Medication As The Only Option
The new paper, a so-called meta-analysis, looked at 34 previously conducted studies. Those studies included more than 5,200 children and teens who took one of 14 antidepressants or a placebo an average of 8 weeks. The study did not consider long-term use of the drugs because there hasnt been enough previous research to analyze, Cipriani said.
Although several of the studies claimed to include patients as young as 6, Cipriani said there was virtually no data on children younger than 9.
Dr. Carl Bell, a community psychiatrist and clinical professor emeritus at the University of Illinois at Chicago, said that until recently, he doesnt remember seeing children younger than 13 who were suicidal or severely depressed. I dont know what happened, but now I see it all the time, he said.
In his experience, antidepressants work well on his preteen and adolescent patients.
Bell said he would be happy to refer his inner-city patients to social services and therapy, but theyre pretty much nonexistent in the communities he serves. That only leaves one choice, he said: medications.
How Effective Are Antidepressants
Do antidepressants work? There is evidence on both sides of the argument.
In a 2008 study led by Irving Kirsch of Harvard Medical School, researchers looked at 35 different antidepressant drug trials submitted to the FDA. This was for the licensing of Prozac, Effexor, Serzone, and Paxil. They found that the effect of these antidepressants was not much greater than the effect of a placebo drug. Overall, the study showed that placebos were 82 percent as effective as the antidepressants.
According to Kirsch, Analyses of the published data and the unpublished data that were hidden by the drug companies reveal that most of the benefits are due to the placebo effect.
The results of Kirschs study were confirmed by the findings of a 2010 study in the Journal of the American Medical Association. Hence, this study found that antidepressants had a benefit only for people with severe depression. Antidepressants for teens may not be as effective for those suffering from mild to moderate varieties of the disorder.
Side Effects Of Antidepressants
Even when antidepressants seem to relieve symptoms of depression, they have many undesirable side effects. In addition, these side effects can be dangerous and even life threatening. Side effects of Prozac in children and teens as well as for other antidepressants include the following:
- Increases in suicidal ideation among children and young adults
- Long-term weight gain
- Sexual dysfunction, which affects 70 to 80 percent of people on SSRIs
- Increased risk of stroke and death among older adults
- Greater risk of relapse after recovery.
When it comes to teenagers and antidepressants, parents need to look at the long-term health effects. In addition, new discoveries are being made about these side effects.
Recently, a study found evidence that long-term antidepressant use may be associated with increased risk of type-2 diabetes for young adults.
Furthermore, data indicates that antidepressant medication may double the risk of suicide and aggressive behavior in teens and children under 18.
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Legitimacy As A Diagnosis
In early research of depression in children, there was debate as to whether or not children could clinically fit the criteria for major depressive disorder. However, since the 1970s, it has been accepted among the psychological community that depression in children can be clinically significant. The more pertinent controversy in psychology today centers around the clinical significance of sub-threshold mood disorders. This controversy stems from the debate regarding the definition of the specific criteria for a clinically significant depressed mood in relation to the cognitive and behavioral symptoms. Some psychologists argue that the effects of mood disorders in children and adolescents that exist do not have severe enough risks. Children in this area of severity, they argue, should receive some sort of treatment since the effects could still be severe. However, since there has yet to be enough research or scientific evidence to support that children that fall within the area just shy of a clinical diagnosis require treatment, other psychologists are hesitant to support the dispensation of treatment.
How To Communicate With A Depressed Teen
Focus on listening, not lecturing. Resist any urge to criticize or pass judgment once your teenager begins to talk. The important thing is that your child is communicating. You’ll do the most good by simply letting your teen know that you’re there for them, fully and unconditionally.
Be gentle but persistent. Don’t give up if they shut you out at first. Talking about depression can be very tough for teens. Even if they want to, they may have a hard time expressing what they’re feeling. Be respectful of your child’s comfort level while still emphasizing your concern and willingness to listen.
Acknowledge their feelings. Don’t try to talk your teen out of depression, even if their feelings or concerns appear silly or irrational to you. Well-meaning attempts to explain why things aren’t that bad will just come across as if you don’t take their emotions seriously. Simply acknowledging the pain and sadness they are experiencing can go a long way in making them feel understood and supported.
Trust your gut. If your teen claims nothing is wrong but has no explanation for what is causing the depressed behavior, you should trust your instincts. If your teen won’t open up to you, consider turning to a trusted third party: a school counselor, favorite teacher, or a mental health professional. The important thing is to get them talking to someone.
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A Different Kind Of Depression
Questions have been raised before about the usefulness of antidepressants in young people whose brains are still developing. More than a decade ago, the Food and Drug Administration added a black-box warning to a number of antidepressants used by teenagers, saying that they might increase suicidal thinking.
In older people, antidepressants like Prozac are believed to trigger the growth of new brain cells and new connections among them, but there is no obvious biological benefit to the developing brains of children and adolescents.
Depression also looks different in young people, often showing up as aggressive behavior, irritability or poor school performance, rather than an obviously depressed mood, said Dr. Andrea Cipriani, the University of Oxford psychiatrist who led the new study.
Several doctors warned that patients shouldnt stop taking their medications because of this study. Abruptly stopping medication can cause problems, including suicidal thinking. And some individuals might still benefit from the other drugs, Cipriani said.
If the patients responding to one treatment, they have to keep the treatment, of course. But on average, if I have to start a treatment, probably the best one is fluoxetine and not the others, Cipriani said.
Repetitive Transcranial Magnetic Stimulation
rTMS is another procedure used if the patient doesn’t respond to medications. It has become a widely used outpatient brain stimulation treatment. With rTMS, magnets are used to activate specific parts of the brain, which allows rTMS to carry only mild side effects. It’s a noninvasive procedure that doesn’t require anesthesia as ECT does.
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What Type Of Medication Is Used To Treat Depression And Anxiety
SSRIs , are medications that may be used to treat depression and anxiety disorders. Some examples of SSRIs are: fluoxetine , citalopram , sertraline and escitalopram .
SSRIs work in the brain to help certain natural chemicals , which are used to communicate between brain cells, manage a persons mood.
How To Help A Teenager With Anxiety & Depression
The symptoms of either anxiety or depression can lead to the development of the other disorder. And they are more difficult to treat when they occur together. For these reasons, early signs of anxiety or depression in a child or teen should be taken very seriously.
An assessment by a mental health professional can help identify the root causes of the symptoms. A clinician will typically assess a clients three areas of vulnerabilityfamily history, individual temperament, and life experiences. Treatment should address the underlying issues causing either anxiety or depression. One goal of treatment is to reduce the chance that anxiety or depression will develop into a dual diagnosis.
At Newport Academy, we take an integrated approach to treating teen mental health conditions, including depression, anxiety, and the co-occurring disorders catalyzed by these disorders. Our treatment model is proven to reduce anxiety and depression while increasing adolescents well-being.
Contact us today to learn more about how our clinical model supports teens to find hope, connection, motivation, and excitement for what the future holds.
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Suicide In Children And Teens
Suicide is the second leading cause of death among young people ages 10-24. Screening for suicide can help at-risk youth get mental health care.
Assessing suicide risk can be more challenging in children and teens facing serious illnesses. You may be asked to step out of the room while the care team member asks about suicide risk. This may help your child feel more comfortable and answer honestly.
Asking about suicide does not make a suicide attempt more likely. It does not put thoughts or ideas into someones head. Asking the question Are you thinking about killing yourself? can help save a life.
Any child or teen who expresses ongoing thoughts of death or comments about suicide should be seen by a mental health professional.
If you or someone you know may be considering suicide, call 911 immediately or contact the 24-hour National Suicide Prevention Lifeline any time at 1-800-273-TALK .
5 Action Steps for Helping Someone in Emotional Pain.
Common Signs Of Depression
Risk factors are just that. Genetic predispositions or having a medical condition doesn’t mean you’ll experience depression. Quite honestly, it can be hard to differentiate sadness from something more serious. Use these signs and symptoms to help you identify if you may have depression. Note that symptoms will vary and can range from mild to severe. Everyone’s experience will differ, there is no one-size-fits-all definition for how depression looks. However, general themes emerge.
Here are the common signs and symptoms of depression:
- Atypical levels of irritability or anger for you
- Difficulty concentrating
- Loss of interest in activities you once enjoyed
- Feelings of sadness or consistent low mood
- Sleep troubles — both insomnia and sleeping too much
- Feelings of fatigue or having no energy
- Loss of appetite
- Thoughts of self-harm or suicide
To be diagnosed with clinical depression, symptoms must persist for at least two weeks and impede your ability to function in your daily life. According to the DSM-5, a major depressive disorder diagnosis comes after five of the nine main clinical symptoms of depression are experienced. The duration of symptoms will vary, from a few weeks, months to even years.
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Tip : Make Physical Health A Priority
Physical and mental health are inextricably connected. Depression is exacerbated by inactivity, inadequate sleep, and poor nutrition. Unfortunately, teens are known for their unhealthy habits: staying up late, eating junk food, and spending hours on their phones and devices. But as a parent, you can combat these behaviors by establishing a healthy, supportive home environment.
Get your teen moving!Exercise is absolutely essential to mental health, so get your teen activewhatever it takes. Ideally, teens should be getting at least an hour of physical activity a day, but it needn’t be boring or miserable. Think outside the box: walking the dog, dancing, shooting hoops, going for a hike, riding bikes, skateboardingas long as they’re moving, it’s beneficial.
Set limits on screen time. Teens often go online to escape their problems, but when screen time goes up, physical activity and face time with friends goes down. Both are a recipe for worsening symptoms. Gently encourage your teen to take an occasional vacation from their devices or engage in family activities that don’t involve screen time. You can also set an example by reducing your own time spent online.
Encourage plenty of sleep.Teens need more sleep than adults to function optimallyup to 9-10 hours per night. Make sure your teen isn’t staying up until all hours at the expense of much-needed, mood-supporting rest.
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How Can I Help My Teen Cope With Depression
Depression can have a profound impact on a persons life and can only compound the difficulties associated with the teenage years.
Teen depression isnt always the easiest condition to spot. However, with proper treatment your teen can get the help they need.
If depression is affecting your teens life, you should seek help from a mental health specialist. The specialist will create a treatment plan specifically for your teen. Its also important that your teen follows that plan.
Other things your teen can do to help manage depression are:
- stay healthy and exercise
Safety Concerns With Ssris And Snris
Despite their relative safety and tolerance, abrupt discontinuation of shorter-acting agents often results in generalized discomfort and flu-like symptoms. Medications often require 4 to 8 weeks to provide clinical benefit, and potentially longer when starting with low doses. Educating families about these expectations and concerns often prevents them from abandoning medication trials prematurely.
Also Check: What To Do With Someone Who Has Depression
Suicide Warning Signs In Depressed Teens
Seriously depressed teens, especially those who also abuse alcohol or drugs, often think about, speak of, or make attempts at suicideand an alarming and increasing number are successful. So it’s vital that you take any suicidal thoughts or behaviors very seriously. They’re a cry for help from your teen.
Medication Comes With Risks
Antidepressants were designed and tested on adults, so their impact on young, developing brains is not yet fully understood. Some researchers are concerned that exposure to drugs such as Prozac may interfere with normal brain developmentparticularly the way the brain manages stress and regulates emotion.
Antidepressants also come with risks and side effects of their own, including a number of safety concerns specific to children and young adults. They are also known to increase the risk of suicidal thinking and behavior in some teenagers and young adults. Teens with bipolar disorder, a family history of bipolar disorder, or a history of previous suicide attempts are particularly vulnerable.
The risk of suicide is highest during the first two months of antidepressant treatment. Teenagers on antidepressants should be closely monitored for any sign that the depression is getting worse.
Teens on antidepressants: Red flags to watch out for
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What Is Samhsa’s National Helpline
SAMHSAs National Helpline, , or TTY: is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations.
Also visit the online treatment locator, or send your zip code via text message: 435748 to find help near you. Read more about the HELP4U text messaging service.
Tip : Support Your Teen Through Depression Treatment
As your depressed teenager goes through treatment, the most important thing you can do is to let them know that you’re there to listen and offer support. Now more than ever, your teenager needs to know that they’re 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.
Stay involved in treatment. Make sure your teenager is following all treatment instructions, whether it’s attending therapy or correctly taking any prescribed medication. Track changes in your teen’s condition, and call the doctor if depression symptoms seem to be getting worse.
Be patient. 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.
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Depression And Social Media Use
Some studies draw a connection between teen depression and social media use. Teens that spend more time on social media tend to report higher rates of depression than their peers. Several explanations may explain this connection:
- Online interactions may be emotionally unsatisfying or increase fear of missing out . For example, your teen may see images of their peers enjoying time together and feel excluded.
- Teens on social media may spend lots of time comparing their looks and their lives with those of their peers. This can damage self-esteem.
- Spending time on social media may decrease the amount of time your teen spends being physically active or developing skills. Some studies show that a sedentary lifestyle can have a negative effect on mental health.
- Too much time on social media may interfere with your teen’s sleep routine, indirectly affecting their mood.