Teens and Depression

Preventing and treating depression in preteens was the focus of the Feb. 23, 2009 Preteen Alliance luncheon co-sponsored by Kaiser Permanente and Lucile Packard Children's Hospital. Stanford psychiatrist Frances Wren, MD, discussed warning signs of depression and other mental health issues, and reviewed research about early intervention programs. Shashank Joshi, MD, also a psychiatrist at Stanford, addressed what role schools can play when dealing with preteen depression, and presented a useful screening tool.

Between 7 million and 12 million American youth suffer from mental, behavioral, or developmental disorders at any given time, according to the American Academy of Child & Adolescent Psychiatry. About six percent of children and adolescents suffer from depression at any one given time. Children living in poverty, experiencing trauma or stress, loss, and those who have attention, learning, conduct, or anxiety disorders are at a higher risk for depression. Depression also tends to run in families, is more commonly diagnosed in females, and the average age on onset for depression is about 15 year old.

I was surprised to hear that 10-14% of teens experience an episode of major depression before they are 18 years old, and that 20-50% of depressed teens have a parent with a depressive disorder. Youth we should worry about are those who appear sad, bored, joyless, anxious and are easily upset (emotions); are socially isolated (relationships); experience hopeless, self-critical and brooding thoughts and are experiencing sleep disturbances.

I can hear you saying "doesn't that apply to all teens?" And the answer is no, although we all have days like this, I am talking about teens for whom this pattern is habitual. The teens we worry about are those who not only are easily upset, but react intensely, stay upset for a long period of time, and who carry the disappointment with them.

Youth who seem to be less vulnerable to depression are those who find joy and humor in things, are flexible in their thinking, can see the positive side of things (with encouragement), are not easily discouraged, and who believe s/he can change things.

They also have strong bonds with family members, have families that are joyous, loving, flexible, responsive, and communicate well. Organized and patterned families are also protective for youth. Youth with adult support (other than parents) and who live in strong and healthy communities are less depressed as well.

Here are the warning signs that parents, providers, and educators should look for:

  • Frequent sadness or crying
  • Feelings of hopelessness
  • Persistent boredom or low energy
  • Frequent absences from school, poor academic performance, or changes in grades or attendance
  • Discussion of, or efforts to, run away from home
  • Decreased interest n activities; or inability to enjoy previously favorite activities
  • Poor concentration
  • A major change in eating and/or sleeping patterns
  • Social isolation, poor communication
  • Low self-esteem, excess guilt
  • Extreme sensitivity to (perceived) rejection or failure
  • Increased irritability, anger, or hostility
  • Difficulty with relationships
  • Frequent complaints of physical illnesses, such as headaches and stomachaches
  • Thoughts of expressions of suicide or self-destructive behavior

If you think your child might be depressed, talk to your doctor, call your medical insurance and get a referral to a behavioral health specialist, call the California Youth Crisis Line (800) 843-5200, or in worst cases, call 911. You are not alone and there are many support services for families.

For more information about the event, and to download the speakers' presentations, visit the Lucile Packard Foundation for Children's Health.

Do you have colleagues or friends who should know about the Preteen Alliance? Encourage them to sign up at The Preteen Alliance for advance notice of all the Alliance's events.

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