Depression in Teenagers
With as many as 25% of teenagers with ADHD being clinically depressed, it is important to understand what depression looks like, why it is important to treat it and manage it, and the treatment options available.
When we think of someone who is depressed, we usually picture a sad, tearful, lonesome person. But teenagers with depression don't look like adults with depression.
Current studies show that there are about as many teenagers who are depressed as there are adults that are depressed, about 10% of the general population. And as we have noted, as many as 25% of teens with ADHD are depressed. However, depression in teenagers doesn’t always look like depression in adults. Teenagers do not commonly display gloom, put themselves down, or talk about feeling hopeless like adults do.
Teenagers with Major Depression are described as often becoming negative and antisocial. Feelings of wanting to leave home or wanting to run away will increase. There may be a strong sense of not being understood and approved of by parents, siblings, or peers. The teen often changes, and becomes more restless, grouchy, or aggressive. A reluctance to cooperate in family ventures, and withdrawing from the family by retreating into their room is pretty common. School difficulties are likely even in those few ADHD teens who were doing pretty well in school, as concentration is even more affected than from the ADHD alone.
Sometimes the teen will stop paying attention to personal appearance, and sometimes they will adopt the “uniform” of social groups that profess depression or despondency as a way of life. They often become much more emotional “at every little thing.” Often there is an increased sensitivity to rejection in love relationships as well.
Which reminds me of a Cornell University study that reported that the leading cause of teenage depression was breaking up with a boyfriend or girlfriend. And that the younger the teen was in this relationship, the more likely the breakup would lead to depression.
Teenage boys will often become aggressive with their parents or peers, seem more agitated around the house, and get into more trouble at home, at school, or with the law. Teenage girls will sometimes become preoccupied with themes of death or dying, and become decreasing concerned about how they look.
Suicidal thoughts are common in depressed teens. Some studies suggest that 50,000 teens attempt suicide each year, and 5,000 are successful. That would be 10%. Other studies suggest that the number is 15% of depressed teens ending their life via suicide.
By the way, another study notes that of all the teenagers that commit suicide each year, only seven percent were receiving mental health treatment at the time of their death, and 93% were not receiving any treatment for depression.
Poor self-esteem is common with teenagers, but especially with those who are depressed, and there is often an increase in “self-destructive behaviors” such as alcohol abuse, drug abuse, and sexual promiscuity.
Parents are often confused and frustrated when their teens begin to act like this. Sometimes parents become stern disciplinarians, or even put the teen down, which only serves to increase feelings of guilt and depression. Other times, parents feel helpless, and stand by waiting for adulthood to arrive. Of course neither course is the best one to take.
And even with only a small percentage of teens with ADHD or depression receiving treatment, the use of ADHD medicines prescribed to girls was up by nearly 75%, and the use of antidepressant medications was up by nearly 10% in girls from 2001 to 2006.
To add to this drama, no doubt you've seen recent news headlines about a federal panel that recommended to the FDA that anti-depressant medications carry the strongest possible warning label for use in children and teenagers. This recommendation to the FDA shook the medical community, especially those who work with depressed young people, and now the FDA mandates that antidepressants used to treat adolescent depression carry the dreaded “black box” warning label.
What the media did not report well is the fact that 10% to 15% of children and teens with depression who receive no treatment will commit suicide. These 10% to 15% will not just think about it, but will actually kill themselves.
So what are we to do? If the media had their way it seems that no teens with depression would receive anti-depressants. As a result the suicide rate for those who could be using the medication would rise from just above zero percent to about fifteen percent, which is the suicide rate for depressed teens who are untreated. And, yes, while there actually are young people, and adults, who have become suicidal only after beginning treatment with an anti-depressant, remember that they were likely suffering from depression already, or else they wouldn't have been treated with anti-depressants.
And it is sadly true that some have in fact gone on to take their own lives after begining anti-depressant medications, which is absolutely tragic and heart-breaking. But so is the fact that untreated depression is very risky and potentially fatal. As many as fifteen out of one hundred young people with depression take their own lives unless they receive treatment. These young people should be allowed to receive a treatment that will lower the suicide rate dramatically, and without any stigma attached to it by the media.
With proper diagnosis and treatment a depressed teen, or adult, can be greatly helped. If someone close to you is suffering from depression, first please understand that depression is a very emotionally painful condition. Please take the situation seriously. If you know of a teen whose behaviors have changed and look like all that we have been discussing, let the parents know that there is help available, and encourage the family to seek help from a professional. Teenagers and Depression.