There are people who can relate to teens with depression
In 1963, Sylvia Plath wrote The Bell Jar, a semi-autobiographical look at teenage depression treatment. Her heroine describes herself, and the feeling of depression, in this way: “To the person in the bell jar, blank and stopped as a dead baby, the world itself is a bad dream.” The glass of the jar stands between the depressed person and the rest of the world, muffling sensations and distorting views.
For teens struggling with depression, Plath’s words ring just as true now as they did in 1963. They may find it hard to communicate, hard to wake up and hard to get out. They may lash out at their family members and friends, or they may withdraw so deep within themselves that they seem impossible to reach. It can be incredibly hard for parents to watch this process, and they, too, may feel depressed and helpless.
Teen Depression Treatment
Thankfully, researchers have devoted a significant amount of time to the study of adolescent depression, and now, doctors know more now than ever before about how to provide help to depressed teens. Treatment is available, and it works.
The Start of Treatment
A diagnosis of depression isn’t something that doctors like to hand out randomly. Teens can become blue and sad for a wide variety of reasons, and some of them aren’t related to depression or any other mental illness. Before a teen enters a specific treatment program for depression, according to an article published in American Family Physician, doctors run a series of tests to rule out problems such as:
- Infectious mononucleosis
- Vitamin deficiencies
- Use of depressant medications, such as Accutane
- Endocrine disorders
If these tests come back negative, the doctor then moves to grading the depression. This isn’t the sort of mental illness a teen either has or doesn’t have. Instead, depression can manifest itself throughout a spectrum of severity, and the way a mild case of depression is treated is much different than the way a major depressive episode is treated. In order to obtain a full diagnosis of depression or a depressive episode, according to an article published in the Western Journal of Medicine, the teen must express a persistent loss of interest in things the teen once enjoyed, and a depressed or irritable mood. Some teens have both of these symptoms at the same time. The more symptoms the teen displays, the stronger the case for severe depression.
Teen Treatment Plans
In some cases, the teen will continue to work with the doctor on an outpatient basis, working on therapies while he or she continues to live at home. There are some teens, however, who need more intensive help.
The Importance of Seeking Treatment
Teens with severe cases of depression are at increased risk of suicide. According to Mental Health America, almost 500,000 people between the ages of 15 and 24 kill themselves every year. Some of these people harbored mental illness for years, and one small event triggered them to take drastic action. Teens at high risk of suicide may need close monitoring by a trained and qualified staff. It can be too difficult for families to provide this level of supervision at home, but in a clinical facility, the teen can receive this sort of care and might be prevented from making a terrible mistake. If your teen is at risk of suicide, enrolling the teen in a facility like ours could be the best thing you’ll ever do. At Newport Academy, we can work to help your teen and ensure that the teen doesn’t make this tragic choice.
The Role of Medications
Most people are accustomed to the idea of taking medications to ease the symptoms of mental illness. In a way, this is perfectly reasonable, as many mental illnesses are caused by chemical imbalances that can be corrected through the use of medications. The way forward with teens and medications for depression is slightly less clear.
For example, adults who face a major episode of depression are often given a standard antidepressant. Slowly, the medication builds up in the adult’s system and the symptoms of depression begin to lessen and ease. In adolescents, these medications aren’t always as effective. For example, a study published in the Journal of Clinical Child and Adolescent Psychology found that use of antidepressants in teens is only mildly effective. It’s possible that the chemistry in an adolescent’s body just doesn’t respond well to the medications commonly used to treat adult depression.
Teen Depression Medications
SSRIs work on different receptors in the brain, and some studies suggest that they have been helpful in easing symptoms without causing bothersome sedation. These medications aren’t without their drawbacks, however. In 2004, the United States Food and Drug Administration warned that some teens who took SSRIs faced a high risk of suicidal thoughts. It’s a bit ironic, as these are the sorts of thoughts the medications were designed to treat, but the risk seemed pronounced enough to point out. Now, the National Institute of Mental Health suggests that the benefits of SSRIs outweigh the risks of the medication, although it pays to monitor teens closely while they take them.
No matter what the teen takes, it may take weeks or even months for the teen to feel a difference in symptoms, and some teens respond to no medications at all. This is one of the frustrating aspects of treating depression, in adults or in teens.
In a therapy session, a teen learns to live with depression and to manage the symptoms. These are life lessons that help the teen build up skills that he or she can use throughout adulthood.
Many therapists use Cognitive Behavioral Therapy with depressed teens. This technique is based on the premise that thoughts have real and measurable power. The thoughts that the teen allows to float freely through the mind can influence the way the teen feels and acts. So the therapy aims to help the teen learn to identify and correct maladapted ways of thinking. In some cases, this can be done through simple identification. The therapist listens for cues such as the words:
Cognitive Behavioral Therapy
When the teen utters these words, the therapist might stop and ask for a time-out. The teen might unpack the sentence to determine if the statement really is true. Is the straight-A student really dumb? Why? Might they be better in math than in English? And therefore, aren’t they smarter in math, and not dumb in English? Cognitive Behavioral Therapy (CBT) involves a significant amount of work and homework. Teens might be asked to keep journals, writing down their thoughts and the methods they’re using to stop negative thoughts from taking over. Teens might also be asked to perform exercises where they challenge their thoughts, just to prove that they are untrue. The emphasis is on building real skills, so these homework sessions matter.
Once the teen has developed the necessary skills, and practiced them in a variety of ways, and once both the teen and the therapist think that the teen has conquered the depression, the sessions are over. This is a delicate question, and the timeline can vary dramatically from teen to teen.
This method has been studied extensively in teens. Some researchers have found that it’s most effective when it’s paired with medications. For example, the Treatment for Adolescents with Depression (TADS) study found that 73 percent of patients taking medications and having therapy felt better in 12 weeks, but only 48 percent of teens felt better when they only had therapy. While it’s clear that therapy works, therapy with medications might work even better.
Most parents want reassurance that their children are going to improve with treatment. There is much reason to be positive. This TADS study, which was partially funded by the National Institute of Mental Health, found that by the end of the 36-week study, 82 percent of people had improved. This is a remarkable rate of improvement for any form of mental illness and it’s certainly something that could help parents feel more comfortable about depression treatment.
There is one final word of caution, however. The TADS study also found that many of these teens relapsed into depression in a few years. In fact, 30 percent relapsed the very next year. Some teens need to participate in small touch-up sessions with their therapists where they review the work they performed before and they work out current problems. Other teens need to return to medication use. Parents can help make sure that happens.
If you have any questions about depression treatment for teens, give us a call today. We are here to help.