& Getting Treatment
Signs of Teen Depression
Parents Can Do
Teenager Is Sad...
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Jeremy did not have to
| On 29 April 2002 we lost Jeremy, our
18-year old son, to his own hand. He seemed to have everything going for
him and his taking of his young life - the thing of greatest value and
potential - came out of the blue for everyone.
It wasn't because
we, his parents, were unobservant or unresponsive. (There was some history
of depression in the family and we are both in the medical
profession.) We consistently watched both Jeremy and his brother for
signs of emotional problems - even picking up ADD in his brother at an
early age. However, Jeremy exhibited none of the then-current signs of
teen-age mental instability or depression published by the American
Association of Pediatrics - in fact even after his death those criteria
still do not apply to Jeremy. His impressive athletic performance,
outstanding academic achievements, and cordial interactions with both
friends and family gave the appearance of a normal kid and young adult who
had a solid grasp on his life.
We had done the usual parent things...talking of alcohol, drugs, safe
sex, compassion to others, rules of the game, survival - at sea, in the
woods or mountains, and on the road. However, because it is perhaps a
parent's greatest fear, we never discussed suicide nor the meaning and
value of life in the big picture. Apparently, he was silently depressed
(never a mention of his feelings) and likely not thinking rationally when
in a fit of depression he made a flawed and fatal decision.
The following article
(When a Teenager is Sad...Pay Attention) by Dianne Hales and Dr.
Robert E. Hales appeared nationwide in Parade
on May 5, 2002 - the day following Jeremy's funeral. The two mentioned individuals fortunately survived; Jeremy did
not. In retrospect, Jeremy met several of the listed Warning Signs of
Teen Depression, too late to change a tragic sequence of events.
For this reason, this outstanding article is reprinted here.
York; May 5, 2002
Teenager Is Sad...
|By Dianne Hales and Dr.
Robert E. Hales
|Up to 8 percent if
American adolescents are seriously depressed, but most parents don't recognize
||Teenagers are notoriously
moody but frequently hide feelings of sadness. Keep channels of
communication open and listen closely to what your child is telling you.
of Teen Depression
- MOOD CHANGES, including feeling sad,
irritable, becoming easily angered or having difficulty getting along
with family members.
- LOSS OF INTEREST in hobbies, sports or social
- LACK OF ENJOYMENT, even when involved in an activity
- CHANGES IN SLEEP PATTERNS, such as difficulty falling
asleep or staying asleep.
- CHANGES IN APPETITE - gaining or losing
- CHANGES IN ENERGY LEVELS, such as frequent
fatigue, restlessness or agitation.
- SCHOOL DIFFICULTIES, including problems concentrating
or a decline in grades.
- SELF-CRITICISM, even taking blame for things
that are not really their fault.
- TALK WITH YOUR CHILD and let him or her know you care and
want to help. Don't assume that a teen's moodiness is "just a
- HAVE YOUR TEEN SCREENED FOR DEPRESSION. You can get information
from a school counselor or pediatrician.
- GET PROFESSIONAL HELP EARLY. The sooner teen depression is
treated, the better.
- LOCK UP that may be deadly-or don't keep
them around at all.
- REMOVE ALL GUNS, including hunting rifles, from the home.
- MAKE SURE YOUR CHILD'S TREATMENT IS UP-TO-DATE and that his
or her therapist is aware of the most effective approaches.
- ADDRESS THE DANGERS OF ALCOHOL AND ILLEGAL DRUGS, explaining
to teems that they are especially vulnerable.
A Teenager Is Sad...Pay Attention
Hales and Dr. Robert E. Hales
Maldonado's world started to fall apart in 1996, when she was 13. Growing
up in Manhattan, Zoe was constantly teased by classmates, but she was
always able to turn to her grandmother. Then her beloved grandmother died
of cancer a few weeks before Zoe began high school.
"It destroyed me," recalls Zoe. More traumas
followed: A boy she considered a friend raped her, she says, and two of
her uncles died within a short time.
"I wanted to crawl under a rock," she says.
"I went from a B student to an F student. I lost weight. I kept
trying to hurt myself. I didn't see any point in living anymore." In
Zoe's junior year, a teacher at her school committed suicide.
"I broke down," she says. "I went to the
dean of students, who is a psychiatrist, and she talked to me about how I
felt." Zoe began treatment with antidepressant medication, individual
therapy and family counseling at Columbia-Presbyterian Medical Center. Now
19 and a college sophomore who wants to teach the deaf, she looks back on
her high school years as "milestones."
"Without those experiences, I might not be the
person I am today," Zoe says. "In therapy, I learned to express
my feelings, to set goals, to communicate better. My grades improved. So
did my social life. I could talk with my mother without fighting. I was
able to save myself. Now I want to save others from feeling like I
did---all alone in the world."
The National Institute of Mental Health estimates that
up to 8% of American teenagers suffer from major depression; girls are
twice as susceptible as boys. According to a 1999 survey, about 20% of
high school students have seriously considered suicide. And every year,
about eight to 11 in every 100,000 teens do take their own lives---as many
as those who die from all other natural causes combined.
"Depression is the most common emotional problem in
adolescence and the single greatest risk factor for teen suicide,"
says Dr. Peter Jensen, a child psychiatrist and director of the Center for
the Advancement of Children's Mental Health at Columbia University in New
Depression is a treatable biological disease
characterized by changes in brain chemistry. The greatest challenges for
parents are recognizing depression in young people notorious for their
moodiness and admitting that their child has a mental disorder. "The
knee-jerk reaction is a sense of failure," says Dr. Jensen.
"Many people still believe that home and family problems cause
depression, but the opposite is true: Depression causes home and family
When he was in high school in the mid-1990s, Ross Szabo
of Nazareth, Pa., put on his "happy face" every morning. "I
was president of my junior class," says Ross. "I played varsity
basketball. I was involved in all sorts of activities. But whenever I was
alone, I was crying. I'd wake up crying, and I'd cry myself to sleep at
night. And nothing was on my mind more than wanting to die."
On a January day in his senior year, Ross played in a
basketball game and celebrated his team's victory at an ice cream parlor.
That night he tried to kill himself with an overdose of pills. His parents
rushed him to a hospital.
Like Ross, many depressed teens don't look or act sad.
They may hide their tears, snap at parents or burst into angry tirades.
Some turn to alcohol or drugs in hopes of feeling better, or become
depressed after they start abusing these substances. Many depressed teens
drop out of activities and pull away from friends. Their schoolwork
suffers; many are labeled as underachievers. One overlooked risk factor is
cigarette smoking. According to psychologists at the University of
Alabama, depressed teens may smoke to feel better, but nicotine alters
brain chemistry and actually can make them feel worse.
"I tell parents that if a teenager has problems at
school, home or play, the problem may be depression," says Dr. Graham
Emslie, professor of psychiatry at the University of Texas Southwestern
Medical Center at Dallas. "If there are problems in two of these
areas, the youngster probably has depression. With problems in all three,
it's almost a certainty."
Many parents are afraid to ask teens if they've thought
about killing themselves. "They're scared of the answers," says
Dr. Miriam Kaufman, author of Overcoming Teen Depression: A Guide for
Parents. She advises parents not to panic if teens say they've thought
about suicide. "Let them know you understand that they must be in a
great deal of emotional pain and assure them that they won't always feel
this way." She suggests asking troubled teens to promise they will
talk to a parent "in person" before attempting suicide.
"This is a promise that teens usually keep," she adds. Most
important of all is seeking treatment from a qualified professional.
In the last decade, mental-health researchers have
learned that 60% to 75% of teens respond to treatment with the medications
called SSRIs (antidepressants such as Prozac and Paxil). Studies also have
shown that cognitive-behavioral therapy---which focuses on teaching new
ways to deal with stress and sadness, such as changing unrealistic or
highly negative ways of thinking---can be as effective as medication.
"Lots of kids feel empty or lonely or sad every day
but don't know why," says Ross Szabo, who recovered with medication
and psychotherapy. Now 24, a senior at American University and youth
spokesperson for the National Mental Health Awareness Campaign, Ross often
speaks to high school students about his experience. "I tell them
that depression can happen to anyone---regardless of gender, intelligence
or socioeconomic status---and that, with help, they can get through it. I
know, because I did."
A NEW TEST is now available nationwide through
the Youth Depression Screening Initiative. The test allows kids to hear
questions over headphones and respond in complete privacy on laptop
computers. The Center for the Advancement of Children's Mental Health at
Columbia University is working with schools and communities to administer
the test and provide treatment, if necessary. For information, contact www.kidsmentalhealth.org.
THE NATIONAL MENTAL HEALTH AWARENESS CAMPAIGN
provides resources for various mental illnesses at www.nostigma.org.
For local referrals, and crisis intervention, call
THE NATIONAL INSTITUTE OF MENTAL HEALTH has launched the
Treatment for Adolescents with Depression Study (TADS) to compare the
effectiveness of Prozac, cognitive-behavioral therapy and a combination of
both. Visit www.nimh.nih.gov/studies/tads.cfm or call
1-866-458-7425. The consent of one parent is required.
Further reproduction or distribution is
prohibited without permission of the copyright owner.
To honor Jeremy among his skiing community, I put up a short web page which
quickly grew and spread to his academic and social circles. Parents,
picking up the site from their kids, shared it with their friends who
likewise with their own kids. The hit counter went off the wall with over
18000 visits in the first week. The site seems to be providing the forum for
much needed discussion. From the posted emails, it's obviously reaching
kids - "at-risk" kids, too.
The JEREMY APRIL
FUND is providing financial backing for this
website. With a number of people who are working with suicidal
adolescents at Columbia, the
bulletin board would focus on questions of depression and suicidality and will
include ways for youngsters to assess themselves. It will provide
information on treatment.
The site will include an interactive bulletin board
as well as other links to sites that are used by
teenagers. A health care professional will review the bulletin board daily. In the
event that a new message suggests the presence of a significant clinical
problem, we will use a variety of approaches to make contact and offer advice or help.
If this site helps establish a dialog
between a parent and a teen-age kid or young adult, Jeremy's legacy lives
20 May 2002
Links For Parents
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Guitar Flute & String