Adolescent Depression: Myths and Realities
Types of Depressions
Identified Risk Factors
Symptoms That May Indicate Depression
Other Symptoms Specific to Children / Adolescents
Diagnostic Criteria
Five or more of the following symptoms have been present during the same 2-week period and represent a change from
previous functioning; at least on of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.
Diagnostic Criteria for Dysthymic Disorder (a chronic depressive disorder) used by Mental Health Professionals:
A. Depressed mood for most of the day, for more days than not, as indicated either by subjective account or observation
by others, for at least 2 years. Note: In children and adolescents, mood can be irritable and duration must be at least 1
year.
B. Presence, while depressed, of two (or more) of the following:
1. poor appetite or overeating
2. insomnia or hypersomnia
3. low energy or fatigue
4. low self-esteem
5. poor concentration or difficulty making decisions
6. feelings of hopelessness
Ways to Help Suicidal Teens
Offer help and listen. Encourage teens to talk about their feelings. Listen, don’t lecture.
Trust your instincts. If it seems that the situation may be serious seek prompt help. Break a confidence if necessary to
help the teen.
Pay attention to talk about suicide. Ask direct questions and don’t be afraid of frank discussions.
Limit access to lethal agents – firearms, lethal medications.
Seek professional help. It is essential to seek expert advice from a mental health professional who has experience
dealing with depressed teens.
Alert key adults in teen’s life. Family, friends, and teachers.
Adolescent Depression – Ways to Help
Try to make new friends – healthy relationships with peers are central to teens’ self-esteem and provide an important
social outlet.
Participate in sports, job, school activities or hobbies – staying busy helps teens focus on positive activities rather than
negative feelings or behavior
Join organizations that offer programs for young people – special programs geared to the needs of adolescents help
develop additional interests.
Ask a trusted adult for help – when problems are too much to handle alone, teens should not be afraid to ask for help.
Consult pediatrician/family physician – rule out any medical condition (e.g., thyroid problem, endocrine problem, etc.).
Obtain referrals for mental health professionals.
Evaluation - rule out other conditions such as ADHD, learning disabilities. Is it a sign of more serious problems. If so,
early intervention is the key.
Therapy – provides adolescents with a safe place to discuss worries, concerns, and stresses.
Medication – consultation with a psychiatrist to determine whether medication is appropriate. It may be a fast way to
obtain symptom relief and allow the adolescent to use therapy more productively.
Special Education – qualifying depressed student for an IEP and special education services. Mental health services can
be paid by the school district.
Read on the topic – More Than Moody: Recognizing and Treating Adolescent Depression by Harold Kopelwicz, M.D.
John Brentar, Ph.D.
Morrissey/Compton Educational Center
2555 Park Blvd, Suite 20
Palo Alto, CA 94304
Tel. 650-322-5910
jbrentar@netzero.com
Types of Depressions
- Major Depression
- Dysthymic Disorder
- Bipolar Disorder
- Mixed Major Depressive episode
Identified Risk Factors
- Stress (family, school, personal stress)
- A loss of a parent or loved one
- Break-up of a romantic relationship
- Attentional, conduct, or learning disorders - poor performance in school
- Chronic illnesses, such as diabetes or epilepsy
- Abuse or neglect
- Other trauma (e.g., natural disasters)
- Suicide of a peer/classmate/family member
- Family History of depression - can be "hidden" as alcoholism
- Cigarette smoking
Symptoms That May Indicate Depression
- Withdrawal from friends and activities
- Sadness and hopelessness
- Lack of enthusiasm, energy or motivation -- Reduced pleasure in activities
- Anger and rage
- Overreaction to criticism, general emotional sensitivity
- Poor self-esteem or guilt Indecision
- Lack of attention, concentration, or forgetfulness
- Restlessness and agitation
- Changes in eating or sleeping patterns -- daytime fatigue
- Substance abuse
- Problems with authority
- Acting-out behavior (missing curfews, unusual defiance)
- Suicidal thoughts or actions
Other Symptoms Specific to Children / Adolescents
- Poor performance in school
- Frequent vague, non-specific physical complaints (e.g., headaches, muscle aches, stomachaches or tiredness)
- Frequent absences from school or poor performance in school
- Talk of or efforts to run away from home
- Outbursts of shouting, complaining, unexplained irritability or crying
- Being bored
- Poor communication with parents and family members
- Fear of death
- Extreme sensitivity to rejection or failure
- Reckless behaviors (e.g., alcohol, drugs, sexual promiscuity)
- Difficulty with relationships (volatile relationships with friends)
- Confusing presentation -- sad/angry in one setting (e.g., at home), happier mood in others (e.g., at parties or with
friends)
Diagnostic Criteria
Five or more of the following symptoms have been present during the same 2-week period and represent a change from
previous functioning; at least on of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.
- Depressed mood most of the day, nearly every day, as indicated by either subjective report or observation made by
others (e.g. appears tearful) Note: in children and adolescents, can be irritable mood. - Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day ( as
indicated by either subjective account or observation made by others) - Significant weight loss when not dieting or weight gain ( a change of more than 5 % of body weight in a month), or
decrease or increase in appetite nearly every day. Note: In children, consider failure to make expected weight
gains. - Insomnia or hypersomnia nearly every day
- Psychomotor agitation or retardation nearly every day (observable by other, not merely subjective feelings of
restlessness or being slowed down) - Fatigue or loss of energy nearly every day
- Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not
merely self-reproach or guilt about being sick) - Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as
observed by others) - Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide
attempt or a specific plan for committing suicide.
Diagnostic Criteria for Dysthymic Disorder (a chronic depressive disorder) used by Mental Health Professionals:
A. Depressed mood for most of the day, for more days than not, as indicated either by subjective account or observation
by others, for at least 2 years. Note: In children and adolescents, mood can be irritable and duration must be at least 1
year.
B. Presence, while depressed, of two (or more) of the following:
1. poor appetite or overeating
2. insomnia or hypersomnia
3. low energy or fatigue
4. low self-esteem
5. poor concentration or difficulty making decisions
6. feelings of hopelessness
Ways to Help Suicidal Teens
Offer help and listen. Encourage teens to talk about their feelings. Listen, don’t lecture.
Trust your instincts. If it seems that the situation may be serious seek prompt help. Break a confidence if necessary to
help the teen.
Pay attention to talk about suicide. Ask direct questions and don’t be afraid of frank discussions.
Limit access to lethal agents – firearms, lethal medications.
Seek professional help. It is essential to seek expert advice from a mental health professional who has experience
dealing with depressed teens.
Alert key adults in teen’s life. Family, friends, and teachers.
Adolescent Depression – Ways to Help
Try to make new friends – healthy relationships with peers are central to teens’ self-esteem and provide an important
social outlet.
Participate in sports, job, school activities or hobbies – staying busy helps teens focus on positive activities rather than
negative feelings or behavior
Join organizations that offer programs for young people – special programs geared to the needs of adolescents help
develop additional interests.
Ask a trusted adult for help – when problems are too much to handle alone, teens should not be afraid to ask for help.
Consult pediatrician/family physician – rule out any medical condition (e.g., thyroid problem, endocrine problem, etc.).
Obtain referrals for mental health professionals.
Evaluation - rule out other conditions such as ADHD, learning disabilities. Is it a sign of more serious problems. If so,
early intervention is the key.
Therapy – provides adolescents with a safe place to discuss worries, concerns, and stresses.
Medication – consultation with a psychiatrist to determine whether medication is appropriate. It may be a fast way to
obtain symptom relief and allow the adolescent to use therapy more productively.
Special Education – qualifying depressed student for an IEP and special education services. Mental health services can
be paid by the school district.
Read on the topic – More Than Moody: Recognizing and Treating Adolescent Depression by Harold Kopelwicz, M.D.
John Brentar, Ph.D.
Morrissey/Compton Educational Center
2555 Park Blvd, Suite 20
Palo Alto, CA 94304
Tel. 650-322-5910
jbrentar@netzero.com
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