Doctors describe treatment options for adolescent depression
New patient page offers practical advice about options parents should consider to help their teen
When a teen is diagnosed with depression,it's normal for parents to feel overwhelmed and to search forinformation about which treatment options are best, doctorswrite in a new patient resource published in JAMA Pediatrics.
Although depression affects about 20 per cent of adolescents,many don't seek help and hesitate to talk to their parents aboutwhat they're experiencing, the authors note.
"Many adolescents don't seek treatment for many reasons, andthose who do come to our office often say they don't want totell mom or dad because they're already dealing with so much,"said Dr. Ana Radovic of the Children's Hospital of Pittsburgh inPennsylvania, who co-wrote the patient resource.
"Parents may also feel guilty that they're the reason forthe depression, especially when it comes to divorce," Radovic told Reuters Health in a phone interview. "At the same time,they need to realize they're not in control of everything thathappens in their child's life."
Available for free, the new patient page offers practical advice about options parents should considerto help their teen, noting that adolescent depression differsfrom adult depression in symptoms, diagnosis and treatment.
Although it's normal for teens to become moody, irritableand independent as they enter puberty, extreme changes that leadto withdrawal from friends and activities, as well asexpressions of hopelessness or worthlessness, are concerning.These are not typical manifestations of teenage angst.
"It can be difficult for parents to identify the symptoms,especially because teens are going through so many changes thatare normal developmentally," Radovic said.
It's important for parents to realize that not alldepression is the same. So treatment will vary based on multiplefactors, including how severe the depression is and whetherthere are accompanying mental illnesses such asattention-deficit/hyperactivity disorder, anxiety, substance useor bipolar disorder.
We've seen countlessstories of healing as parents and kids come together at meetingsand open up communication.-MariaSilva
In addition, not all therapy is the same. For instance,cognitive behaviour therapy is often recommended for children andteens to learn about their depressive thoughts and developskills to change them. Another type of talk therapy, calledinterpersonal therapy, focuses on resolving interpersonalproblems and social functioning issues. These two therapies havethe most evidence for their effectiveness in treating adolescentdepression, the patient resource says.
Some adolescents may also benefit from an antidepressant,such as a selective serotonin reuptake inhibitor (SSRI), whichare safe medications that have been associated with decreases insuicide rates, the authors point out. Parents, teens and doctorsshould discuss treatment preferences, depression severity andassociated mental or physical illnesses to find the bestprescription.
In addition, the patient resource emphasizes healthy sleep,nutrition and exercise. "Teenagers just do not have thecognitive energy to manage depression without enough sleep," the authors write. And lack of sleep has been associated withworsening depression, especially for teens who must wake upearly to attend school daily.
Although lifestyle changes around sleep, diet and exercisemay be difficult to enforce with a depressed teen who doesn'twant to get off the couch, there may be strategies to encouragehealthy behaviours among all members of the family. Overall, it'salso important to talk to children and teens about depression,anxiety and suicide to open up communication and normalize theconversation related to the topics.
"Parents are afraid that if they talk about suicide withtheir kids, it's going to happen, and that's just not true.Instead, avoiding the subject makes it taboo andunapproachable," said Maria Silva, chief program officer of theAllegheny Family Network in Pittsburgh, who wasn't involved withthe patient page.
It's important for parents to find support through areliable healthcare team and local mental health advocacy parentgroup such as the National Alliance on Mental Health to helpthem through the process of supporting their child.
"These groups eliminate the feeling of aloneness and givestories of hope, so you know you don't have to do it alone,"Silva told Reuters Health by phone. "We've seen countlessstories of healing as parents and kids come together at meetingsand open up communication."
Where to get help:
Canada Suicide Prevention Service:1-833-456-4566 (Phone) |45645 (Text) |crisisservicescanada.ca(Chat)
In Quebec (French):Association qubcoise de prvention du suicide: 1-866-APPELLE (1-866-277-3553)
Kids Help Phone: 1-800-668-6868 (Phone), Live Chat counselling atwww.kidshelpphone.ca
Canadian Association for Suicide Prevention:Find a 24-hour crisis centre
If you're worried someone you know may be at risk of suicide, you should talk to them about it,says theCanadian Association forSuicide Prevention.Here aresomewarning signs:
Suicidal thoughts.
Substance abuse.
Purposelessness.
Anxiety.
Feeling trapped.
Hopelessness and helplessness.
Withdrawal.
Anger.
Recklessness.
Mood changes.
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