Teen Depression

Today we continue our discussion of child and adolescent mental health into the area of mood disorders, with depressive and bipolar disorders.

Surveys supported by the N.I.M.H. show that up to 3 percent of younger children and up to 8 percent of adolescents suffer from depression. Parents need to remember: life's normal ups and downs include moments of sadness as well as those of excitement and bliss. Childhood and adolescent depressions often look like adult ones, with sadness, tearfulness, hopelessness, lack of enjoyment, withdrawal and so on. With younger people, though, other signs of depression may be less obvious. For example, depressed kids may complain of boredom, refuse to go to school, give vague complaints of physical distress, throw tantrums, or talk about running away. They may reveal sensitivity to rejection, and take interest in alcohol and substance abuse. Recently, suicide was identified as the third leading cause of death in the adolescent age group and the sixth leading cause of death in younger kids.

Sometimes disobedience can point to depression, as opposed to a lack of discipline or even disrespect?

Yes, parents really need to tune into the multiple levels of meaning of their young people's behavior. Don't just react to the behavior. Figure out what he or she is trying to communicate. If it's only willfulness, then use approaches like behavior modification. But if it's showing up alongside some of the indicators that I mentioned above, like isolation or emotional outbursts, then talk to someone who knows about this stuff. Bone up on childhood mental health awareness by reading, attending public talks and talking to the experts in your community, such as your pediatrician or a mental health professional.

Now, let's talk about Bipolar Disorder, which is a condition of mood disregulation and presents with a characteristic symptom, called mania. Mania reveals itself by severe shifts in mood, often to the extremes, with deep sadness, say, alternating with intense excitation. Bipolar Disorder is rare in young kids, but an increasing number of adolescents are now receiving this diagnosis. In an adolescent manic state, we might see grandiose flights of self-esteem, like superpower stuff. He or she might stay up all-night and then stay up all day. Other symptoms can include distractibility, unstoppable talking, and high risk-taking behaviors like sex, drugs and reckless driving. The mania tends to "cycle," sometimes back and forth with depression and sometimes to a more normal state. These cycles can take days or weeks, but in "rapid cycling" cases can flip-flop many times in the same day.

How treatable are these conditions and what can parents do?

The most important consideration is early detection and intervention. Childhood mood disorders are treatable, but a lot of young people suffer without treatment, risking more severe states and, of course, suicide. The treatments include medications that reduce depression and help to better regulate mood. Cognitive and interpersonal psychotherapies and symptom management strategies can be effective and may be tried first, if the symptoms are not too disabling.

Parenthood is a gift as well as a responsibility that requires continuing education. Parents who keep informed and learn new skills to keep up with their growing kids' needs are the best equipped to face both the expected as well as the unexpected challenges of adolescence.

Discount Jewelry