Depression in Children and Adolescents (Fact Sheet)

depressed child

This is an excellent fact sheet from the National Institute of Mental Health (NIMH)  on Depression in Children and Adolescents

About 11 percent of adolescents have a depressive disorder by age 18 according to the National Comorbidity Survey-Adolescent Supplement (NCS-A). Girls are more likely than boys to experience depression. The risk for depression increases as a child gets older. According to the World Health Organization, major depressive disorder is the leading cause of disability among Americans age 15 to 44.

Because normal behaviors vary from one childhood stage to another, it can be difficult to tell whether a child who shows changes in behavior is just going through a temporary “phase” or is suffering from depression.

Yesterday

  • People      believed that children could not get depression. Teens with depression      were often dismissed as being moody or difficult.
  • It wasn’t      known that having depression can increase a person’s risk for heart      disease, diabetes, and other diseases.
  • Today’s      most commonly used type of antidepressant medications did not exist.      Selective serotonin reuptake inhibitors (SSRIs) resulted from the work of      the late Nobel Laureate and NIH researcher Julius Axelrod, who defined the      action of brain chemicals (neurotransmitters) in mood disorders.

Today

  • We now      know that youth who have depression may show signs that are slightly      different from the typical adult symptoms of depression. Children who are      depressed may complain of feeling sick, refuse to go to school, cling to a      parent or caregiver, or worry excessively that a parent may die. Older      children and teens may sulk, get into trouble at school, be negative or      grouchy, or feel misunderstood.
  • Findings      from NIMH-funded, large-scale effectiveness trials are helping doctors and      their patients make better individual treatment decisions. For example,      the Treatment for Adolescents with Depression Study (TADS)      found that combination treatment of medication and psychotherapy works      best for most teens with depression.
  • The Treatment of SSRI-resistant Depression in Adolescents      (TORDIA) study found that teens who did not respond to a first      antidepressant medication are more likely to get better if they switch to      a treatment that includes both medication and psychotherapy.
  • The Treatment of Adolescent Suicide Attempters (TASA)      study found that a new treatment approach that includes medication plus a      specialized psychotherapy designed specifically to reduce suicidal      thinking and behavior may reduce suicide attempts in severely depressed      teens.
  • Depressed      teens with coexisting disorders such as substance abuse problems are less      likely to respond to treatment for depression. Studies focusing on      conditions that frequently co-occur and how they affect one another may      lead to more targeted screening tools and interventions.
  • With      medication, psychotherapy, or combined treatment, most youth with      depression can be effectively treated. Youth are more likely to respond to      treatment if they receive it early in the course of their illness.
  • Although      antidepressants are generally safe, the U.S. Food and Drug Administration      has placed a “black box” warning label—the most serious type of warning—on      all antidepressant medications. The warning says there is an increased      risk of suicidal thinking or attempts in youth taking antidepressants.      Youth and young adults should be closely monitored especially during      initial weeks of treatment.
  • Studies      focusing on depression in teens and children are pinpointing factors that      appear to influence risk, treatment response, and recovery. Given the      chronic nature of depression, effective intervention early in life may      help reduce future burden and disability.
  • Multi-generational      studies have revealed a link between depression that runs in families and      changes in brain structure and function, some of which may precede the      onset of depression. This research is helping to identify biomarkers and      other early indicators that may lead to better treatment or prevention.
  • Advanced      brain imaging techniques are helping scientists identify specific brain      circuits that are involved in depression and yielding new ways to study      the effectiveness of treatments.

Tomorrow

  • Years of      basic research are now showing promise for the first new generation of      antidepressant medications in 2 decades, with a goal of relieving      depression in hours, rather than weeks. Such a potential breakthrough      could reduce the rate of suicide, which is consistently one of the leading      causes of death for young people. In 2007—the most recent year for which      we have statistics—it was the third leading cause of death for youth ages      15 to 24.
  • Research      on novel treatment delivery approaches, such as telemedicine (providing      services over satellite, Internet, phone, or other remote connections) and      collaborative or team-based care in medical care settings will improve the      quality of mental health care for youth.
  • Sophisticated      gene studies have suggested common roots between depression and possibly      other mental disorders. In addition to identifying how and where in the      brain illnesses start before symptoms develop, these findings have also      encouraged a new way of thinking about and categorizing mental illnesses.      In this light, NIMH has embarked on a long-term project—called the Research Domain Criteria (RDoC) project—aimed      at ultimately improving the treatment and prevention of depression by      studying the classification of mental illnesses, based on genetics and      neuroscience in addition to clinical observation.

Click on link for full article and to download the fact sheet:  http://www.nimh.nih.gov/health/publications/depression-in-children-and-adolescents/index.shtml

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