| What's Wrong with my Teen? A Primer on Adolescent Depression |
July 2000 |
| Shawn seems to be a different
kid these days. This normally friendly, outgoing and active teen
has suddenly become quiet. He avoids his family and friends.
His schoolwork is falling behind. He seems pretty sad much of
the time. He doesn't even go to basketball practice--his favourite
pass-time. So, what should mom and dad think? Is this just normal
teen angst, or has Shawn fallen in with a drug crowd? Given these
symptoms there's a strong chance that Shawn is suffering from
depression. And Shawn's parents should be concerned. Depression is on the increase all across society. A lot of people are very unhappy for a lot of different reasons. And for teens, depression is just as real as for adults. According to Statistics Canada, 183,000 teens experienced some form of depression over the 12-month period from 1998-1999. As parents, it's important that we learn to recognize the symptoms of depression, and to take the necessary steps that the depressed child cannot do for him- or herself. |
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| What is depression? There are two types of depression, each with a completely different cause. Depression can be a normal reaction to a major setback. The death of a parent or sibling, the loss of a relationship, even the perceived loss of one's childhood, can all trigger depression. Called episodic depression, this condition is, by its nature, self-limiting. Episodic depression is a type of mourning, and it can be a necessary step in coming to terms with life's stresses and traumas. The depression will last between 2 weeks and 2 months, although it can last up to 4 months. While the person appears to be depressed much of the time, he or she will continue to show interest in some activities. A girl might spend the night crying in her room and then show up on time for volleyball practice the next day. Episodic depression also responds to verbal support. This teen can talk about the problem and may gradually improve as a result. Episodic depression can usually be traced back to some significant event. On the other hand, so-called clinical depression has a physiological origin. According to the Canadian Medical Association, it is caused by a chronic chemical balance, and is the most common of the mood disorders. A clinically depressed adolescent will descend into the gloom for days at a time. No amount of comforting will get to through to them. They will resist all attempts be to be cheered up or distracted or even to get them to talk about the problem. Favourite activities are abandoned. Nothing is interesting. Nothing is enjoyable. The depression is so entrenched it can even resist formal therapy. The symptoms are always there and are in control. Clinical depression is usually a long-term condition, with episodes recurring relentlessly. |
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| What are the symptoms? The symptoms for episodic and clinical depression are the same. They differ in intensity and duration but otherwise are hard to tell apart. Identifying depression is further complicated because some symptoms resemble a normal part of today's teen experience. Depressed adolescents may exhibit a continuum of feelings and behaviours, from the normal misery of adolescence to major depression. The symptoms in adolescents are the same as those of an adult, but a teen's symptoms may look different. The signs to look for include: |
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| Are girls and boys affected differently? Girls, in particular, may become sad or anxious. They will cry or seek support. Sometimes they will cut or burn themselves to feel more in control. Cutting is widespread among stressed-out adolescent girls (and some boys as well.) One theory is that these young women may be trying to carve themselves into an acceptable image. Both boys and girls may be protesting by taking proof of emotional pain to an extreme, asking for help by their dramatic actions, or trying to gain control by hurting themselves more than life can hurt them. The danger in inflicting harm on the body is that it becomes cathartic and can be difficult to stop. Boys may withdraw from relationships, become angry, or appear tired and apathetic. They will deny pain. They can't cry. They often feel sick, talk of death or suicide, and may become fanatical about being left alone. They frequently become impulsive and may act out constantly. Some will become over-involved in academic work or sports. |
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| What triggers depression in adolescence? Depression can arise for a number of reasons, including: conflict between parents, loss of friends, loss of childhood pass-times, prolonged confusion about what to do and who to be, and rejection. Separation from the family (emotionally and physically) creates emotional pain for teens. If they blame themselves they may get depressed. If they blame others they may get angry. Boys and girls may both be grieving for the lost of self - their childhood, the authentic person who disappears in adolescence. Their own development and the North American culture put enormous stress on our kids. A physiological depression can occur for no discernible reason and may follow a predictable schedule, such as an episode every two or three weeks. |
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| How do I know if it's depression
and not teen angst? Expect your teen to go through some sad times. But the degree of sadness-its depth and duration-will differentiate mere sadness from depression. How much do they act a certain way? Do they always seem to be that way? How intense is the behaviour? How long does the behaviour last? Does the mood seem to be taking over? One night on the phone and trouble getting up the next day is normal, but if it occurs night after night, it may signal a problem. The magnitude or importance of a triggering event may also be a clue. For the normal teen, a major loss may lead to grieving in the form of depression. For a teen prone to depression, the negative event, real or imagined, is just one more insult in a long series of personal setbacks, and therefore is easier to overlook. |
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| What can be done? Watch for the signs of depression and intervene early. First, talk to your child about your observations. If they're willing to talk about how they feel, structure some time with them just to talk, or provide them with someone to talk to on a regular basis (e.g. school social worker, child and youth counsellor, private practice therapist, or clergy with therapeutic training). Consult with a therapist if symptoms persist. Obtain medical intervention if needed. Don't buy into the argument that their depressed friend, who understands what they're going through, is a good source of support. If they refuse to talk to anyone, insist on a visit to the family doctor and make sure that the doctor hears your observations and perspective. The job at this point is to have a professional confirm or rule out physiological depression, and propose treatment. Keep in mind that any depression can last up to two months. But early intervention is better than waiting. It's far better for your teen to think you're an idiot for over-reacting rather then letting them suffer in silence-or worse. Depression is one of the most dangerous of the mood disorders because of the possibility of suicide. Even an episodic depression can end in suicide. Be especially aware of someone who suddenly cheers up after a period of depression. They may have decided to end their suffering, and their relief is exhilarating. |
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| Conclusion Clinical depression is a physiological disorder. It is not caused by bad thoughts or experiences, although the depressed person has plenty of both. It's bad chemistry, usually caused by genetics. Normal treatment is with medication. It may take time to find an effective medication and this must be done by a professional, preferably a psychiatrist. Many people with depression respond well to insight therapy as well, provided they have the support of a drug that will keep the disorder under control. Mostly, kids want to feel good and they are glad to have help and counselling. Occasional mild depression is a normal part of living. We get through it with our life skills and the support of family and friends. So will your teen. Clinical depression typically is a life-long disorder. Yet most people with clinical depression can manage their disorder very well with treatment. With appropriate medication and support, these people can handle life's ups and downs as well as anyone else. |
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