If life were a musical comedy, each and every teen would be depressed just long enough to sing a heartfelt tune about how miserable he or she was feeling. Then, a few tunes later, everything would be better, including that nagging case of acne.
It doesn’t work that way “offstage,” though. As the UW’s Dr. Laura Richardson will tell you, true depression isn’t just a short-term problem with a bad mood and a lousy attitude. True depression impairs a teen’s interest in activities, friends, sports or clubs that they previously enjoyed. Teens who are depressed tend to be more withdrawn, spending more time by themselves.
“Many adolescents who become depressed will relapse, and many depressive episodes in adolescence will actually predict being depressed in adulthood,” says Richardson, assistant professor of pediatric and adolescent medicine in the UW School of Medicine. “We should take depression in adolescence seriously.”
“Depression can sometimes be hard to identify,” Richardson says. “It’s really about knowing your own child and being sensitive to a change in his or her behavior. I think you need to be concerned if kids who were doing very well suddenly are doing poorly. Kids who pull out of activities and no longer want to spend time with friends are sending a signal as well.”
Just expressing concern and then listening can be the right kind of help for a depressed teen. Sometimes just helping kids get back into their activities and a more normal daily life can be enough. Richardson adds, though, that once depression has set in, it can be hard for kids to return to normal activities quickly.
Sometimes kids are reluctant to talk about depression because they’re worried about others’ opinions of them. If parents are worried because their child isn’t getting better or because they fear the child will harm himself, it’s time to seek help from a primary care doctor or school mental health professional. Suicide is the third-leading cause of death among teenagers, so any concerns that a teen may harm himself should be taken seriously.
“The good news is that we have learned more about good treatments for depression in kids, and we’re learning more every day,” Richardson says. “The doctor wll usually assess the severity and duration of the depression first of all. If a teenager is at risk of harming him- or herself, sometimes the doctor will recommend hospitalization, but most teens don’t need that. If the doctor recommends treatment, the three main options are therapy, medication or both in combination. The doctor will often discuss the options with the patient and try to select the best treatment for the teen.”
Treating depression can take time. While teens may notice benefits after just four to six weeks of treatment, most antidepressants are continued for up to a year if the health-care practitioner sees a positive response to the medication. Therapy is usually focused on helping teens think more clearly about what they are experiencing and change situations that are contributing to depression. Therapy appointments can be as frequent as once a week and the duration of therapy can range from three months to a year, depending on the teen.