Treating depression in adolescents

Depression is not a sign of weakness, it is a sign that you have been strong for too long  ~ Unknown

 

Depression is very damaging when left untreated, so don’t wait and hope that the symptoms will go away. If you see depression’s warning signs, seek professional help. A person can have mild, moderate, or severe major depression. If there are no health problems that are causing your teenager’s depression, ask your doctor to refer you to a psychologist or psychiatrist who specializes in children and adolescents. Depression in teens can be tricky, particularly when it comes to treatment options such as medication. Adolescents with mild or moderate depression are usually treated with counselling alone. If the depressive symptoms do not begin to improve within 6 to 12 weeks, or if symptoms worsen, an antidepressant medication may be recommended. Adolescents with severe depression generally require counselling in addition to one or more medications. Treatment with medication and counselling increases the likelihood of improved symptoms and relationships with family and friends; it can also improve self-confidence and the ability to cope effectively. Depression is a treatable condition. Psychotherapy (counselling), drug therapy, and other measures can alleviate symptoms and help adolescents to succeed in school, develop and maintain healthy relationships, and feel more self-confident. In adolescents, treatment for depression is most successful when the parents are involved. Learning about depression is an important component of depression treatment. Family education is also important before decisions are made about the adolescent's treatment plan.

 

When choosing a specialist, always get your child’s input. Teenagers are dependent on you for making many of their health decisions, so listen to what they’re telling you. No one therapist is a miracle worker and no single treatment works for everyone. If your child feels uncomfortable or is just not ’connecting’ with the psychologist or psychiatrist, ask for a referral to another provider that may be better suited to your teenager. Understanding how depression affects the teen's mood and behaviour can help the adolescent and his or her family in several ways:

• Family members can learn about the symptoms of depression and how these symptoms impact the teen's relationships with friends and family, willingness to attend school, and ability to complete school work.
• Family members can learn how to recognize if the adolescent's depressive symptoms are recurring or coming back.
• Other family members might be able to identify their own depressive symptoms and need for treatment.
• Family members can learn how to help the teen with depression. It is important to clarify the role of parents, other family members, and teachers in the teen's treatment and recovery.
• Family members can learn how to make the environment safer for depressed adolescents. For example, the need to limit access to certain items (e.g. prescription medications, weapons) should be discussed.
• Family members can learn about the treatment options that are available to treat depression, including the pros and cons of various treatment options, so that they can make well informed decisions.

 

Counselling Therapy

Counselling, also called psychotherapy or talk therapy, teaches patients and their families to understand themselves and the nature of depression, including how to manage relationships and life stressors associated with depression. Therapy sessions are usually conducted in the therapist's office once per week for 30 to 60 minutes. The adolescent, parents, and therapist should work together to determine the optimal schedule. During a therapy session, the teen talks to the therapist about their feelings, thoughts, behaviours, and relationships. The patient and therapist can discuss alternate ways of thinking or taking action, which often helps the teen to cope more effectively with depressive symptoms, improve social skills, and increase self-confidence. While it is important to involve parents in some aspects of their adolescent's treatment (particularly regarding education and ensuring safety), parent(s) usually do not sit in the room with the teen and therapist throughout therapy discussions. The reason for this is that adolescents have a right to privacy and may be reluctant to openly discuss important topics when parents are present.

 

Psychiatrist

If an adolescent needs an antidepressant medication, he or she may be treated by their paediatrician or referred to a psychiatrist. A psychiatrist is a medical doctor with specialized training in the treatment of mental health issues. The psychiatrist should have training and experience in child and adolescent psychiatry or, if the person has adult-only training, he or she should have experience treating teenagers. In some cases, a psychiatrist provides counselling and prescribes medications if needed; in other cases, a therapist provides counselling and a psychiatrist prescribes medication.

If a healthcare provider recommends an antidepressant medication for an adolescent's depression, the following issues should be discussed before treatment begins:

• The expected benefits and possible risks and side effects
• The instructions for the dose and timing
• Potential interactions with other prescription or non-prescription medications
• Alternatives to medication (e.g. continued therapy)

It is not clear if antidepressants increase the risk of a teenager actually committing suicide. However antidepressants have been associated with a slightly increased risk of suicidal thinking in adolescents and young adults, particularly during the initial weeks of treatment. In considering whether or not to use medication to treat depression, the parent(s) and psychiatrist must balance the small increased risk of suicidal thoughts against the very real risk of suicide if the teen's depression is not adequately treated. Any mention of suicidal thoughts or feelings in a depressed adolescent should be taken seriously.

 

Encouraging a depressed teenager to open up

If you suspect that a teenager in your life is suffering from depression, speak up right away. Even if you’re unsure that depression is the issue, the troublesome behaviours and emotions you’re seeing in your teenager are signs of a problem. Whether or not that problem turns out to be depression, it still needs to be addressed—the sooner the better. In a loving and non-judgmental way, share your concerns with your teenager. Let him or her know what specific signs of depression you’ve noticed and why they worry you. Then encourage your child to share what he or she is going through. Your teen may be reluctant to open up. He or she may be ashamed, afraid of being misunderstood. Alternatively, depressed teens may simply have a hard time expressing what they’re feeling. If your teen claims nothing is wrong, but has no explanation for what is causing the depressed behaviour, you should trust your instincts. Remember that denial is a strong emotion. Furthermore, teenagers may not believe that what they’re experiencing is the result of depression.

 

Tips on how to communicate with a depressed teenager

Offer support : Let depressed teenagers know that you’re there for them, fully and unconditionally. Hold back from asking a lot of questions (teenagers don’t like to feel patronized or crowded), but make it clear that you’re ready and willing to provide whatever support they need.

Be gentle but persistent : Don't give up if your adolescent shuts you out at first. Talking about depression can be very tough for teens. Be respectful of your child's comfort level while still emphasizing your concern and willingness to listen.

Listen with an open mind : Resist any urge to criticize or pass judgment once your teenager begins to talk. The important thing is that your child is communicating. Avoid offering unsolicited advice or ultimatums as well. Avoid lecturing.

Validate feelings : Don't try to talk teens out of their depression, even if their feelings or concerns appear silly or irrational to you. Simply acknowledge the pain and sadness they are feeling. If you don't, they will feel like you don't take their emotions seriously.

 

Supporting a depressed teen

As the depressed teenager in your life goes through treatment, the most important thing you can do is to let him or her know that you’re there to listen and offer support. Now more than ever, your teenager needs to know that he or she is valued, accepted, and cared for.

• Be understanding. Living with a depressed teenager can be difficult and draining. At times, you may experience exhaustion, rejection, despair, aggravation, or any other number of negative emotions. During this trying time, it’s important to remember that your child is not being difficult on purpose. Your teen is suffering, so do your best to be patient and understanding.
• Encourage physical activity. Encourage your teenager to stay active. Exercise can go a long way toward relieving the symptoms of depression, so find ways to incorporate it into your teenager’s day. Something as simple as walking the dog or going on a bike ride can be beneficial.
• Encourage social activity. Isolation only makes depression worse, so encourage your teenager to see friends and praise efforts to socialize. Offer to take your teen out with friends or suggest social activities that might be of interest, such as sports, after-school clubs, or an art class.
• Stay involved in treatment. Make sure your teenager is following all treatment instructions and going to therapy. It’s especially important that your child takes any prescribed medication as instructed. Track changes in your teen’s condition, and call the doctor if depression symptoms seem to be getting worse.
• Learn about depression. Just like you would if your child had a disease you knew very little about, read up on depression so that you can be your own “expert.” The more you know, the better equipped you’ll be to help your depressed teen. Encourage your teenager to learn more about depression as well. Reading up on their condition can help depressed teens realize that they’re not alone and give them a better understanding of what they’re going through.

 

The road to your depressed teenager’s recovery may be bumpy, so be patient. Rejoice in small victories and prepare for the occasional setback. Most importantly, don’t judge yourself or compare your family to others. As long as you’re doing your best to get your teen the necessary help, you’re doing your job.

 

Taking care of the whole family when one child is depressed

As a parent dealing with teen depression, you may find yourself focusing all your energy and attention on your depressed child. Meanwhile, you may be neglecting your own needs and the needs of other family members. While helping your depressed child should be a top priority, it’s important to keep your whole family strong and healthy during this difficult time.

• Take care of yourself – In order to help a depressed teen, you need to stay healthy and positive yourself, so don’t ignore your own needs. The stress of the situation can affect your own moods and emotions, so cultivate your well–being by eating right, getting enough sleep, and making time for things you enjoy.
• Reach out for support – Get the emotional support you need. Reach out to friends, join a support group, or see a therapist of your own. It’s okay to feel overwhelmed, frustrated, helpless, or angry. The important thing is to talk about how your teen’s depression is affecting you, rather than bottling up your emotions.
• Be open with the family – Don’t tiptoe around the issue of teen depression in an attempt to “protect” the other children. Kids know when something is wrong. When left in the dark, their imaginations will often jump to far worse conclusions. Be open about what is going on and invite your children to ask questions and share their feelings.
• Remember the siblings – Depression in one child can cause stress or anxiety in other family members, so make sure “healthy” children are not ignored. Siblings may need special individual attention or professional help of their own to handle their feelings about the situation.
• Avoid the blame game – It can be easy to blame yourself or another family member for your teen’s depression, but it only adds to an already stressful situation. Furthermore, depression is normally caused by a number of factors, so it’s unlikely—except in the case of abuse or neglect—that any loved one is “responsible.”

 

Please add in comments or statements you feel may help understand this topic better.