Monday, November 28, 2022

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How To Treat Teen Depression


Many parents view their children as extensions of themselves. Early signs of clinical depression in teens are often overlooked as the parent prefers to see a happy and adjusted product of their parenting. 

Consequently, teen depression is viewed as moodiness, hormonal changes, illness, or other rationales, rather than believing the teen is “damaged.” It often requires an acute episode for parents to accept they need to seek out teen depression treatment.

Even though most forms of adolescent depression are not the result of poor parenting, the depressed teen’s caretaker can feel responsible, feeling their unhappiness is the result of a parenting failure.

While this may certainly be true in certain cases of teen depression, it is not the general rule.

Treating Teen Depression

The effective way to treat teen depression depends on the cause of the depressed mood, as the term “teen depression” is itself an entire spectrum of clinical presentations and symptoms.

Many of the symptoms of teen depression are the same as normal teenage reactions to daily stress, however, in clinical depression, the symptoms persist and affect their perception and enjoyment of daily life. 

In 2020, The National Institute of Mental Health (NIMH) reported that 4.1 million 12 to 17-year-olds had at least one episode of major depression. 

To make a diagnosis of depression in a teen, a qualified professional (Psychiatrist or Child Psychologist) must document five symptoms of depression every day, lasting most of the day, for two weeks or more. 

The first step in how to treat teen depression is identification. 

Symptoms of Depression

One of the symptoms required to establish the diagnosis is a loss of interest or pleasure in most or all activities including hobbies that they previously enjoyed. 

Other symptoms of teen depression are:

  • Physical complaints that do not respond to treatment or do not have a clear cause. Aches, headaches, and stomach issues are the most common complaints.
  • Change in weight or appetite.
  • Change in sleep pattern. This can be either excessive sleepiness or insomnia.
  • Difficulty with executive function, leading to persistent difficulty making decisions, concentration, or memory recall.
  • Fatigue, loss of energy, or feeling “run down.”
  • Persistent or recurrent feelings of helplessness, guilt, or worthlessness.
  • Irritability, restlessness, or easy frustration.
  • Sad, anxious, or experiencing a mood void. 

It is easy to see how many of the symptoms of teenage depression are passed off as normal teenage behavior due to the propensity for hormonal changes to affect their moods. The difference is that depressive symptoms persist and worsen, inhibiting enjoyment or satisfaction in life.

In some cases, and it is difficult to predict in which cases, the result of teen depression can even lead to thoughts of suicide. The goal of understanding how to treat teen depression is essential to preventing those thoughts from becoming a reality.

Any intervention that inhibits contemplation of suicide and improves their quality of life should be a priority, and there are plenty of helplines available that can offer assistance as needed, both for you and the teen. 

Maintain an Open Dialog

As early as the first suspicion a teen may have a depression disorder, the first principle of treatment is communication.

Whether as a parent or other relative, a teacher, or a concerned friend, keep a comfortable line of communication open with the teen. Provide frequent reassurance that they are not alone and that the burden can be shared.  

Be available when the teen requires your attention. Listen more, talk less.

Treatment by Diagnosis

Before any evaluation for mental health conditions is undertaken, consider possible physical causes of depressive symptoms.

Hypothyroidism is a common disorder that presents with weight gain, lethargy, and depression. The treatment for that specific cause of teen depression is thyroid hormone replacement. 

Within the psychological spectrum of depression, there are multiple identifiable depressive states.

Aside from psychiatric disorders (such as bipolar diseases 1 and 2) and major depression with psychotic features, psychological depression in teens is approached with a multidisciplinary approach. 

In general, the modalities in the treatment of most teen depression are a combination of psychotherapy (talk therapy) and medication. 

Psychotherapy

Available psychotherapeutic interventions can include one on one therapy with a trained adolescent therapist or group therapy. The psychotherapist can find the root cause of the depression if one exists, then provide advice for daily management of the symptoms and future improvement.

Group therapy has been called “mirror therapy.” In group discussions, certain comments from other participants can elicit strong emotions in the depressed teen.

Analyzing and evaluating through identification, relatedness, and significance of the emotional reaction can lead to understanding the underlying causes and lead to a resolution.

Medication

There are currently only two approved prescription antidepressants used for teens.

Both Prozac (Fluoxetine) and Lexapro (Escitalopram) are Selective Serotonin Uptake Inhibitors (SSRIs). They work by keeping serotonin neurotransmitters in the synaptic cleft where they exert their effects countering depression. 

It is important to note that both drugs carry a black box warning, as a known side effect is that they can increase the symptoms of depression and increase the chances of suicidality, especially in teens. Due to the increased risks when initiating this type of treatment, careful monitoring is required.

There are also natural interventions that can treat teen depression.

St. John’s Wort (Hypericum perforatum) is a flowering herb. Research shows that when used in appropriate doses, it is an effective treatment for depression in adults. However, its use in teens has not been studied extensively. 

Other Treatment Options

Other modalities that may treat teen depression include acupuncture, guided meditation, yoga, tai chi, and music therapy.

There are cases, however, that require more drastic measures to preserve life such as involuntary monitoring or confinement, electroconvulsive therapy (ECT), and experimental psychotropics.

The Bottom Line

How to treat teen depression is not a simple question. It requires the time, patience, and courage to identify and then appropriately explore methods to eliminate or reduce teen depression. Each case is unique and treatment must be tailored to the individual and family.

If you suspect a teen of being depressed beyond what you might consider normal, intervene – and intervene now

Every minute a depressed teen is denied treatment is another minute of turmoil and another step toward a more serious situation. The most important step in treating teen depression is simply to get involved before it is too late.

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