Depression: The Warning Signs


(The Vancouver Sun, October 14, 2002)

Dear Teresa: My 15 year old daughter came home from school the other day requesting to be put on antidepressants. I didn’t even know she was depressed. It appears her girlfriend has been recently prescribed antidepressants and now my daughter seems to think it is the new thing to do. It is almost like she thinks it’s cool. I have tried to talk to her about why she feels she needs them but as usual she just gets annoyed and storms away. She does seem to be moodier lately- if that is possible. Is it my imagination, or are more teens being placed on antidepressants than ever before? Also, do you have any information on signs of depression? We are finding it hard to tell whether she is just 15 or truly depressed.

Thanks, H.T. New Westminster, BC

Dear H.T.,
Unfortunately it is not your imagination; more teens are being treated for depression with antidepressants than ever before. According to Canadian statistics, 1 in 8 teens suffer from depression by the time they are 15 years old. Teenage girls, over the age of 16, seem to be at the highest risk. In fact depression in all ages is becoming so wide spread, I have heard it referred to as the “common cold of psychology”. Staggering isn’t it? Although the research on depression specifically related to teens is in relatively short supply, we know that factors like learning disabilities and substance abuse can play powerful roles. Adolescent Psychiatrists also tell us that a parent who suffers from depression is 6 times more likely to have a teen that also suffers from this illness. As far as defining depression for teens goes, there are some notable differences from defining depression in adults. Where an adult may describe feeling a sense of being depressed, teens may not experience depression in the same way. Rather than an overall dulling of emotion some teens may experience depression as an overwhelming state of boredom, irritability, and hostility combined with acting out behaviors. (Before 75% of parents with teens panic feeling like I just described their teen, there are other symptoms and time lines to keep in mind.) As the research describes, here is a list of warning signs specifically for teen depression:

  • Frequent sadness and crying.
  • Feeling of life not being worth it.
  • Decrease in self-care.
  • Decrease in interest in formerly enjoyed activities.
  • Persistent boredom.
  • Increase in time spent alone in their rooms.
  • Decrease in self-esteem.
  • Extreme sensitivity to rejection and failure.
  • Increase in hostility and irritability.
  • Frequent complaints of physical ailments.
  • Decrease in school attendance and grades.
  • Lack of concentration.
  • Change in eating habits.
  • Change in sleeping patterns. (Teens who are depressed often sleep excessively)
  • ANY talk of suicide.
  • Alcohol or drug abuse.
  • Frequent injuries or self inflicted injury.

Some teens may exhibit several signs, others only a few. Most of the research indicates the signs need to be present for a duration of at least two weeks leaning towards a month to be considered depression. In either case, given the high rates of teen suicide, I highly recommend talking to your family doctor if you feel your daughter is depressed. In fact, since she has requested antidepressants, perhaps a trip to the doctor for his or her opinion is a good idea even if you feel she is OK. As far as placing a teen on antidepressants is concerned, I would get as much information as you can before jumping into that decision. I have heard stories from parents who swear antidepressants saved their teen’s life, and I’ve heard stories suggesting the very same drugs on a different teen induced states ranging from zombie like to manic and aggressive. Often parents end up unnecessarily blaming themselves for their teens depression so the offer of depression merely being a medical condition with a medical solution can be seductive. As most good doctors will tell you, it would be neglectful to place a child or teen on antidepressants without investigating the root of the problem. I have counseled dozens of teens demonstrating symptoms of depression for reasons turning out to be histories of unimaginable abuse, loss, problems at home, or conflicts at school. They had internalized years of pain until they could not put their finger on specific reasons they felt so depressed. They just knew they hated their lives. Simply giving them a drug to raise levels of serotonin in their brains without any support or acknowledgement of what they had experienced would have been another form of abuse. Though they may not know how to say it, I believe most teens would say what they really need is someone to talk to, support and information.