Major Depression In Adolescents

What is major depression?

Major depression is a type of mood disorder. A mood is an emotion or a feeling. Moods affect a person's behavior and how a person feels about himself and life in general. Depression is a sad mood that your child cannot control. Major depression is a medical condition.

What causes major depression?

Depression may be caused by a stressful change in your child's life. It may also be caused by a change in the chemicals in your child's brain. Teenaged girls are more likely to get depressed than teenaged boys. This may be because of changes in their hormones. Your child may be at higher risk for major depression if:

  • Your child's family member has had a mood disorder, like depression.

  • Your child uses drugs or alcohol.

  • Your child has experienced loss, such as a divorce or separation of parents, a breakup, or death of a friend or family member.

  • Your child becomes ill or he has problems dealing with a family member or friend's illness.

  • Your child has been abused. An abused child may be hit, beaten, yelled at, or hurt by a parent or other adult. The child may be ignored or told that he is not any good. The child may have a parent or other adult who is making him do sexual things. These are forms of physical, emotional, and sexual abuse.

  • Your child has learning problems or a conduct or anxiety disorder.

What are the signs and symptoms of major depression?

It may be hard for you to know the difference between your child's normal teenaged behavior and his depressive behavior. However, there are certain things that you can look for. He may have major depression if he is sad, irritable, or loses interest in things he enjoys almost every day for 2 weeks. These signs and symptoms affect his daily activities. He also has 4 or more of the following signs and symptoms during the same 2-week period:

  • Your child's appetite changes. He may lose his appetite and lose weight without trying. His appetite may also increase and he may gain weight.

  • Your child's sleeping habits change. Your child has trouble going to sleep or staying asleep at night. He wakes up in the middle of the night or very early in the morning. He sleeps too much or he feels very sleepy all day long.

  • You notice that your child acts restless or he has outbursts. He may also talk or move more slowly than usual.

  • Your child says that he feels tired or has less energy than usual. Your child may not do well school. He may miss school or skip his classes and his grades may go down.

  • Your child feels worthless, hopeless, and discouraged. Your child feels very guilty all the time. Your child is very negative and sees only the bad side of things.

  • Your child has trouble concentrating and remembering things. Your child has trouble doing daily tasks or making decisions.

  • Your child says he thinks about death a lot or he talks about death a lot. He talks about hurting or killing himself. He tries to harm himself by using sharp objects to cut his skin, or he burns himself. Your child tries to commit suicide.

How is major depression diagnosed?

Caregivers will ask about your child's signs and symptoms. This may help them diagnose and treat your child.

How is major depression treated?

Your child may need 1 or more of the following treatments:

  • Therapy: Your child's treatment may include talk therapy. During therapy, your child will talk with caregivers about how to cope with depression. This can be done alone or with a group of other adolescents. Family members also may be asked to attend meetings.

  • Medicines: Your child may be given antidepressants or other medicines to decrease or stop the symptoms of depression. Your child may need to take antidepressants for several weeks before he begins to feel better. Do not stop giving your child this medicine unless his caregiver tells you to.

  • Hospital treatment: Your child may need to be treated in the hospital if his depression is very bad. He will be able to go home once his medicine begins to work or therapy has been started. He may also need to go to the hospital for treatment if he is trying to harm or kill himself.

How can I help my child at home?

  • Give your child depression medicine as directed: Make sure your child takes his medicine every day. Do not stop giving him his medicine unless his psychiatrist tells you to. Watch your child very closely when he begins to take depression medicine, or if his psychiatrist changes the dose or type of medicine.

  • Take your child to therapy as directed: If your child cannot come to an appointment, schedule another one as soon as possible.

  • Watch your child carefully for any behavior changes: Talk to your child's psychiatrist if you have concerns or questions about the way your child is acting.

  • Help your child live a healthy lifestyle: Make sure your child eats healthy food and gets plenty of sleep. Talk with your child about playing a sport. If he does not like sports, your child can take regular long walks, hikes, or bike rides, or use the gym.

  • Encourage your child to be with people and to do things he enjoys: Encourage your child to spend time with caring and supportive family and friends. Encourage him to talk to you or others about the way he feels. Suggest that he join a club or do after-school activities. He can also write about his activities, thoughts, and feelings in a daily journal.

  • Remove all alcohol, medicines, and guns from your house: Keep medicines and sharp objects, such as knives and razor blades, in a safe place away from your child. Do not keep guns in your home.

  • Meet with school staff: Make an appointment to meet with your child's school counselor, nurse, psychologist, or teachers. Tell them that your child is being treated for depression. Make sure they know the warning signs of depression that is getting worse and of suicide. Tell them what they need to do if they have concerns about your child.

What are the warning signs of suicide?

An adolescent with major depression may be at higher risk for committing suicide. Be alert. Watch and listen for these warning signs of suicide:

  • Your child tells you he wants to commit suicide, he talks about his plan for committing suicide, or he makes a will. He says things to you about death that he would not normally say. He may talk about wanting to die. Your child may talk about voices that tell him to kill himself. Your child may begin to joke, read, or write often about suicide, killing, and death.

  • Your child starts giving or throwing away his favorite things.

  • Your child becomes suddenly very happy and cheerful after a time of depression and sadness.

  • Your child cuts himself or does other things to hurt himself.

  • Your child acts in ways that are dangerous and life-threatening. For example, he may drive very fast and recklessly, drink alcohol, or use drugs.

  • Your child takes medicine for depression, and his depression gets worse.

What should I do if my child says he wants to commit suicide?

  • Let your child do the talking: Listen to him very carefully. Tell and show your child that you take his feelings and thoughts very seriously.

  • Ask direct questions: Do not be afraid to ask direct questions about whether he is thinking about ending his life. You can also ask him if he has a plan for hurting or killing himself.

  • Stay with your child: Do not leave your child alone if he says he wants to commit suicide. You may save his life by staying with him.

  • Get help immediately:

    • Call your child's psychiatrist or the caregiver who is treating him for depression. Tell the caregiver about your child's thoughts and feelings of suicide.

    • Call 1-800-SUICIDE: This phone number is open all the time to help people who are thinking about committing suicide. You may also call the National Crisis Hotline at 1-800-999-9999.

What are the risks of major depression?

If your child takes medicine to treat his depression, he may have side effects from the medicine. Depression often gets worse if your child is not treated. Once your child has major depression, his risk of becoming depressed again increases. Your child also has a higher risk of developing other mental health problems. Depression may cause your child to want to hurt himself or others if he is not treated. Depression increases your child's risk of committing suicide.

Where can I find more information?

  • American Academy of Child and Adolescent Psychiatry
    3615 Wisconsin Avenue, NW
    Washington , DC 20016
    Phone: 1- 202 - 966-7300
    Web Address: www.aacap.org
  • Mental Health America
    2000 N. Beauregard Street, 6th Floor
    Alexandria , VA 22311
    Phone: 1- 703 - 684-7722
    Phone: 1- 800 - 969-6642
    Web Address: http://www.nmha.org

When should I contact my child's caregiver?

Contact your child's caregiver if:

  • Your child is taking antidepressants and his depression gets worse, or he talks about harming himself or committing suicide. Call if he begins to behave differently.

  • Your child is not taking depression medicine and you think your child's depression is getting worse.

  • You have questions or concerns about your child's condition or care.

When should I seek immediate care?

Seek care immediately or call 911 if:

  • Your child says he wants to commit suicide and has a plan or way to do it.

  • Your child has done something on purpose to hurt himself, or he tries to commit suicide.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child. 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.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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