Legal Law

Depression in adolescents: now what can we do?

You’ve no doubt seen the recent news headlines about a federal panel recommending to the FDA that antidepressant medications carry the strongest possible warning label for use in children and adolescents. This recommendation to the FDA shocked the medical community, especially those who work with depressed youth. The biggest problem from the point of view of the treatment community was not the recommendation for the warning label, but rather the way the panel’s recommendation was portrayed in the media. The panel reported that 2% to 4% of children and adolescents who received antidepressants for the treatment of depression became suicidal, that is, had suicidal thoughts or attempted suicide of one kind or another. None of the 4,000 children and adolescents studied committed suicide. What has been misreported by the media is the fact that 15% of children and adolescents with depression who do not receive treatment will commit suicide. This 15% will not only think about it, but will commit suicide. Then, what are we going to do? If the media had their way, it seems that no teen with depression would be on antidepressants. As a result, the suicide rate for those who might be using the drug would rise from almost zero percent to around fifteen percent. But at least we wouldn’t have to worry about evil drugs. Look, I understand that there are actually young people, even adults, who have become suicidal only after starting treatment with an antidepressant. Some, in fact, have even taken their own lives. This is absolutely tragic. But so is the fact that untreated depression is a potentially fatal disease. Fifteen out of every hundred young people with depression take their own lives. They must be allowed to receive treatment that drastically reduces the suicide rate, and without any stigma attached to it by the media. We recently had a patient brought into our counseling center named John (not his real name). John was rebellious, angry, withdrawn and often got into trouble and yet he was diagnosed and treated for depression. When we think of someone who is depressed, we usually picture someone sad, tearful, and lonely. But adolescents with depression are not like adults with depression. Current studies show that there are as many depressed teens as there are depressed adults. However, depression manifests itself very differently in adolescents than in adults. Teens don’t often show pessimism, self-deprecation, or talk about feeling hopeless like adults do. Adolescents with major depression are described in diagnostic manuals as often becoming negative and antisocial. Feelings of wanting to leave home, or of not being understood and approved of increase. The adolescent often changes and becomes more restless, moody or aggressive. Reluctance to cooperate in family businesses and isolation from social activities, retiring to one’s own room, are frequent. School is likely as concentration is affected. Sometimes there is a lack of attention to personal appearance and increased emotionality. There is also often a heightened sensitivity to rejection in love relationships. Teenagers often become aggressive, agitated, and get into trouble at home, at school, or with the law. Teenage girls sometimes worry about issues of death or dying, becoming increasingly concerned with their appearance. Suicidal thoughts are common. Some studies suggest that 500,000 adolescents attempt suicide each year and 5,000 succeed. Increased use of alcohol or other drugs is common, along with other forms of “self-destructive behaviors.” Low self-esteem is common among adolescents, but especially among those who are depressed. Parents often feel confused and frustrated when their teens start acting this way. Sometimes parents become harsh in disciplining, or even belittling the teen, which only serves to increase feelings of guilt and depression. Other times, parents feel helpless and are left waiting for adulthood to arrive. Of course, neither of the two courses is correct. If you know of a teen whose behaviors have changed to resemble what was described above, let the parents know that help is available and encourage the family to seek professional help. With proper diagnosis and treatment, a depressed teen or adult can be greatly helped. If someone close to you is suffering from depression, first understand that depression is a very emotionally painful condition. For some people with depression it becomes a “terminal illness” due to suicide. Please take the situation seriously. 1) Get a medical evaluation. The symptoms of depression can be the result of a wide variety of illnesses, including thyroid problems, viral infections, and other factors. 2) Deprex is an amino acid and homeopathic medicine for the treatment of depression that we have seen to work well with our patients. It may be worth trying as long as the situation is “stable” and there are no suicidal thoughts on the part of the depressed person. 3) Medications like Prozac can be very helpful for the most difficult cases. Consult your doctor. These drugs are often prescribed by family medicine doctors, but in most cases they must be supervised by psychiatrists. 4) Increase your protein intake a little. Use a protein powder supplement, such as a weight lifter. 5) Exercise every day. Just get out and walk around for about 15 minutes. 6) Seek advice from someone who is good at treating depression. This can do a world of good for you. However, always use great wisdom and common sense when choosing a therapist. Some are good and some are not, so choose wisely.