Teen Depression

Q: "Having a depressive episode as a teen more than doubled the risk of having another depressive episode in young adulthood," says Ian H. Gotlib, PhD, co-author of the study. The study also found that only about one in four people who had been diagnosed with depression as teens said they remained free of psychiatric illness in early adulthood.

A:"There's a lack of appreciation that depression is a dysregulation of mood, just as diabetes is a dysregulation of blood sugar," Findling says. "We see youngsters with profound disturbances in function who suffer needlessly because parents or other well-meaning adults say it's part of being a teen-ager or it's just a phase." Depression should be distinguished from common sadness, says Gotlib: "Some warning signs are loss of interest, sadness, fatigue, concentration difficulties, sleep disturbances, and appetite problems that last for at least two weeks." But, he cautions, "it's important not to overreact if you see sadness for a few days in an adolescent." For more than 10 years, doctors have been studying a group of 1,700 Oregon teen-agers, aged 14 to 18, who were randomly selected from nine high schools. The doctors originally wanted to find out how common depression and other mental disorders were in this group of "normal" teen-agers. In this study, published in the American Journal of Psychiatry, they focused on teens who originally were found to be depressed but had recovered when questioned again a year later to see what happened to them as they got older. These subjects were interviewed by phone around the time of their 24th birthdays. Findling adds that parents should find a mental health professional who is proficient in caring for depressed adolescents. "We're fortunate in Cleveland to have a center of experts in pediatric mood disorders," he says. "But every community is different. Even if there is no specific program available, your doctor can probably tell you who is good at seeing young people with depression within your community." Almost half of the group of formerly depressed teens developed another type of problem, such as substance abuse or anxiety, between the time they were 19 and 23 years old. Preventing new problems is another reason to treat depression early, the doctors say. "The earlier the disorder is caught, the less malignant it is, like any disorder in medicine," Findling says. "Because a disturbance in mood can affect a youngster's ... social, academic, and [family] functioning ... we know the longer we let the disorder

go on, the more the 'tumor' grows. I wish I had a dime for every parent who said, 'I wish we had done this [gone for treatment] sooner.'" Findling says he knows some parents are reluctant to bring their children in for treatment because of possible side effects of medications or uncertainty that the treatments will work. "There may be risks of treatment, and there may be some knowledge gaps," he says. "But more important is the fact that we know there are profound and pronounced risks associated with depression that should never go unaddressed. ... You need to find an expert who's comfortable and familiar and expert at this to assure the best for your youngster."