RECOGNIZING TEEN DEPRESSION AND SUICIDAL THINKING

Teen depression appears to be on the rise, but recognizing their symptoms continues to be confusing for many parents, because the signs are somewhat different in children than with adults. They may not always seem sad, so increased conflict at home or at school may be the earliest indication that your child is depressed.

DSM V defines “Major Depression” as a period of low or irritable mood lasting two or more weeks together with at least five of the following signs:

1. Sleep Disturbance: increased, decreased, frequent or early morning awakening.
2. The Interest: decreased of interest in one’s usual activities.
3. Guilt: “I’m terrible, no one likes me,” “nothing good will ever happen to me.”
4. Increased irritability and anger.
5. Increased physical complaints like headaches and stomach aches.
6. Energy: diminished energy level.
7. Concentration: reduced concentration/grades.
8. Appetite: weight gain or weight loss.
9. Physical slowing: looks depressed, slow moving, lethargic.
10. Isolation like staying in room to avoid the family interaction.
11. Increased difficulty at school with performance and attendance.
12. Increasing talks about running away.
13. Suicidal thoughts about or attempted suicide.

Adolescent Suicide

If you find that your child is showing signs of depression and suicidal intent, you need to act decisively and seek assessment help from a professional or seek hospitalization. Teen depression is a serious illness that can be successfully treated with counseling and sometimes medication.
Adolescence is a very difficult time. Youth suicide has become more prevalent in our society. The American Academy of Pediatrics states, “Suicide is the third leading cause of death for adolescents fifteen to nineteen-years-old.” The suicide rate has increased by three hundred percent from 1950-1990 (American Academy of Pediatrics, 2000). A recent population study of five thousand teenagers found that forty percent of them had contemplated suicide at least once in their lives. Since suicide cuts across all socioeconomic strata, one must look at all social and emotional predictors in order to assess for risk of suicide. Homicide is the third leading cause of death among the youth, second to suicide.

Most suicide attempts are a cry for help, and statistically speaking, nine out of ten adolescents who do commit suicide give clues to others beforehand. One of the most important warning signs is the repeated discussion of one’s death. The moment a threat is made, it should be taken very seriously and help should be provided right away. Our society’s ignorance is what perpetuates this problem. It is important for parents, family members and friends to become educated and learn more about how to assess and intervene with youth suicide. With a depressed individual, it is important to ascertain any planning of suicide and to remove any means of following through. Clearly, although females do have more attempted suicides using pill overdoses, male attempts are more lethal with the use of firearms. Firearms and medications need to always be secured.

Adolescents can become suicidal even when they are not experiencing a clinical mental illness. Their suicidal intentions can come from life situations, like physical or sexual abuse at home or bullying at school, in which ambivalence may be present regarding whether to stay in their pain or continue living with no hope.

Treating Depression

Below are therapies indicated for all depressed teens that have been demonstrated to be particularly effective:

1. Cognitive-Behavioral Therapy (CBT):

An approach that assumes that distorted ways of thinking and resultant negative views of the self or the environment feed the depression. The therapist helps the teen to identify these “cognitive distortions” and to subject them to logical scrutiny.

2. Interpersonal Therapy (IPT):

The therapist becomes a trusted adviser/confidante who focuses on the problems of today and helps the teen solve them.

3. Medications:

General Principles:

a. Medications alone are virtually never good treatment for depressed teens.
b. Medications should generally only be used together with therapy.
c. One is quicker to use medications under certain circumstances:

1. Severe depression.
2. Strong family history of depression, especially with family history of response to specific medications.

Keith A. King, titled, Fifteen Prevalent Myths Concerning Adolescent Suicide