Consumer Information

Major Depression In Adolescents

WHAT YOU SHOULD KNOW:

Major depression is a type of mood disorder. A mood is an emotion or a feeling. Moods affect a person's behavior (how the person acts). Moods also affect how a person feels about himself and life in general. Depression is a sad mood that your child cannot control. If your child feels sad for at least two weeks, he may be depressed. Major depression is a true medical condition, just like diabetes and high blood pressure. Major depression is also called Major Depressive Disorder.
Your child's caregivers will talk with you about the many ways to treat depression. Treatment for depression includes medicine, therapy, or both. Specially trained caregivers will teach you and your child how to manage your child's depression. They can teach your child how to handle problems better and how to cope with stress.

CARE AGREEMENT:

You have the right to help plan your child's care. To help with this plan, you must learn about your child's health condition and how it may be treated. You can then discuss treatment options with your child's caregivers. Work with them to decide what care may be used to treat your child.

RISKS:

Depression often gets worse if your child is not treated. Depression may cause your child to want to hurt himself or others if he is not treated. If your child takes medicine to treat his depression, he may have side effects from the medicine. Once your child has major depression, his chance of becoming depressed again increases, especially over the next five years. Your child is also at higher risk for having other mental health problems. Depression may cause your child to kill himself (commit suicide). Call your child's caregiver if you are worried or have questions about your child, his medicine, or care.

WHILE YOU ARE HERE:

Informed consent: You have the right to understand your child's health condition in words that you know. You should be told what tests, treatments, or procedures may be done to treat your child's condition. Your child's caregiver should also tell you about the risks and benefits of each treatment. You may be asked to sign a consent form that gives your child's caregivers permission to do certain tests, treatments, or procedures. If you are unable to give your consent, someone who has permission can sign this form for you. A consent form is a legal piece of paper that tells exactly what will be done to your child. Before giving your consent, make sure all your questions have been answered so that you understand what may happen to your child.

Care setting: Your child may need to stay in a psychiatric or pediatric unit. This unit usually has bedrooms and a living area, and sometimes the doors must stay locked.

Clothes: Caregivers may take your child's clothes and have him wear a gown at the beginning of his stay. Later he may wear his own clothes while he is in the hospital.
Meals: Your child will eat his meals on the unit or in the cafeteria with other patients.
Personal belongings: When your child is admitted to the unit, caregivers may search his belongings (things he wore and brought in). Any belongings brought to your child during his stay will also be searched. This search is done to keep your child and the hospital staff safe.

Caregivers:

Psychiatrist: This is a medical doctor who works in the area of mental health. The psychiatrist (seye-KEYE-ah-trist) is in charge of ordering your child's medicine. You and your child may work closely with this doctor and another caregiver.
Therapist: This is a caregiver that works closely with you while your child is being treated. This person may be a doctor, psychologist, nurse, mental health counselor, or social worker.

Examination: Caregivers will check your child's vital signs. This includes taking your child's temperature, blood pressure, pulse (counting his heartbeat), and respirations (counting his breaths). Caregivers will ask you and your child questions to learn how alert your child is. They may check your child's skin for scars or signs of self-harm. They may take blood and send it to the lab for tests. Blood tests help caregivers know if your child has other medical problems that may be causing the depression. They may also help caregivers know if your child has drugs or other substances in his blood.

Medicine: Your child may have one or more of the following medicines during his stay:

Antidepressants: This medicine is given to decrease or stop the symptoms of depression. Sometimes this medicine may take a while to work. Your child may need to take antidepressants for up to one year. If your child has had major depression in the past, he may need to use antidepressants longer.
Anti-anxiety medicine: This medicine may be given if your child's depression makes him feel nervous. It may make him feel drowsy.
Mood stabilizer: This medicine is given to control mood changes. It may also help your child's antidepressant work better.
Sedative-hypnotics: This medicine may be given if your child is having trouble sleeping. It may make him feel drowsy.
Neuroleptics: If your child has very bad agitation (restlessness) this medicine may be used.
Psychostimulants: This medicine may be given if your child's depression makes him feel tired all the time.
Thyroid medicine: This medicine may be added to your child's antidepressant to help it work better.

Safety:

72-Hour Hold: This is when your child is put in the hospital for 72 hours without his permission. The police or a caregiver may decide to put your child in the hospital. This may only be done if others fear that your child may hurt himself or someone else. It may also be done if caregivers or police do not think your child can safely care for himself.
Quiet Room: This is an empty room used for patients who need to have time out in a safe place. Your child may be put here if caregivers fear that your child may hurt himself or others.
Restraints: There are two types of restraints that may be used while your child is in the hospital. They will only be used if caregivers feel your child is in danger of hurting himself or others. Physical restraints may be put on your child's wrists or ankles and tied to something else. These are usually cloth or leather bands. Other things will always be tried before using physical restraints, such as going into a quiet room or seclusion. Caregivers may use "chemical" restraints which is medicine used to help your child calm down and relax. Restraints should never be used to punish your child.
Seclusion: This is when your child needs to be locked in a safe room because he is out of control. The door is locked because your child might want to leave the room. Caregivers will closely watch your child while your child is in seclusion. Your child may come out of seclusion when caregivers feel your child will not hurt himself or others.
Sharps: Your child will not be allowed to keep any sharp items with him. Sharp items may include scissors, nail files, razors, or glass. Ask a caregiver if your child needs to use one of these items.
Time Out: This is time spent away from other people. This is usually needed when your child is not able to control his behavior. Your child may be put in time out if his behavior is affecting others. Time out may be in your child's room or another room.

Therapy: Your caregiver may suggest several different types of talk therapy in addition to medicine. The therapy may be done with your child alone or in a group. Your child may start therapy in the hospital and continue the therapy after he is discharged. Your child may have one or more of the following therapies and treatments for major depression:

Cognitive-behavioral therapy (CBT): This therapy helps your child understand how he sees himself and things around him. Your child may have trouble seeing the good in himself and the things around him. When this happens, he is more likely to feel depressed, sad or angry. CBT teaches your child how to set goals for himself, to solve problems, and to help himself. It teaches your child how to act and think in a more positive way.
Dialectical-behavioral therapy (DBT): This therapy helps your child have more control over his emotions (feelings). It may help him to understand his emotions and how they cause him to act. This therapy provides training on how to be more assertive. It teaches your child ways to handle situations that cause negative thinking and painful feelings.
Family therapy: This therapy helps your child and family members learn how to have a better relationship with each other. It helps all family members learn how to be more positive and supportive of each other in the home.
Group therapy: This is a very effective type of therapy for adolescents. Your child will work together with a therapist and other adolescents to deal with his depression. During therapy, your child can learn how to talk about his feelings and work on his social skills. Group therapy may help your child understand that other adolescents have same or similar feelings to his own.
Interpersonal psychotherapy: This therapy helps your child focus on having better relationships at school and home. Your child may learn how to cope with loss, rejection, and stress in a healthy way. Your child will learn ways to get along better with friends, parents, and other household members.
Psychodynamic therapy: This therapy helps your child to deal with conflict in a healthier way. It helps your child deal with rejection and bad things that happened in his past. This therapy may help your child to feel better about himself, and to feel more in control of his life.
Light therapy: This therapy may be used if your child's depression gets worse during certain seasons (fall or winter). It also may be used if you and your child live in a place that gets little sunshine. Your child will sit in front of a box that gives off a safe light. Your child may need to do this daily for several months.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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