Depression in adolescents, difficulties in diagnosing teen depression, treatment options, and hope for parents of depressed teenagers
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Government Task Force Says All Teens Should Be Screened for Depression

By Hugh C. McBride

An advisory task force that is associated with the U.S. Department of Health and Human Services has issued a report calling upon physicians to routinely evaluate their teen patients for signs of depression.

The U.S. Preventive Services Task Force (USPSTF), which is composed of 16 primary care physicians with expertise in prevention and evidence-based medicine, announced their call for increased screenings for adolescent depression in an article that is slated to be published in the April issue of the journal Pediatrics.

A March 30 article by Associated Press writer Lindsey Tanner called the task force’s actions “a bold step that acknowledges that nearly two million teens are affected by the debilitating condition” of depression.

Increasing Diagnoses, Improving Treatment

The call for increased screening for teen depression was announced in a March 30 press release that was issued by the Agency for Healthcare Research and Quality (AHRQ), which oversees the actions of the USPSTF.

According to the release, the task force is encouraging physicians to screen patients between the ages of 12 and 18 “when appropriate systems are in place to ensure accurate diagnosis, treatment and follow-up care.” The USPSTF established the age-12 cutoff for regular depression screenings because task force members did not find sufficient scientific assessments of the benefit/harm balance of screening younger children.

The March 30 release notes that USPSTF members believe that increased screenings for teen depression can significantly enhance the quality of life for young people who are suffering from heretofore undiagnosed mental and emotional conditions.

“The task force said that when followed by treatment, including psychotherapy, screening can help children cope and improve symptoms,” Lindsey Tanner’s AP article reported. “Because depression can lead to persistent sadness, social isolation, school problems and even suicide, early screening is crucial, the panel said.”

A Widespread Problem

As the AHRQ press release indicates, adolescent depression remains a highly under-diagnosed condition that can drastically impact a young person’s ability to develop appropriately and live a satisfying life:

“Depression in adolescents has a significant impact on both mental and physical health, and adolescents with depression have more hospitalizations for psychiatric and medical issues than adolescents who are not depressed,” said Task Force Chair Ned Calonge, M.D., who is also chief medical officer for the Colorado Department of Public Health and Environment. “It is important that adolescents are diagnosed and treated for clinical depression in order to improve their health and quality of life, especially if they have a family history of depression.” …

Depressed children and adolescents are at an increased risk of suicide, which is the third-leading cause of death among people age 15 to 24 and the sixth-leading cause of death among those age 5 to 14. Adolescents suffering from clinical depression are also more likely to suffer from depression in early adulthood. Nearly 6 percent of adolescents 13 to 18 years of age are clinically depressed, and it is more common among girls than boys.

Signs of Adolescent Depression

Experts estimate that as many as 70 percent of young people who suffer from adolescent depression do not receive any type of professional treatment – a treatment gap that can be blamed in part on the difficulty parents have in noticing the signs that their children need to be assessed by a qualified physician or pediatric mental health expert.

Parents should be aware of the symptoms of teen depression, and should be prepared to act on their observations by contacting their family physician if they suspect that their child could be struggling with depression or a related mental-health challenge. If the following behaviors persist for more than a few weeks, they may indicate that a young person is suffering from depression:

• Abnormally low energy level
• Excessive irritability, and persistent “blue moods” or melancholy
• Significant unexplained weight loss or gain
• Insomnia (trouble sleeping) or hypersomnia (excessive sleeping)
• Expressions of worthlessness, self-deprecation, or self-hatred
• Unexplainable drop in academic performance
• Loss of interest in social activities, sports, hobbies, or other experiences that were once very important
• Withdrawal from family and/or friends
• Rapid and unexplained mood swings, from excessive enthusiasm and energy to angry outbursts and violent tendencies

How to Help

As the USPSTF release indicates, the first step in helping a young person overcome adolescent depression is making an effective diagnosis. Once the problem has been identified, the most important decision is arranging for treatment that will most effectively address the depression and any underlying or co-occurring conditions.

Some young people respond well to outpatient therapy or other more limited forms of intervention, while others may be best served by enrolling in a therapeutic boarding school or other residential program for adolescent depression.

The family’s primary care physician should be able to discuss appropriate treatment options. Other sources of information include the child’s school guidance counselors and local mental health organizations, as well as legitimate and medically sound websites.

The good news about adolescent depression is that the condition is treatable, and significant strides continue to be made in terms of both therapeutic interventions and medically assisted recovery. But none of this can occur in the absence of an effective diagnosis.

If you believe that your child may be suffering from adolescent depression, don’t assume that it’s “just a phase” or merely a bout of teen angst. Get professional assistance, and be sure that your child receives the help he needs to pursue the future he deserves.

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