Major Depression in Adolescents
What is major depression?
Major depression, also known as clinical depression or unipolar depression, is classified
as a type of affective disorder (also called mood disorder). This goes beyond the
day's ordinary ups and downs. It has become a serious medical condition and important
health concern in this country.
Depression is a mood disorder that involves an adolescent's body, mood, and thoughts.
It can affect and disrupt eating, sleeping, or thinking patterns. It is not the same
as being unhappy or in a "blue" mood, nor is it a sign of personal weakness or a condition
that can be willed or wished away. Adolescents with a depressive illness cannot merely
"pull themselves together" and get better. Treatment is often necessary and many times
crucial to recovery.
There are three primary types of depression, including:
Major depression (clinical depression)
Bipolar disorder (manic depression)
Persistent depressive disorder (dysthymia)
Who is affected by major depression?
The National Institute of Mental Health, part of the National Institutes of Health,
reports the following:
Research indicates that depression onset is happening earlier in life today than in
Early-onset depression often lasts, happens again, and continues into adulthood. Depression
in youth may also predict more severe illness in adulthood.
There is an increased incidence of depression in adolescents whose parents experience
What are the risk factors for major depression?
The following are the most common risk factors for major depression:
Family history of depression (especially if a parent experienced depression as a child
Abuse or neglect
Trauma (physical and/or emotional)
Other psychiatric disorders
Loss of a parent, caregiver, or other loved one
Loss of a relationship (for example, moving away, loss of boyfriend or girlfriend)
Other chronic illnesses (such as diabetes)
Other developmental, learning, or conduct disorders
What are the symptoms of major depression?
The following are the most common symptoms of major depression. However, each adolescent
may experience symptoms differently. Symptoms may include:
Lasting feelings of sadness
Feeling hopeless or helpless
Having low self-esteem
Feelings of wanting to die
Loss of interest in usual activities or activities once enjoyed
Difficulty with relationships
Sleep disturbances (such as insomnia or hypersomnia)
Changes in appetite or weight
A decrease in the ability to make decisions
Suicidal thoughts or attempts
Frequent physical complaints (for example, headache, stomachache, or fatigue)
Running away or threats of running away from home
Hypersensitivity to failure or rejection
Irritability, hostility, aggression
For a diagnosis of major depression to be made, an adolescent often needs to exhibit
a several of the above symptoms during the same two-week period. The symptoms of major
depression may resemble other problems or psychiatric conditions. Always talk with
your adolescent's healthcare provider for a diagnosis.
How is major depression diagnosed?
Depression has shown to often coexist with other psychiatric disorders, such as substance
abuse or anxiety disorders. Because of this, seeking early diagnosis and treatment
is crucial to the recovery of your adolescent.
A child psychiatrist or other mental health professional usually diagnoses major depression
following a comprehensive psychiatric evaluation. An evaluation of the adolescent's
family, when possible, in addition to information provided by teachers and care providers
may also be helpful in making a diagnosis.
Treatment for major depression
Specific treatment for major depression will be discussed with you by your adolescent's
healthcare provider based on:
Your adolescent's age, overall health, and medical history
Extent of your adolescent's symptoms
Your adolescent's tolerance for specific medicines or therapies
Expectations for the course of the condition
Your opinion or preference
Mood disorders, including major depression, can often be effectively treated. Treatment
should always be based on a comprehensive evaluation of the adolescent and family.
Treatment may include one, or more, of the following:
Antidepressant medicines (especially when combined with psychotherapy has shown to
be very effective in the treatment of depression in children and teens)
Psychotherapy (most often cognitive-behavioral and/or interpersonal therapy) for the
adolescent (focused on changing the adolescent's distorted views of themselves and
the environment around them; working through difficult relationships; identifying
stressors in the adolescent's environment and learning how to avoid them)
Consultation with the adolescent's school
Parents play a vital supportive role in any treatment process.
For several reasons, many parents of children or adolescents with depression never
seek the appropriate treatment for their adolescent. This is true even though many
people with major depression who seek treatment improve--usually within weeks. Continued
treatment may help to prevent the depressive symptoms from returning.
Without appropriate treatment, symptoms of depression can last for weeks, months,
or years. In addition to causing interpersonal and psychosocial problems, depression
in children and adolescents is also associated with an increased risk for suicide.
This risk rises, particularly among adolescent boys, when the depression is accompanied
by other mental health disorders. These include conduct disorder and substance abuse.
It is crucial for parents and care providers of children and adolescents to take all
depressive and suicidal symptoms very seriously. Seek treatment immediately. Suicide
is a medical emergency. Talk with your adolescent's healthcare provider for more information.