KNOWING WHEN TO SEEK TREATMENT FOR TEEN DEPRESSION

If your teen’s teeth ache, you phone the dentist.  If his fever persists, you call the doctor.  But how do you tell whether she’s a “typically moody teen” or needs to see a psychologist for depression?

Subhead: Trust your instincts

“Since September 11, I sense more anxiety among students—but no fear running rampant.  Like adults, they wonder what’s next,” says Jim Stapert, principal.  “I haven’t seen more students isolating themselves.  When parents do phone about depression, however, their instincts are usually correct.”

Pat DenBesten agrees.  “Christian High has four guidance counselors.  We find that parental concerns are usually valid.  Each of us makes about 10 referrals a year, but many more parents phone psychologists without involving us.

“Some students become depressed because of situations—learning disabilities, a breakup, parents fighting or losing jobs.  Depression can also stem from brain chemistry imbalances,” Ms. DenBesten says.  She has books, articles, and videos on depression and is willing to talk with any concerned parent.

Experts diagnose depression when many (not all) symptoms persist for two or three months: significant changes in sleep, appetite, grades, or social interaction; substance abuse; sadness; low energy; emotional numbness; loss of pleasure.  One bad week does not equal depression.

“During depression, life feels overwhelming, scary, very dark.  When depressed teens express hopelessness, yet feel helpless to improve things, it’s very important they be assessed for suicide potential.  Adolescents lack the life experience for a long view.  They assume that how bad their life feels now is predictive for the rest of their lives,” says Dr. Kerry McAvoy, a local psychologist.

Subhead: Most depression is very treatable

“Adolescents feel relieved to know someone cares enough to help them get help, that they don’t have to feel this way forever,” she adds.

Yet, most teens get angry or minimize their depression when parents first propose counseling.  “Don’t get into a power struggle,” advises Dr. Peter Everts, a local psychologist.  “You might say, ‘We see how hard you are trying to overcome this.  But depression erodes your will, energy, and mental strategies.  It depletes brain chemicals.  All we’re asking is that you get assessed.’

Psychologists assess for depression by meeting separately and together with teens and parents.   They ask parents about medical history and developmental milestones and listen for patterns or symptoms that suggest an organic cause a doctor or psychiatrist should treat.  They try to establish quick rapport with teens.

“Teens come in terse, glum, grim.  But few can sit with a stranger behind a closed door and say nothing,” Dr. Everts says.

Psychologists typically schedule appointments every week or two.  Most suggest anti-depressants for a third of teens, but only if depression hasn’t lifted after months of psychotherapy (listening and talking); in any case, families may refuse drugs.