February 15, 2019 by John Fernandez and Tanya Racoobian
Depression in Adolescents, Teens Rising Dramatically
Depression is a health condition that has a negative impact on overall well-being, and the number of young Americans experiencing it is increasing. The number of adolescents and teenagers diagnosed with depression between 2013 and 2016 represents 2.6 percent of all children ages 12 to 17, according to research released two weeks ago by Blue Cross Blue Shield.
The 63 percent increase in the adolescent and teen depression rate is the most dramatic change noted during the three-year study of insurance claims from more than 41 million Americans.
“Kids have a lot of stressors put on them these days to perform well in school and extracurricular activities, with pressure to get good grades, score high on standardized tests and be a star athlete to get into good programs or universities,” said Grace Jimenez, psychotherapist with Care & Counseling at Baptist Health South Florida. “All that activity can be beneficial, but it also increases stress and leaves less time for the rest that kids need to do well and be healthy. The repercussion is we have kids who are overly stressed and anxious, and that’s when depression starts to come in.”
Depression is one of the most common mood disorders. It results when a combination of factors interact, such as stressful life events, biological changes in the brain, genetics and sometimes medications and medical problems.
Coupling multiple stressors with being connected 24/7 on a cell phone or digital device makes it hard for today’s kids to get the down time they need, Ms. Jimenez says.
“Rest lets the body reset itself and allow growth to happen, both physically as well as connections in the brain,” she said. “If you’re going 24/7, worried about school, dance class and who’s liking you on social media, your brain doesn’t disconnect. When the brain doesn’t turn off, it doesn’t allow the body to get the rest it needs for cognitive and physical growth.”
Kids’ stressors also affect parents, experts say.
“A lot of parents feel if they’re not helping children participate in activities all the time, they’re not providing what they need to be successful,” Ms. Jimenez said. “But considering working, commuting, picking kids up from school, rushing to after-school activities and then for homework, parents have no down time either. I tell them, ‘If you’re not taking care of yourself, you’re not teaching your kids to take care of themselves because they can’t see it and don’t know what to do.’”
Signs and Symptoms of Depression in Children
As primary care givers, parents are in the best position to first notice signs of depression in children. But identifying changes in the moods of adolescents and teenagers can be hard because their personalities are changing as they grow. Ms. Jimenez tells parents to look for any significant behavior shifts that affect a child’s mood, most notably changes in:
- Weight – weight loss or weight gain.
- Sleeping patterns – sleeping too much or too little.
- Academics – declining school grades or difficulty concentrating or remembering.
- Energy levels – frequent fatigue or loss of interest in previously enjoyable activities.
- Feelings – sadness, irritation or pessimism in someone who’s usually happy, friendly and positive.
“Sometimes we think depression is just sadness and withdrawal, but anger and irritability are signs as well,” she said. “When changes happen across the board and affect how well they’re doing in school and at home, it’s time to start asking the child more questions and getting help.”
While a clinical diagnosis of depression depends on presentation of several symptoms together, parents who notice two or three signs – for two weeks or more – should seek treatment, Ms. Jimenez adds.
Treating Depression in Children
The growing amount of research defining the ages and increasing rates of depression among youth led the American Academy of Pediatrics (AAP) to update its screening guidelines for the condition. The new guidelines announced earlier this year call for pediatricians and primary care physicians to screen children for depression each year starting at age 12. There is not yet enough evidence to support universal screening in younger kids, the AAP said.
While more adolescents and teenagers with depression may be identified, Ms. Jimenez tells parents they don’t always have to wait for a doctor’s diagnosis.
“If you’re reaching out to your child trying to talk with them and you’re not getting clear answers – or the depression gets increasingly worse – you should reach out for support,” she says. “Clinically, we’re looking for any behavior changes that last two weeks or more.”
Support can come from a counselor at school or a psychotherapist in the community. Psychotherapy, or talk therapy is the standard treatment for depression. It involves a therapist talking with the patient to help him or her identify thoughts and feelings that are affecting their behaviors.
“If they can identify the cause of the depression, they can manage it,” Ms. Jimenez says. “Once the therapist has helped an adolescent or teen manage thoughts and feelings, they’re better able to do it themselves in the future.”
The length of therapy depends on the child and severity of the problem. Therapists say a good rule of thumb is to consider how big the situation is and how long the behaviors and depression have been set in.
“In general for mild-to-moderate issues, parents can expect to start to notice positive changes after 6-8 sessions,” Ms. Jimenez said. “But if a teenager has been fighting depression for years, it takes longer to help them change their way of thinking so their feelings and behaviors start to change.”
Art therapy can be especially useful in treating kids this age. Activities like drawing or coloring are soothing and therapeutic because the brain is focusing on one thing and stops thinking about the rest of the world. As a result, they’re calm, clear thinking and more likely to express their feelings.
Parents Crucial to Helping Depressed Children
Ms. Jimenez emphasizes treating depression in children is a lot about getting them to open up and talk about what they’re feeling. Parents can help by employing “play therapy.” It involves getting the child active – taking them outside, going for a walk, or playing a board or video game – anything enjoyable that gets them moving.
“A lot of time adults think getting a kid active means going to the gym, running or another organized activity. But sometimes it’s easier and better to just play,” Ms. Jimenez says. “As long as you’re with them having fun, they’re just as excited to share with you the things they’re doing and feeling.”
Getting children active can be difficult if he or she is on the more severe side of anxiety or depression, she adds. Parents should keep encouraging them and suggest they pick the activity.
“And especially for the parents, it’s important to remember ‘you’re not alone in this,’” she said.