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Depression In Adolescents

Alternate Names

  • teenage depression

Definition

Depression is a medical condition that leads to intense feelings of sadness or despair. These feelings will not go away on their own. They are not necessarily related to a particular life event.

What is going on in the body?

Depression is a disorder of the brain. Researchers believe that chemicals called neurotransmitters are involved in depression. Nerve impulses cause the release of neurotransmitters from one nerve cell to the next. This release allows cells to communicate with one another. Too little or too much of these important neurotransmitters may be released. This can cause or contribute to depression. These neurotransmitters include serotonin, norepinephrine, and dopamine.

Symptoms

What are the signs and symptoms of the condition?

Some symptoms are common in people of all ages with depression. These symptoms include: appetite problemsdecreased energydifficulty paying attention or making decisionsfeeling very sensitive emotionallyfeelings of irritabilityfeelings of sadness, despair, and emptinessinability to feel pleasurelow self-esteemloss of motivation and withdrawal from otherspessimism, negativitysleeping problemsthoughts about suicide and death

Teens with depression may have additional symptoms, including: alcohol abusedifficulty with friendships or social outingsdrug abuse and addictionfear of deathfrequent vague physical ailments, such as headacheirritability or hostilitypoor school performance, tardiness, or absencesproblems with authoritiesrecklessnesssensitivity to failure or rejection

Risks

What are the causes and risks of the condition?

There are many theories about what causes depression. Depression may be caused by one or more of the following: certain illnessescertain medicines, including antibiotics and medicines used to treat acnechanges in brain chemicalsheredityhormonal changeslack of sunlightmajor stressesnegative thinking patterns

Common risk factors for depression in adolescents include: abuse or neglectalcohol abusebreakup of a romantic relationshipchronic illness, such as diabetescigarette smokingdivorce of parentsdrug abuse and addictionfamily history of depressionlearning disabilitieslow self-esteemmajor trauma, such as a natural disasterother psychiatric disorders, such as attention deficit disorder or adolescent conduct disorder

Adolescent girls are twice as likely to develop depression as adolescent boys.

Prevention

What can be done to prevent the condition?

Depression may not be preventable. However, these steps may be helpful in preventing it: avoiding alcohol and illegal drugsavoiding cigarette smokinggetting prompt treatment for other psychiatric disordersseeking effective treatment for chronic diseasestalking with a counselor after experiencing a major trauma or loss

Depression can lead to suicide. The lifetime risk of suicide for a person with depression is about 15 percent. It is important to recognize and treat the condition early.

Teens should be encouraged to seek help from a physician, licensed counselor or psychologist if they are concerned about depression. Conversations with parents, other family members, clergy members, peers, and teachers are important and very helpful, but do not substitute for the clinical care needed to treat depression.

Diagnosed

How is the condition diagnosed?

Screening tests for depression in teens include: the Beck Depression Inventory (BDI) 19the Center for Epidemiologic Studies Depression (CES-D) Scalethe Children's Depression Inventory (CDI) 18the Zung Depression Scale

A teen who screens positively on one of these tests should have a comprehensive evaluation for depression. The evaluation may include a medical history, physical examination, and laboratory tests.

Long Term Effects

What are the long-term effects of the condition?

Most adolescents recover well from a single episode of depression. However, episodes are likely to recur. Adolescents with depression are at risk for further episodes of depression later in life. They are also at risk for adult personality disorders.

There is a strong connection between depression and suicide in adolescents. Suicide is the third leading cause of death for people in the U.S. between the ages of 15 and 24.

Other Risks

What are the risks to others?

Depression is not contagious and poses no risk to others.

Treatments

What are the treatments for the condition?

The two most common ways of treating depression in adolescents are with antidepressant medicines and psychotherapy. Often a combination is used. Occasionally, a teen must be hospitalized for intense treatment.

Antidepressant medicines are effective in: increasing the teen's ability to function in daily lifelowering the risk of suicidemaking the teen feel better

Antidepressant medicines known as selective serotonin reuptake inhibitors (SSRIs) can be used in teens. Some common SSRIs include fluoxetine (i.e., Prozac, Sarafem) and paroxetine (i.e., Paxil, Paxeva).

Psychotherapy can help adolescents: cope better with having depressionfeel less aloneimprove relations with family, friends, and coworkerslearn about depression and how it affects themlearn to recognize and avoid situations that can bring on a depressive episodelearn to view the world and others more positively and more realisticallypositively address problems that they may be facingstop episodes of depression early by recognizing warning signs and symptoms

Treatment of depression in a teen should involve the family as well as the individual.

Side Effects

What are the side effects of the treatments?

Antidepressants may cause mild and usually temporary side effects in some people. The most common side effects are: agitationconstipationdizzinessdrowsinessdry mouthnausea

There is some recent evidence that risk of suicide is greater among adolescents receiving SSRI's than among those receiving placebo, especially during the first month of treatment. Although this should not prevent treatment, since depression itself increases the suicidal risk, parents and teens should be aware of this risk and closely watch for clinical worsening or unusual behavior changes.

After Treatment

What happens after treatment for the condition?

An episode of depression in a teen usually responds to treatment with medicine and psychotherapy. The teen can help prevent relapses by living a healthy lifestyle. Some important parts of the healthy lifestyle include: avoiding alcohol, illegal drugs, and smokingdoing regular exerciseeating a balanced diet, following the food guide pyramidfinding a support system for dealing with depressionfinding ways to manage stressgetting enough rest

Monitor

How is the condition monitored?

Once a teen has an episode of depression, he or she is at higher risk for further episodes. Any new or worsening symptoms should be reported to the healthcare provider. The provider may recommend regular visits to monitor symptoms. The provider may also order blood tests to monitor the levels of medicines.

Sources

Professional Guide to Diseases, Sixth Edition. Springhouse: Springhouse Corporation, 1998.

"Depression Treatment Guide" [hyperLink url="http://www.anxiety.org.za/deprtguide.htm" linkTitle="www.anxiety.org.za/deprtguide.htm"]www.anxiety.org.za/deprtguide.htm[/hyperLink]

"Adolescent Depression" [hyperLink url="http://www.healthtouch.com/level1/leaflets.htm" linkTitle="www.healthtouch.com/level1/leaflets.htm"]www.healthtouch.com/level1/leaflets.htm[/hyperLink]

"Depression in Teenagers" [hyperLink url="http://www.psychologyinfo.com/depression/teens.htm" linkTitle="www.psychologyinfo.com/depression/teens.htm"]www.psychologyinfo.com/depression/teens.htm[/hyperLink]

"Clinical Depression and Children/Adolescents" [hyperLink url="http://www.intelihealth.com/specials/depression/htmDeprChildren.htm" linkTitle="www.intelihealth.com/specials/depression/htmDeprChildren.htm"]www.intelihealth.com/specials/depression/htmDeprChildren.htm[/hyperLink]