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 Parenting 101 - Parenting Advice Understanding Teenage Depression: A Guide to Diagnosis, Treatment and Management By Maureen Empfield, M.D., and Nicholas Bakalar DEPRESSION IS A DISEASE Depression -- that is, the illness that is often called "clinical depression" -- is not the same as a bad mood, or a feeling of unhappiness. It is a disease. Although there are some theories about it, no one knows exactly what causes depression in teenagers (or in anyone else, for that matter), but we do know that it is not caused by poor parenting, and that it cannot be cured by good parenting. Nor is it caused by the victim of the disease, something that is for some people all too easy to conclude. A "change in attitude" or a willingness on the part of the youngster to "straighten up and fly right" will not relieve the terrible symptoms of depression. It is a disease that requires the attention of experienced professionals, using both medical and psychological treatments, methods scientifically established as valuable in relieving the symptoms of depression and allowing a teenager to lead a normal life. These techniques are complex, time-consuming, and sometimes expensive, and they require not only the conscientious work of medical professionals but considerable cooperation from the teenager being treated, as well as the dedicated attention of the people who love her. Nor are they 100 percent effective 100 percent of the time. But they do work, and when they do they provide relief that many patients describe with the most thankful phrases: "I've been given back my life, I'm myself again" or similar words are often heard when a youngster's depression begins to lift.` PSYCHIATRIC TREATMENT THAT SAVES LIVES Phil was a 19-year-old sophomore at a Big Ten school. He was a serious athlete -- an almost Olympic-caliber ice hockey player -- and a top-notch student as well, majoring in chemistry. He had had some problems during early adolescence -- for a brief period he was hanging out with a group of daily marijuana smokers -- but certainly no serious psychiatric illness. In any case, his parents, one of whom had had a depressive episode, were very much invested in his academic and athletic success and minimized any emotional complaints, which they viewed as a sign of weakness. No sooner had hockey practice begun, however, than Phil had a serious falling out with one of teammates, whose ex-girlfriend he had begun to date. This boy turned other players against him, and Phil found himself excluded from the social life of the team, essentially shunned. Gradually he became isolated from his other friends as well and began having trouble concentrating on his studies. His grades suffered. He started drinking heavily, and one night he told one of his friends that he was thinking of jumping off the roof of a building, if only he had the guts to do it. This friend called Phil's parents, his parents called me, and I urged them to either hospitalize him there or bring him home. His father flew to the Midwest to get him, and we hospitalized him immediately upon his arrival home. Phil's own attitude was that hospitalization wouldn't help, but, feeling despairing or numb, he put up no resistance to the plan. His time in the hospital began with the quick establishment of an anti-depressant medicine regimen, along with individual group psychotherapy. His family also needed therapy and education to help them recognize that Phil suffered from a real illness, not from moral weakness. After two weeks in the hospital and now well established on a drug regimen, Phil came home and worked for several months, then returned to school. Although he never went back to playing hockey, he has done well in college, and has continued his medication with almost complete relief from symptoms. The treatment he received in the hospital quite literally saved his life.
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