More than just a phase: Teen depression
Laura Lee Bloor, Athens NEWS Contributor
July 5, 2005
Twenty years ago, no one thought depression in adolescents was possible; being "moody" was a rite of passage into adulthood. Research today shatters that preconceived notion and shows teen depression is real and climbing.
Lindsey Smith (not her real name), 19, sits curled up in a worn armchair in the bustling coffee shop. Her raven waves are gathered neatly on top of her head spotlighting her creamy complexion. She is all smiles and giggles in a green sweatshirt and jeans as she wraps her arms around her knees. She speaks vibrantly with an easy enthusiasm as we chitchat. The more we talk, the more I wonder: How is it possible that such an outgoing girl can be depressed?
Apparently highly possible. One in every 33 children and one in every eight adolescents may have depression, according to a 1998 Center for Mental Health Services report.
Depression among 9- to 17-year-olds is estimated at more than 6 percent in any six-month period, with 4.9 percent having major depression, according to a 1996 study sponsored by the National Institute of Mental Health (NIMH). To be considered as having major depression, a patient must have had one or more major depressive episodes, each lasting at least two weeks.
The NIMH has said that new epidemiological study results on mental illnesses, including depression, should be released this summer. These types of studies are usually conducted every 10 years.
Smith, a freshman at Ohio University, said her symptoms of depression started appearing when she was about 10 years old.
"I had feelings of emptiness, thoughts of suicide," Smith said. "I wondered what my funeral would be like -- if people would go, if they would miss me."
During the next five or six years, Smith's negative thoughts ebbed and flowed like the tide. Sometimes she would be fine for a year; sometimes she would not. Smith attempted to cope as best she could. She tried writing her thoughts and feelings, but it didn't seem to help.
The cyclical nature of Smith's depression is not uncommon to Kathy Stotts, guidance counselor at Athens High School. Stotts sees an increase in students coming to her with depression or depressive symptoms around holidays and anniversaries of personally traumatic events.
Athens High School includes grades nine through 12, and Stotts said she sees no one age group more frequently than another. However, according to a NIMH fact sheet on teen depression, adolescent girls are twice as likely as teenage boys to develop depression.
By the time Smith started high school, the depression slowly engulfed her.
"I would cry every night, but I wouldn't know what the reason was," Smith said. "I didn't know why I was so sad, and it got to a point where I couldn't take it anymore."
Smith hit her breaking point when she was 16. After years of private struggle, she poured out her feelings of despair to her mother. Because Smith seemed so happy on the outside, even her mother's initial reaction was disbelief.
"She didn't think I was really depressed. She thought it was my period or something. You know how mothers are," Smith said, rolling her eyes and laughing. "She thought it was just a phase."
Her mother's reaction is reflected in research that shows parents are less likely to identify major depression in their adolescents than the adolescents themselves. However, when Smith suggested she see a psychologist, her mother was too shocked to support her getting treatment.
But Smith's mother came around to the idea when she realized there was a pattern: The mother had been diagnosed with clinical depression as well.
Two decades of research have shown that children who have a parent with a mental illness are at a significantly greater risk for multiple psychosocial problems. According to a January 2005 study by professor Myrna Weissman of Columbia University, children of a depressed parent were 14 times more likely to develop depression if their grandparent was also depressed. In addition, nearly 60 percent of children descended from a parent and grandparent who had suffered depression experienced some psychopathology themselves by age 12.
"What is interesting is the sturdiness of depression across the generations and the impairment it produces," Weissman said of her study results. "Particularly for a young person with two generations affected, they have very high rates of depression."
Weissman said she plans to conduct another study on early-onset depression in the fall or winter of this year.
"We know that some people get depressed when they've had something bad happen to them -- lose a job, a death, a divorce -- and others don't, and we're trying to understand who is vulnerable genetically," Weissman said. "Not everyone who is high risk (for depression) is depressed, and we want to know what protects them."
In the fall, she will start recruiting people with an onset of depression before the age of 30 who have a sibling with a similar history of depression.
Smith could have been a case study for Weissman's research. The lineage of the disorder runs deep in Smith's family. Not only has Smith and her mother been diagnosed with depression, but several other family members as well. Her grandfather on her mother's side exhibits symptoms of depression, Smith said, but because of ingrained generational influences, refuses to see a doctor or take medication for it. Similarly, Smith's aunt on her mother's side has been diagnosed with mild depression and anxiety disorder. In addition, Smith's father believes he has depression but has never been diagnosed or sought therapy.
But the spread of depression doesn't stop there in the family tree. Smith's brother, 23, was diagnosed with depression and Attention Deficit Disorder (ADD) in middle school. He had a couple years of therapy combined with medication, but Smith said he took it so inconsistently that he quit altogether in high school. Since high school, Smith's brother has not had any additional therapy of which she is aware and seems to be fine without medication.
The combination of ADD with depression is familiar to part-time practicing psychologist Lesli Johnson of Athens, who has worked with children and families for 20 years. Often it is the ADD or Attention Deficit Hyperactivity Disorder (ADHD) that grabs teachers and parents' attention, and the depression stems from the difficulties of dealing with ADD or ADHD.
"Kids who suffer this disorder, especially when they hit adolescence, often experience this disorder along with depression," Johnson said. "It seems to be related to their increased frustration at not being able to meet the expectations of those around them and the increase in negative attention and negative feedback that they get from adults."
Depression can affect people emotionally, cognitively, physically and behaviorally, but teens especially show the most disturbances in the cognitive components, Johnson said. The cognitive element of depression is associated with negative thoughts about self, oth
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