March 23, 2011
Reprinted with permission from the March 2011 Pennsylvania Child and Adolescent Service System Program Newsletter
by Christopher Petersen, M.D. and Santoshkumar Mathapati, M.D.
Is my child at risk?
In a startling revelation, a recent study showed only a third of teens with depression received mental health services and more than half received no treatment at all. The latest results comparing depression treatment in teens showed antidepressant use decreased, psychotherapy use decreased, and combination treatment also decreased. These decreasing trends in service utilization explain increasing suicide rates and suffering in our children. To minimize depression’s future impact, more vigorous efforts are required to increase awareness in identifying mood and anxiety disorders and to improve access and availability of services.
What is depression?
Depression is not merely the absence of happiness. Depression is group of symptoms including sadness, depressed mood, loss of interest or pleasure, feelings of guilt and low self worth. Other symptoms may include disturbed sleep and appetite, decreased activity, low energy, poor concentration, wishing to be dead, suicidal ideation or attempts. Generally presentation of depression is the same in children as in adults. However, there are some developmental considerations. Children present with less subdued symptoms, less delusions and fewer serious suicide attempts than adults. There are different types of depression, such as Major Depressive Disorder (MDD) and Dysthymic Disorder (DD).
Children may present with mood in- stability, irritability, anxiety, and low frus- tration tolerance. Temper tantrums, physical/medical complaints and social withdrawal may predominate as they may not readily express their feelings. For ex- ample, Johnny is five years old. He gets cranky, looks worried and often complains of stomach aches and headaches. He has frequent temper tantrums and it is getting difficult to sooth him. Another example is a 13-year-old named Bob. He used to play with his friends but now spends most of his time alone and with- out interests. Things that were once fun now bring little joy and easily bore him. He is moody, irritable and easily frus- trated. He has trouble sleeping and is losing weight. Teachers com- plain that Bob has been unfocused, does not complete assignments and has unexplained ab- sences. Recently he told a friend that he feels no one cares about him, and he feels he is better off being dead. He has even tried to run- away from home. He is typical of a teen who is very depressed.
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