Parents of Depressed Teens

Help for Parents and caregivers of Depressed Teens

Parents of Depressed Teens

How do doctors diagnose teen depression?

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The most common diagnostic tool used by doctors to help them decide if a patient with symptoms of depression is actually suffering from the full on illness (and not just a passing state of feeling sad that’s caused by a life event) is a questionnaire.

How do doctors diagnose teen depression? Here are the common tests they use:How do doctors diagnose depression?

Currently the most common ones are:

  1. Hamilton Depression Rating Scale (HAMD)
  2. Montgomery-Asberg Depression Rating Scale (MADRS)
  3. Beck Depression Inventory
  4. Patient Health Questionnaire (PHQ-9)

The doctor will likely used one of these tests to assess your teen. Questions are similar in nature for each.  They ask you about symptoms your experiencing – such as: Sleep disturbances, issues with fatigue, suicidal thoughts, feeling uninspired or hopeless, loss of motivation, loss of pleasure.  They will also ask your teen questions to help them understand the severity of symptoms.

Here are some examples of the types of questions you may be asked:

  • Have you lost interest in activities you used to find pleasurable?
  • Ae you experiencing changes in appetite such as eating too much or not feeling like you want to eat?
  • Are you having difficulty concentrating?
  • Having you been experiencing thoughts of suicide, death, or wanting to die?

In most cases, if your teen has felt hopeless for a least two weeks or more and it’s so bad it’s affecting their quality of life – they’re having trouble going to school, socializing, enjoying activities they once thought were pleasurable etc. – these are high indications they have depression.

The diagnostic criteria for depression appears in a medical text for mental illness called the DSM-IV.  (Read the diagnostic criteria here).

The doctor will also likely run some basic biological tests to rule out other potential issues that cause depression. The most common ones are the:

  1. Physical exam. The doctor will likely examine your teen to ensure there is nothing notable wrong with their physiology that could be causing depression symptoms.
  2. Blood tests : A blood sample may be taken and a complete blood count (CBC) will be performed. This helps the doctor find out if they have any hormonal issues or a vitamin deficiency.

How doctors “fix depression”: Antidepressants

If the doctor rules out all other medical issues that could be causing your teen’s depressed mood and suggests a diagnosis of major depression they’ll likely treat them by prescribing an antidepressant medication. Doctors are trained to fix medical problems and this is how they cure depression. It’s the only tool available to them, aside from referring your teen to a different type of specialist.

As the parent, you need to be aware that the problem with this route is that they may skip identifying other potential causes for your depression. They will treat the symptoms without curing them. So, you need to investigate therapeutic forms of treatment – especially for teens – that teach your teen how to proactively deal with negative and uncomfortable emotions.

What you need to understand about antidepressant medications:

Finding the right antidepressant for your teens is like finding the perfect wedding dress. They’ll have to “try on” many to find what works for you.  This is because the current diagnostic criteria that doctors use is based on asking you a line of questions, ruling out other illnesses with basic physical tests, and then making an educated assumption.

 

As you can see, this is hardly an effective treatment. But for now, it’s all doctors have. A questionnaire, some basic tests and a lot of trial and error with antidepressants.

It’s important that depressed teens try all other natural alternatives and therapies first before going on an antidepressant. These medications are serious and may make the symptoms more severe in individuals under 18 years of age.

Medical and mental illnesses where depression is a symptom

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Here’s a list of medical and mental illnesses (in alphabetical order) where depression occurs as a symptom. If you’re teen seems depressed or is suicidal their may have another issue you may not have considered. This is why it is always important to see a General Practitioner/Family Doctor. They will be able to rule out any other underlying medical concerns that could be related to your depressed mood.Medical and mental illnesses where depression is a symptom

This list has basic descriptions. If you are concerned you may have one of these illnesses you’ll want to do more of your own research, as well as, consult a trained medical professional.

Medical and mental illnesses where depression is a symptom:

Bipolar Disorder

Bipolar disorder is characterized by having extreme mood swings that fluctuate between depression and mania. When you feel depressed you have low energy, you feel hopeless and unhappy and have difficulty with daily activities. This depressed mood fluctuates with mania. During mania you may feel completely euphoric. You’re likely highly productive, and full of energy. Or, you may be completely impulsive and do things like gamble, party and have a lot of sex.  There are different types of bipolar and each has different characteristics.

Borderline personality disorder

Individuals with borderline personality disorder (BPD) suffer from a pervasive pattern of instability in interpersonal relationships, self-image and emotions. They are commonly considered unstable by friends and family members. Their moods fluctuate often and they have a tendency to say things that hurt people’s feelings. They often have a unhealthy self-image, which is related to unhealthy social interactions early in life. Some people with BPD exhibit impulsive and destructive self-injurious behaviors, like: Cutting themselves, attempting suicide and have lots of casual sex.

Brain tumor

Depending on where a brain tumor is situated it may affect an individual’s mood and personality. An individual with a brain tumor will often start to act completely different from their past behaviors.

Eating disorders

The types of eating disorders are:

  • Anorexia – starvation behaviors
  • Bullemia – cycles of eating and purging the body of food
  • Binge eating – starving and then consuming large amounts of food in a short amount of time

While each type of eating disorder has different behaviors associated, they are all connected to unhealthy perceptions and relationships with food, weight and body image.

Fibromyalgia

Doctors don’t have a clear understanding of what causes fibromyalgia. Though, many researchers believe it’s a problem with the way the brain deals with pain signals. Individuals who suffer from it deal with widespread pain that can occur in the neck, shins, elbows, lower back, hips and knees. Pain and stiffness can be worse in the morning. Individuals with fibromyalgia often experience fatigue, trouble sleeping or concentrating, or have frequent headaches.

Hypopituitarism

Hypopituitarism is a rare disorder where the pituitary glands (an gland found in the brain that secretes hormones into the blood) don’t make enough hormones that are necessary in bodily functions  of: Growth, metabolism, and sexual development. It’s often caused by brain tumors, head injuries, or infections.

Hypothyroidism

Hypothyroidism occurs when the thyroid gland can’t produce enough thyroid hormone. The thyrod gland affects how the body produces energy. The result of low thyroid is a slowing of body processes. Weight gain, fatigue and low mood.

Lupus

Lupus is a chronic autoimmune disease (that doctors do not completely understand). The body attacks healthy tissue in different ways. Symptoms are: Severe exhaustion, joint pain, and a “butterfly rash” on the cheeks and the bridge of the nose. Individuals with lupus may have mild symptoms, while some will develop life-threatening versions of the disease that attack the the kidneys and other organs. Symptoms come and go frequently. They can clear up entirely, disappear from months to years and return again.

Obesity

Individuals with excess weight often suffer from depression. What is less clear whether it’s depression or weight gain that happens first. Eitherway, depression and weight gain go hand-in-hand. Trouble managing food and urges, increased appetite coupled with reduced activity and weight gain can lead to depression and thoughts of suicide. One recent study found that overall, obese individuals have a 20 percent elevated risk of depression.

Pick’s disease

Pick’s disease is a rare type of dementia that affects areas of the brain.  It is similar in nature to Alzhiemers. Though, it has a more major affect on mood and behavior. It often runs in families. It starts between the ages of 40-60. Once symptoms start it takes usually 2-10 years for an individual with Pick’s to become fully disabled.

Porphyria

Porphyria is a rare genetic condition that affects the skin and nerves. It’s caused by low enzyme levels that prevent the body from making an essential protein in red blood cells.  Without it, destructive chemicals build up in the blood and cause damage.

Postpartum

Many new mothers experience the “baby blues” within the first two weeks-four weeks after giving birth. Doctors suggest that all mothers are susceptible to it anytime within the first year of the baby’s life. New mothers deal with major life changes, sometimes loneliness, dealing with new fears, and changes in hormone and lack of sleep. But, postpartum depression is more severe and long-lasting. It occurs when the depression last longer than two weeks. Symptoms are: Sadness, hopelessness, anxiety, loss of energy, loss of interest in things, guilt, changes in appetite, and insomnia. Sometimes a woman may experience negative feelings about her baby or thoughts of harming her child. In rare cases, postpartum psychosis can occur and the woman will experience delusions of hallucinations.  Symptoms that last for more than two weeks or even up to a week should be addressed immediately to prevent unnecessary harm to the mother or baby from occurring.

PTSD

Post traumatic stress disorder is delayed anxiety disorder that occurs 6 months to one year after an event. It can happens commonly to individuals who suffer from a dangerous or traumatic experiences, such as a war, natural disaster, abuse, assault, or accident. Many individuals  who have PTSD experience flashbacks, bad dreams about the event or have difficulty sleeping. They may also feel agitated, guilty, depressed, or emotionally numb. Individuals with PTSD may avoid people or things that remind them of the event.

Premenstral Dysphoric Disorder

Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome where a woman experience major mood fluctuations that interfere with her ability to do regular activities. It occurs immediately before menstruation and often goes away during her period. It can cause a women to be severely depressed, or irritable. The causes are not fully known, but hormonal changes and fluctuation of the brain chemical serotonin may play a part.

Premenstral syndrome (PMS)

PMS is a common condition that affects many women during the two weeks prior to their period. Symptoms vary from woman to woman. Generally, they include such things as bloating, irritability, fatigue, breast swelling and tenderness, and depressed mood.  The mood may be slightly distressing but will not interfere with a woman’s ability to carry out regular activities.

Schizophrenia

Schizophrenia is a serious, chronic mental illness. People who have schizophrenia often hear voices, see things that aren’t there, or believe that the world is plotting against them. It can occur between the teen years and age 40. Doctors don’t understand exactly what causes schizophrenia, but it can run in families. It can also be brought on through regular substance abuse that over time causes changes in brain chemistry. There is no cure for schizophrenia. Therapy and medications can help treat symptoms and many people can live happy lives with this illness.

Substance Abuse

Mood is highly affected mental drinking alcohol or taking drugs, (including some prescription drugs). While a substance will bring a mood up and make an individual feel better immediately after taking in, it also brings their mood down further as the substance wheres off. The symptoms are the same as depression or mania: depressed mood, lack of interest in activities, fatigue, feelings of worthlessness, sleep problems, talkativeness, distractedness, or suicidal thoughts.

SAD

Seasonal depression, or SAD, is depression that occurs every year during a change of season. SAD can cause problems ranging from sadness and sleep problems to anxiety and moodiness. SAD is most common in fall and winter when the weather turns cold, people spend more time indoors and they weather can be grey and rainy. In this case, symptoms will improve during spring and summer months. In rare cases, people have SAD in spring and summer and their symptoms improve in the fall. Doctors are unclear what causes said.  It could be related to light, hormones, lack of vitamin D from the sun or changes in body temperature. SAD is treated with light therapy, antidepressants, and psychotherapy.

If you feel depressed your first step is to get a diagnosis and rule out all other issues that could be affecting your mood. And, most importantly, make sure you take small daily actions to live a great life that you love to wake up.

The difference between depression and sadness

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The word “depression” is one of the most commonly misused words in the english language.  People use it incorrectly when they are trying to explain feeling sad.  But sadness and depression are two very different things. Below, each is defined and key differences are highlighted to help illustrate how sadness and depression differ.

As a parent with a depressed teen, it’s crucial you recognize the difference. It can be difficult making the distinction when you’re teen is shut down and doesn’t communicate well.

Understanding the difference between depression and sadness

Sadness defined: 

SADNESS is a normal human emotion that is characterized by a state (or states) of feeling unhappy.  It is not constant, meaning it comes and goes. One moment you can feel sad, an hour later after being with a friend you may feel happy.

Being sad is a healthy response to unpleasant life events. It’s valuable because it can help you decipher what you want or don’t want.  It also helps you feel and understand the reverse emotional state, which is happiness.

Sadness occurs in frequency on a scale that ranges from brief and fleeting moments of sad feelings to severe lengthy periods related to major life traumas. For example, the death of a loved one can make you feel sad for months.

Depression defined:

DEPRESSION is a medical condition that affects mood.  It’s unclear what specifically causes it, though experts agree it is a physical issue where a variety of factors related to both internal and external processes lead to a neurological chemical imbalance. The most current research suggests that individuals with depression have a 25% smaller brain region for regulating emotion (called the hippocampus).

It is often difficult for individuals who have not experienced depression to understand it, because it’s not something that can be seen or measured. It’s not like other physical ailments, like a broken leg.

Characterizing someone with depression as “sad”, suggests they have the ability to control their mood. That is not the case. They are physically unable to be happy.

Key differences:

  • Depression is debilitating. The low mood is so pervasive that it interferes with an individual’s ability to do normal things like: Go to work, concentrate on basic activities like watching a movie, take care of themselves or their family, or want to get out of bed.  When you’re sad you can still do basic tasks even if you don’t feel happy.
  • Sadness fluctuates. Depression is constant.
  • People with depression feel sad.  People who are sad do not necessary get depression.
  • Individuals with depression have no ability to change their mood. No matter what actions they take, they often still feeling an underlying feeling of emptiness and their mental processes feel slowed.
  • Depression makes you feel like you don’t want to live. Sadness makes you feel low but still hopeful. You can recognize that you have a life to live for.
  • Sadness doesn’t produce significant weight changes or prolonged periods of sleep changes.
  • Sadness does not involve psychotic events like delusions or hallucinations.
  • Depression requires multiple forms of treatment that involve nutrition, exercise, self care and many times, medication.

Factors that raise the likelihood a teen will develop depression

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The following is a list of risk factors that will heighten a your teen’s chance of getting depression and considering suicide as a valid option. A person could have one Factors that raise the likelihood of suicideor more of the risk factors to be considered vulnerable, though, it’s often a combination.

Factors that raise the likelihood a teen will develop depression and/or consider suicide 

1) Dealing with difficult life circumstances:

  • Having a childhood history of trauma or abuse and not having dealt with it using therapeutic tools
  • Major financial loss suffered by the family
  • Loss of valuable relationship
  • The death of a close loved one or parent

2) Actions that can worsen mood and lead to major depression:

  • Abusing substances like alcohol and drugs
  • Not eating enough daily calories or carbohydrates (which are important for brain energy)
  • Eating too many processed foods and sugars
  • Not getting enough physical exercise
  • Spending too much time alone (up to three days without seeing or speaking to anyone)
  • Doing something they deeply believes goes against their morality.  (ie. having sex when it’s against their religion and the beliefs of their family)

3) Environments that can increase the risk of depression and/or suicide:

  • Family history of mental health issues or suicide attempts
  • Living in household of trauma or abuse or being in an environment (ie. school or work) where they feel trauma regularly
  • Easy to access lethal means like guns or drugs or dangerous objects
  • Living in an area where local suicides have occurred
  • Lack of social support and sense of isolation
  • Lack of health care, especially mental health and substance abuse treatment
  • Not having financial stability or living in poverty
  • Cultural and religious beliefs, such as the belief that suicide is a noble resolution of a personal dilemma
  • Exposure to others who have died by suicide (in real life or via the media and Internet)

4) Having an underlying medical disorder or mental illness that’s affecting mood:

  • Mental disorders, particularly mood disorders, schizophrenia, anxiety disorders and certain personality disorders
  • Major physical illnesses
  • Illness that have them deal with daily physical pain

5) Having a weak emotional IQ:

  • Never having learned how to properly deal with  emotions. It’s a learned skill that isn’t taught in schools or taught to parents.
  • Believing there is something wrong with asking for help, so they try to do it on your own and don’t get very far.
  • If they’ve been put down and taught that they aren’t good enough, they may have very low self-esteem.

Teen depression and other types

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There are six common types of major depression and they are listed with symptoms below. It’s important to familiarize yourself with the different types so you can understand if your teen is dealing with one of them.

It’s also important you understand that teen depression has some distinctive features, here they are:

Teen depression symptoms

In additional to the regular symptoms of depression, a teen with depression may exhibit:

  • Irritability
  • Self harm
  • Negative emotions expressed in art
  • Skipping school or bad grades
  • Lack of socialization with other teens or lack of drive to be social
  • Abusing substances
  • Complaining about physical symptoms like headaches or stomach ache
  • Highly sensitive to criticism

Types of major depression

Major depressive disorder, also referred to as unipolar depression

  • Interferes with ability to function
  • Affects all areas of life – relationships, work, sleep eating
  • Episodes may occur several times in a person’s life
  • Slowed movements, speech and thinking, speak less, some stop speaking
  • Have recurring thoughts about their own death – range from thinking about it to seriously considering

Manic-depressive disorders, more commonly known as bipolar disorder

  • Serious mental illness involving episodes of depression that alternate with mania. Mania is feelings or greatness and elation, sudden energy, and feeling uncontrollable power. Sometimes depression and mania occur simultaneously shifting from one to the other rapidly.

Dysthymic disorder

  • Milder form of depression that lasts longer.
  • Feeling of melancholy
  • Unable to get really excited about life
  • Can still function but feel gloomy

Seasonal Affective disorder

  • Often brought on in the winter months, though it can occur as a reverse
  • Could be a result of disruption of circadian rhythm or lack of Vitamin D
  • Full spectrum lights can help
  • Less that 2% of people in Florida have SAD, while 10% of people in New Hampshire do

Psychotic depression

  • 15% of depressed people experience delusions or hallucinations
  • Often need to be hospitalized to prevent themselves from suicide

Postpartum depression

  • 4 weeks – year after a woman gives birth
  • Most women experience baby blues, postpartum is far more severe
  • May involve delusions or hurting themselves or their newborn
  • Many women feel a great amount of guilt
  • 10% of new mothers