Adolescence can be a difficult time for both young people and their parents.
The normal and often turbulent hormonal, physical, and cognitive changes that occur during this stage of development sometimes make it difficult to recognized and diagnose underlying depression in adolescents.
Although the symptoms of depression in teenagers are much the same as those in adults, they often manifest in very different ways. For instance, self-injurious behaviors such as cutting or burning are rare in adults but are much more common practices among depressed teens.
Depression in adolescence may also lead to behavioral problems such as irritability or moodiness, fighting, defiance, skipping school, running away, drug use, sexual experimentation, and poor grades. It is estimated that, at any given time, 10 to 15 percent of teenagers suffer with depression, yet it is often written off as normal teenage angst. ?
Facts & Statistics About Teenage Suicide
Suicide is the third leading cause of death in young people between the ages of 15 and 24 in the U.S. In 2007, the suicide rate among teens between the ages of 15 and 19 was 6.9 per 100,000. Males in that age group commit suicide at five times the rate of females, although females attempt suicide more often.
Each year nearly 20 percent of teens seriously consider suicide while nearly one in 12 attempt suicide, according to a study by the Centers for Disease Control and Prevention.
In addition to depression, risk factors for teenage suicide include:
- a family history of mental illness
- prior suicide attempts
- alcohol and/or drug abuse
- stressful events
- access to firearms
- exposure to other adolescents who have committed suicide
- self-injurious behaviors such as cutting or burning
Risk Factors of Teenage Depression
Many depressed adults first suffered from depression as teenagers.
Risk factors for depression during adolescence include:
- a family crisis such as death or divorce
- physical, emotional or sexual abuse
- frequent arguing
- witnessing violence in the home
Young people who are struggling with their sexual identity are at an especially high risk for depression, as are those who have trouble adjusting socially or a lack of social or emotional support.
Fortunately, depression in teens is highly treatable once a diagnosis is made.
Diagnosing Teenage Depression
Because of the difficulty in recognizing depression during adolescence, it is important that parents receive a comprehensive evaluation by a qualified mental health professional—preferably one who has experience or special training with teens.
An evaluation should encompass the full developmental history of the adolescent, as well as family history, school performance, and home behaviors.
Self-injurious behaviors, while usually not intended to end one's life, are a warning sign of depression and must be taken very seriously. These behaviors are typically transient and usually end as the teen develops better impulse control and other coping skills.
Treatments for Depression in Teenagers
The best treatment for adolescents with depression is a combination of medication and psychotherapy (including cognitive-behavioral and interpersonal therapies), according to a study funded by the National Institute of Mental Health.
Treatment plans should encompass individual, family, school, medical, and legal issues. Because depression in teens is often related to problems in the home, enhancing parenting skills is often an important part of treatment.
Also, depression may result in academic delays, which may require changes to the teen's school environment. For instance, an educational assessment may find that a depressed adolescent would ?fare better in a private rather than public school setting or even in day treatment programs.
Older adolescents will have a say in their treatments, including which, if any, medications they receive as well.
There has been some concern in recent years about the effects of selective serotonin reuptake inhibitor (SSRI) type antidepressants and adolescents. An FDA review found that four percent of teens experienced suicidal ideation and even suicide attempts while taking SSRIs—about twice the rate of those taking a placebo (although no suicides were completed). The FDA responded to this study by placing a "black box" warning label on all SSRIs indicating that the use of this type of antidepressants may increase the risk of suicidal ideation or behavior in adolescents with major depressive disorder (MDD).
It is important to note, however, that as the use of antidepressants has declined in teens due to the warnings (22 percent in the U.S. as of 2005), the rate of suicide among adolescents actually increased by 14 percent between 2003 and 2004; perhaps indicating a need for further study.