Sue Scheff - Mistreated Depression

Source: Connect with Kids

“Basically, psychiatrists are pretty busy. They don’t want to spend a lot of time with people. They want to get people in and out, maybe two or three an hour. … It pays better to do that than spending an hour doing psychotherapy.”

– David Gore, Ph.D., clinical psychologist

Fifteen-year-old Sarah McMenamin suffers from depression. It started a year ago with the death of her father.

“I was just like, ‘I just want to die,’” she says, describing her feeling before seeing a therapist. “I would never kill myself, but I just wish I was dead, I just wish I was never going to wake up.”

For depressed teens, experts at the American Academy of Child and Adolescent Psychiatry say what can help is medicine – combined with talk therapy.

“I think the therapist helped me,” explains Sarah, “’cause it was talking, you know, I got it out. I didn’t bottle everything up.”

“The advantage to getting some therapy along with medication is that you get to the root of the problem,” explains Dr. David Gore, clinical psychologist. “You get to see why you’re feeling that way. And if you start understanding why you’re feeling that way, chances are pretty good you’ll stop feeling that way.”

But according to a new study from Thomson-Reuters, more teens than ever are getting medication without psychotherapy. Why? Gore has an answer.

“Basically, psychiatrists are pretty busy,” Dr. Gore says. “They don’t want to spend a lot of time with people. They want to get people in and out, maybe two or three an hour. … It pays better to do that than spending an hour doing psychotherapy.”

Three months ago, Sarah started seeing a new doctor.

“Right away he put me on Zoloft,” she says. “He didn’t even know me for an hour and he put me on it.”

But psychologists say medicine alone just won’t work as well.

“You take your pill, you’ll get some immediate relief,” explains Dr. Gore, “but the problem’s going to crop up again in two months or four months or six months. You’ve got to get to the root of the problem.”

Sarah will resume talk therapy again in a few months. She says she is looking forward to it.

“You get it out on the table and you know your feelings’” she says, “and you go in thinking it’s one thing and you come out finding out it’s like 10 different things and you’re like, ‘Wow.’”

Tips for Parents

All teens experience ups and downs. Every day poses a new test of their emotional stability – fighting with a friend, feeling peer pressure to “fit in” with a particular crowd or experiencing anxiety over a failed quiz – all of which can lead to normal feelings of sadness or grief. These feelings are usually brief and subside with time, unlike depression, which is more than feeling blue, sad or down in the dumps once in a while.

According to the Nemours Foundation, depression is a strong mood involving sadness, discouragement, despair or hopelessness that lasts for weeks, months or even longer. It also interferes with a person’s ability to participate in normal activities. Often, depression in teens is overlooked because parents and teachers feel that unhappiness or “moodiness” is typical in young people. They blame hormones or other factors for teens’ feelings of sadness or grief, which leaves many teens undiagnosed and untreated for their illness.

The Mayo Clinic reports that sometimes a stressful life event triggers depression. Other times, it seems to occur spontaneously, with no identifiable specific cause. However, certain risk factors may be associated with developing the disorder. Johns Hopkins University cites the following risk factors for becoming depressed:

Children under stress who have experienced loss or who suffer attention, learning or conduct disorders are more susceptible to depression.

Girls are more likely than boys to develop depression.

Youth, particularly younger children, who develop depression are likely to have a family history of the disorder.

If you suspect that your teen is clinically depressed, it is important to evaluate his or her symptoms and signs as soon as possible. The National Depressive and Manic-Depressive Association cites the following warning signs indicating that your teen may suffer from depression:

Prolonged sadness or unexplained crying spells
Significant changes in appetite and sleep patterns
Irritability, anger, worry, agitation or anxiety
Pessimism or indifference
Loss of energy or persistent lethargy
Feelings of guilt and worthlessness
Inability to concentrate and indecisiveness
Inability to take pleasure in former interests or social withdrawal
Unexplained aches and pains
Recurring thoughts of death or suicide

It is important to acknowledge that teens may experiment with drugs or alcohol or become sexually promiscuous to avoid feelings of depression. According to the National Mental Health Association, teens may also express their depression through other hostile, aggressive, risk-taking behaviors. These behaviors will only lead to new problems, deeper levels of depression and destroyed relationships with friends and family, as well as difficulties with law enforcement or school officials.

The development of newer antidepressant medications and mood-stabilizing drugs in the last 20 years has revolutionized the treatment of depression. According to the Mayo Clinic, medication can relieve the symptoms of depression, and it has become the first line of treatment for most types of the disorder. Psychotherapy may also help teens cope with ongoing problems that trigger or contribute to their depression. A combination of medications and a brief course of psychotherapy are usually effective if a teen suffers from mild to moderate depression. For severely depressed teens, initial treatment usually includes medications. Once they improve, psychotherapy can be more effective.

Immediate treatment of your teen’s depression is crucial. Adolescents and children suffering from depression may turn to suicide if they do not receive proper treatment. Suicide is the third leading cause of death for Americans aged 10-24. The National Association of School Psychologists suggests looking for the following warning signs that may indicate your depressed teen if contemplating suicide:

Suicide notes: Notes or journal entries are a very real sign of danger and should be taken seriously.

Threats: Threats may be direct statements (“I want to die.” “I am going to kill myself”) or, unfortunately, indirect comments (“The world would be better without me.” “Nobody will miss me anyway”). Among teens, indirect clues could be offered through joking or through comments in school assignments, particularly creative writing or artwork.

Previous attempts: If your child or teen has attempted suicide in the past, a greater likelihood that he or she will try again exists. Be very observant of any friends who have tried suicide before.

Depression (helplessness/hopelessness): When symptoms of depression include strong thoughts of helplessness and hopelessness, your teen is possibly at greater risk for suicide. Watch out for behaviors or comments that indicate your teen is feeling overwhelmed by sadness or pessimistic views of his or her future.

“Masked” depression: Sometimes risk-taking behaviors can include acts of aggression, gunplay and alcohol or substance abuse. While your teen does not act “depressed,” his or her behavior suggests that he or she is not concerned about his or her own safety.

Final arrangements: This behavior may take many forms. In adolescents, it might be giving away prized possessions, such as jewelry, clothing, journals or pictures.

Efforts to hurt himself or herself: Self-injury behaviors are warning signs for young children as well as teens. Common self-destructive behaviors include running into traffic, jumping from heights and scratching, cutting or marking his or her body.

Changes in physical habits and appearance: Changes include inability to sleep or sleeping all the time, sudden weight gain or loss and disinterest in appearance or hygiene.

Sudden changes in personality, friends or behaviors: Changes can include withdrawing from friends and family, skipping school or classes, loss of involvement in activities that were once important and avoiding friends.

Plan/method/access: A suicidal child or adolescent may show an increased interest in guns and other weapons, may seem to have increased access to guns, pills, etc., and/or may talk about or hint at a suicide plan. The greater the planning, the greater the potential for suicide.

Death and suicidal themes: These themes might appear in classroom drawings, work samples, journals or homework.

If you suspect suicide, it is important to contact a medical professional immediately. A counselor or psychologist can also help offer additional support.

References
American Academy of Child and Adolescent Psychiatry
American Foundation for Suicidal Prevention
Johns Hopkins University
Mayo Clinic
National Association of School Psychologists
National Depressive and Manic-Depressive Association
National Institute of Mental Health
National Mental Health Association
Nemours Foundation
Thomson-Reuters

Sue Scheff: Teens, Sex and Depression

Source: Connect with Kids

“It hurts, because I care so much about him.”

– Teagan, 15 years old

Fifteen-year-old Teagan says her new boyfriend is wonderful. “I never thought anyone like Preston could come along,” Teagan says. “He’s the greatest guy I’ve ever known.”

But is she as lucky as she thinks?

Studies show that romantic involvement brings adolescents down, rather than up. What’s more, researchers at the University of North Carolina find that teen girls who are sexually active are twice as likely to be depressed compared to girls not having sex.

But, even among abstinent teens who date, one of the problems is trust.

“Say your boyfriend went off to work and never called you that day,” Teagan says. “And you talked every single day on the phone. I mean you’d be kind of concerned and kind of wondering why. And then someone comes along and says ‘well maybe he’s cheating on you…’”

Combine adolescent insecurity with imagination and the result is a lot of questions: Where is he? Why doesn’t she call? Does he really like me? Why is she talking to that other boy?

That’s where most of the stress comes in,” Teagan says. “Getting thoughts in your head about what might be going on, when it probably isn’t going on at all.”

Experts say parents can help ease their child’s pain by listening and taking them seriously. It’s not puppy love to them, it’s real. “It hurts,” Teagan says, “because I care so much about him.”

Experts also advise teaching your child that early relationships may hurt, but they’re indispensable. “They will have many relationships before they finally settle on a life mate,” says Cheryl Benefield, a school counselor. “Let them know that when things happen, it’s maybe just preparing them for a better relationship in the future.”

Tips for Parents
According to the National Institute of Mental Health, boys and girls seem to be equally at risk for depressive disorders during childhood, but during adolescence, girls are twice as likely as boys to develop depression. Family history and stress are listed as factors, but another factor that often causes depression in girls is the break-up of a romantic relationship.

The authors of a study conducted at Cornell University titled “You Don’t Bring Me Anything but Down: Adolescent Romance and Depression,” found that females become “more depressed than males in adolescence partly as a consequence of their involvement in romantic relationships.” The reason? According to the study, “females’ greater vulnerability to romantic involvement explains a large part of the emerging sex difference in depression during adolescence.”

At any given time, five percent of children suffer from depression. Children under stress, who have experienced a loss, or who suffer from other disorders are at a higher risk for depression. Here are some signs of depression from the American Academy of Child and Adolescent Psychiatry (if one or more of these signs of depression persist, parents should seek help):

Frequent sadness, tearfulness, crying
Hopelessness
Decreased interest in activities, or inability to enjoy previously favorite activities
Persistent boredom; low energy
Social isolation, poor communication
Low self-esteem and guilt
Extreme sensitivity to rejection or failure
Increased irritability, anger or hostility
Difficulty with relationships
Frequent complaints of physical illnesses such as headaches and stomachaches
Frequent absences from school or poor performance in school
Poor concentration
A major change in eating and/or sleeping patterns
Talk of or efforts to run away from home
Thoughts or expressions of suicide or self destructive behavior
Getting an early diagnosis and medical treatment are critical for depressed children.

Depression is a serious condition, which, if left untreated, can even become life threatening. Suicide is the third leading cause of death among young people, leading to nearly 4,000 deaths a year. The rate has tripled since 1960. Therapy can help teenagers understand why they are depressed and learn how to handle stressful situations. Treatment may consist of individual, group or family counseling. Medications prescribed by a psychiatrist may be needed to help teens feel better.

Ways of treating depression include:

Psychotherapy: to explore events and feelings that are painful and troubling. Psychotherapy also teaches coping skills.
Cognitive-behavioral therapy: to help teens change negative patterns of thinking and behaving.
Interpersonal therapy: to focus on ways of developing healthier relationships at home and school.
Medication: to relieve some symptoms of depression (often prescribed along with therapy).
References
Journal of Health and Social Behavior
National Institute of Mental Health
American Academy of Child and Adolescent Psychiatry
National Mental Health Association
University of North Carolina