The National Institute of Mental Health (NIMH) estimates that 8% of adolescents and 2% of children (some as young as 4) have symptoms of depression. Early onset of depression in children and teenagers has become increasingly common; some even use the word “epidemic.” No one knows whether there are actually more depressed kids today or just greater awareness of the problem, but some researchers think that the stress of a high divorce rate, rising academic expectations, and social pressures may be pushing more kids over the edge. This is a huge change from two decades ago, when many doctors considered depression strictly an adult disease. Teenage irritability and rebelliousness was “just a phase” kids would outgrow.
But scientists now believe that if this behavior is chronic, it may signal serious problems. New brain research is also beginning to explain why teenagers may be particularly vulnerable to mood disorders. Psychiatrists who treat adolescents say parents should seek help if they notice a troubling change in eating, sleeping, grades, or social life that lasts more than a few weeks.
Public awareness of the need for help does seem to be increasing. Without treatment, depressed adolescents are at high risk for school failure, social isolation, promiscuity, “self-medication” with drugs or alcohol, and suicide — now the third leading cause of death among 10-24- year olds.
The earlier the onset, the more people tend to fall away developmentally from their peers. If you become depressed at 25, chances are you’ve already completed your education and you have more resources and coping skills. If it happens at 11, there’s still a lot you need to learn, and you may never learn it. Early untreated depression also increases a youngster’s chance of developing more severe depression as an adult as well as bipolar disease and personality disorder.
For kids who do get help, the prognosis is increasingly hopeful. Both anti-depressant medication and cognitive-behavioral therapy (talk therapy that helps patients identify and deal with sources of stress) have enabled many teenagers to focus on school and resume their lives. New medications and treatment options are becoming available. In fact, some researchers are working to identify gene markers that indicate which patients are likely to respond to different drugs.
The hardest task for us may be pinpointing kids at risk. Depressed teens usually suffer for years before they are identified, and fewer than one in five who needs treatment gets it. Even adults who make a career of working with kids — teachers, coaches, and pediatricians — can misread symptoms. Finding the right help can be as difficult as identifying the kids who need help. There is an extreme shortage of child psychiatrists around the country.
Types of Depression
Major depression — usually begins in the late teens, but has been diagnosed in children as young as 4.
Dysthymic disorder — chronic mild depression; starts in early childhood and can last for decades.
Bipolar disorder — older teens cycle between mania and depression; young teens and children can experience both symptoms at once.
Double depression — victims alternate between major depression and dysthymic disorder.