call from a friend.)
-
Lack of energy.
-
Frequent complaints of headaches or
stomachaches.
-
Missing school often, or doing more
poorly in school than previously.
-
Lack of concentration, even for a
conversation, a movie, or a television program.
-
A change in sleep habits, either
sleeping a lot more or having difficulty sleeping.
-
A change in eating habits (eating a
lot more or loss of appetite).
-
Talk of wanting to run away from
home.
-
TALKING ABOUT WANTING TO BE DEAD, or
"life isn't worth the trouble," or "you'd all be
better off if I wasn't around." ALWAYS TAKE
THIS KIND OF STATEMENT SERIOUSLY AND GET HELP
IMMEDIATELY. Conversely, don't be afraid to
ask you child if she's ever had thoughts about
suicide. Asking about it won't "put it into
her mind," and it may give you information you
urgently need. Asking the question will also
let your daughter know that her distress has not
gone unnoticed, and that you care enough to ask a
difficult question.
-
Use of alcohol or drugs can be an
attempt to self-medicate for depression.
-
Some teens will burn or cut
themselves as a way of demonstrating pain that they
can't put into words.
-
Defiance, irritability or beginning
to suddenly get into trouble can be signs of
depression as well.
Seeking help, by the way, doesn't mean
your child will be put on a medication. First, a
thorough physical exam should be done to rule out any
medical reason for her symptoms. If the working
diagnosis is depression, psychotherapy (or counseling)
may be all that is needed. However, sometimes a
depressed person is too dysfunctional to begin actively
working on their problems until the chemical part of
their depression is addressed. Medications should
NOT be used to treat the normal sadness and grief
brought about by painful situations in a child's life,
since they may actually interfere with resolution of
those situations. Medications also should not be
used without psychotherapy.
Antidepressant medications are used to normalize brain
chemistry that has been altered by depression.
There are several antidepressants now available that
have a much better safety profile than those previously
available; both in terms of side-effects and in terms of
the risk of dangerous overdose, as in a suicide attempt.
If your daughter is prescribed a medication, be sure to
ask the specific purpose of the drug, how long it will
be before you can expect to see results, how often your
daughter will be seen to monitor these results, what
medications could interact in a bad way with the
prescribed drug, and how long she is likely to need
treatment.
Keep in mind that suicide is the third leading cause of
death in 15 to 19 year olds. If you even think
that there is a slight risk of a suicide attempt, remove
all razor blades, medications (including aspirin and
Tylenol), and guns from your home. Have the 24
hour Lower Columbia Mental Health Emergency phone number
taped to the bottom of your phone (360-425-6064).
Be especially concerned if your child begins to give
away things she treasures, or can't describe any plans
for her future. Best of all, seek help early!
 
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