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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.

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 illnesses
  • certain medicines, including antibiotics and medicines used to treat acne
  • changes in brain chemicals
  • heredity
  • hormonal changes
  • lack of sunlight
  • major stresses
  • negative thinking patterns
Common risk factors for depression in adolescents include:
  • abuse or neglect
  • alcohol abuse
  • breakup of a romantic relationship
  • chronic illness, such as diabetes
  • cigarette smoking
  • divorce of parents
  • drug abuse and addiction
  • family history of depression
  • learning disabilities
  • low self-esteem
  • major trauma, such as a natural disaster
  • other 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 drugs
  • avoiding cigarette smoking
  • getting prompt treatment for other psychiatric disorders
  • seeking effective treatment for chronic diseases
  • talking 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) 19
  • the Center for Epidemiologic Studies Depression (CES-D) Scale
  • the Children's Depression Inventory (CDI) 18
  • the 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 life
  • lowering the risk of suicide
  • making 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 depression
  • feel less alone
  • improve relations with family, friends, and coworkers
  • learn about depression and how it affects them
  • learn to recognize and avoid situations that can bring on a depressive episode
  • learn to view the world and others more positively and more realistically
  • positively address problems that they may be facing
  • stop 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:
  • agitation
  • constipation
  • dizziness
  • drowsiness
  • dry mouth
  • nausea
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 smoking
  • doing regular exercise
  • eating a balanced diet, following the food guide pyramid
  • finding a support system for dealing with depression
  • finding ways to manage stress
  • getting 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]

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