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Adolescent Depression
An emotional state marked by sadness, discouragement, and loss of self-worth that occurs during the teenage years.

Major Depression
A recurrent emotional state characterized by feelings of persistent sadness, worthlessness, dejection, loss of hope, and loss of interest in usual activities.


Adolescent Depression

Alternative names:
Depression in adolescents; teenage depression

Definition:
An emotional state marked by sadness, discouragement, and loss of self-worth that occurs during the teenage years.

Causes, incidence, and risk factors:
Depression can be a transient mood change in response to many stimuli. In adolescents, depression is common because of the normal maturation process, the stress associated with it, and independence conflicts with parents. It may also be a reaction to a disturbing event such as the death of a friend or relative, a breakup with a boyfriend or girlfriend, failure at school, or for no apparent reason. Depression may also be caused by medical or psychiatric illness or medications.

Normal behavior in adolescents is marked by both up and down moods, with alternating periods of feeling 'the world is a great place' and 'life's a bummer'. These moods may alternate over a period of hours or days. Persistent depression with no interspersed periods of happiness, faltering school performance, failing relations with family and friends, substance abuse and other negative behaviors may indicate depression. Teenagers may also mask depression with a put-on front of happiness but acting-out and risk-taking behavior indicate the underlying problem.

Suicide may follow either a short or prolonged period of depression.

Prevention:
Feelings of depression may not be preventable. Sometimes, counseling may help the adolescent deal with feelings of depression.

Symptoms:
  • depressed or irritable mood
  • temper, agitation
  • loss of interest in activities
  • reduced pleasure in daily activities
  • change in appetite, usually a loss of appetite
  • change in weight (unintentional weight loss or unintentional weight gain)
  • persistent difficulty falling asleep or staying asleep (insomnia)
  • sleeping difficulty
  • excessive daytime sleepiness
  • fatigue
  • difficulty concentrating
  • memory loss (amnesia) episodes
  • preoccupation with self
  • feelings of worthlessness or sadness
  • excessive or inappropriate guilt feelings
  • acting-out behavior
  • thoughts about suicide or abnormal thoughts about death
  • plans to commit suicide or actual suicide attempt
  • excessively irresponsible behavior pattern

Note: Symptoms often persist for weeks or months

Signs and Tests:
A physical examination rules out medical causes for the symptoms. A psychological evaluation confirms depression.

Treatment:
Psychotherapy is used to treat milder forms of depression. It may be used in combination with antidepressant medications for more severe forms of depression. Occasionally, hospitalization in a psychiatric unit may be required for individuals with severe depression, or at risk of suicide.

Expectations (prognosis):
Depression usually responds to treatment. In a few people, depression may be a life-long illness.

Complications:
Teenage suicide is associated with depression as well as many other factors. If a teenager threatens suicide, take it seriously. Drug and alcohol abuse may also occur.

Calling your Health Care Provider:
Call your Health Care Provider if one or more warning signs of potential suicide are present.  Although there is no one type of suicidal person, be alert to the following signs:

  • withdrawal, with urge to be alone, isolation
  • moodiness
  • personality change
  • threat of suicide
  • giving most cherished possessions to others

NEVER IGNORE A SUICIDE THREAT OR ATTEMPT!



Major Depression

Alternative names:
Depression, major; unipolar depression

Definition:
A recurrent emotional state characterized by feelings of persistent sadness, worthlessness, dejection, loss of hope, and loss of interest in usual activities.

Causes, incidence, and risk factors:
There are multiple causes of depression. In many people, personal loss or severe stress is identified that may interact with a predisposition to depression. The causes may include genetic, familial, biochemical, physical, social, and psychological factors. Major depression occurs in all groups of people.

It affects both sexes, with an increased incidence in women. Major depression affects 1 out of 10 Americans at some point in their lives. Major depression is most common in adolescent girls, affecting 5 - 10% of the population. Before puberty, boys and girls seem to be equally vulnerable, about 1 to 2% of the population.

Prevention:
Many episodes of depression are not preventable. Treatment, including medications and psychiatric intervention, may prevent recurrences.

Symptoms:
  • persistent sadness lasting greater than 2 weeks
  • loss of interest in usual activities
  • weight loss
  • sleep disturbances
  • depressed most of the day
  • energy loss
  • fatigue
  • hyperactive or slowed behavior
  • decreased sexual drive
  • feelings of worthlessness
  • difficulty concentrating or making decisions
  • recurrent suicidal thoughts
  • memory loss

Note: Symptoms often persist for weeks or months

Signs and Tests:

  • history of persistent sad mood
  • history identifying a source of loss or stress
  • Beck's depression scale
  • psychological tests

Treatment:
Antidepressants drug therapy combined with psychotherapy appears to have better results than either therapy alone. Drug therapy includes tricyclic antidepressants, monoamine oxidase inhibitors (see MAO inhibitor antidepressants - oral) , and serotonin re-uptake blockers. Lithium and thyroid supplements often enhance the effectiveness of antidepressants.

Electroconvulsive therapy is a psychiatric treatment that causes a central nervous system seizure by means of an electrical current. Electroconvulsive therapy (ECT) may improve the mood of severely depressed or suicidal people who don't respond to other treatments

Support Groups:
The stress of illness can often be helped by joining a support group where members share common experiences and problems. See mental health - support group and depression - support group.

Expectations (prognosis):
The outcome is usually good with treatment.

Complications:

  • Suicide

Calling your Health Care Provider:
Call your Health Care Provider or Mental Health Professional if you feel you can't continue to go on.

Set up an appointment with a Counselors Link Mental Health Professional if you have stopped eating, are eating all the time, are eating irregularly, or if you are hearing voices.



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