A new study published in the Journal of Affective Disorders has suggested that depression screening and treatment should start at a younger age.
The results of the study involving a sample of 275 people with recurrent depression stated that “half of adults who experience clinical depression had their first episode start in adolescence,” according to a press release from Bangor University, which is one of the universities that conducted the research. Adolescents ranging from 13 to 15 years old on average could be having their first depressive episodes at this young age, according to the study.
Researchers find that once you have depression at least once in your life, there is a 50 percent chance that you could suffer from depression again later in life, according to the press release.
However, once you have depression more than twice in your life, the likelihood of becoming depressed again becomes even higher. That is why researchers consider the study results important, because if depression generally starts at such an early age instead of in middle age, then prevention efforts should start early.
According to the press release, talk therapy like cognitive therapy and mindfulness-based cognitive therapy could be effective treatments for recurrent depression that starts in adolescence.
Chip Coffey, a licensed professional counselor and director of outpatient services at St. Luke’s Behavioral Health Center in Phoenix, said in an email that the results support what many mental health professionals have already noticed.
“We continue to see a pattern of familial linkage with mental health issues, depression, anxiety and bipolar disorder,” Coffey said. “If we accept that there is a familial linkage, then it would be extremely unlikely that the first episode of depression would be suppressed until adulthood.”
Besides a genetic factor, he said adolescence can be full of changes that contribute to mental health issues.
“There are so many changes that occur to us in our teen years, from puberty to social groupings, school and beginning work – all of these are stressors,” Coffey said. “We do know that all people handle stressors differently; those with depression are less able to manage stressors and go into a sense of being overwhelmed. This constant state of being overwhelmed then can lead to a decreased sense of self-worth and self-acceptance.”
“As our sense of self-worth decreases, we tend to pick on ourselves even more, compounding existing unhealthy messages that we have about ourselves,” he added. “This then can lead to isolative behavior or a lack of motivation, which then can lead to worsen depression.”
Biological makeup can also leave some teens predisposed to depression.
“There is also a biochemical nature to depression, where our brain chemistry ... becomes unbalanced,” Coffey said. “When our brain chemistry is geared to depression and our behaviors then support depression, we become more and more depressed.”
David Reiss, a psychiatrist and a previous interim medical director at Providence Behavioral Health Hospital, said in an email that the results of the study are not really new, the statistics are just updated.
“Adolescence is a time of physiological and psychological growth, change and ‘stress.’” Reiss said. “Thus, any underlying vulnerabilities, psychological and/or biochemical, are going to be ‘tested’ and often ‘triggered’ during these years. Actually, the fact that many psychiatric disorders (depression, schizophrenia) first manifest during adolescence has long been a known and accepted fact.”
However, the study could help more people take depression at a young age seriously.
“The study could be used in a positive manner to remind people not to ignore depression at any point in life, especially adolescence, and to seek appropriate evaluation and intervention,” Reiss said.
Coffey said that unfortunately people are not as open to the idea of teens having mental health issues, and teens suffer because of this.
“Many times ... when children or teens are reporting signs and symptoms of depression, it is misconstrued as just teen angst or a teenager experiencing puberty,” Coffey said. “There is still a stigma attached to mental health issues. Many families and the teens themselves look for other explanations or causes. This may lead teens to believe that this is just the way it is and that they must suffer through it.”
Prevention can be difficult, even knowing ahead of time through these study results that some people can develop depression in adolescence.
“If we have a predisposition to depression from our family, it is difficult to prevent it,” Coffey said. “What can be done though, is to teach teens ahead of time how to recognize the signs and symptoms of depression, and what to do when they do experience them.”
“On the other side, it would be wonderful it this was taught to kids throughout their school lives,” he added. “If we taught children how to handle anger, stress, sadness, hurt and other emotions starting when they were in kindergarten, children would likely develop a better mental health outlook. Depressed teens would be more likely to seek treatments such as medications or counseling and this would thereby reduce some symptoms.”
Luckily there are many treatment options available, including the therapies mentioned in the study press release.
“The most serious option is inpatient hospitalization down to regular one-on-one sessions with a counselor or social worker,” Coffey said. “There are many outpatient options, such as partial hospitalization, intensive outpatient programs, individual and family therapy, as well as community support groups.”
Reiss added that treatment for depression in the teen years needs to be approached differently in some cases.
“It must be realized that depression in teenage years presents differently than in adult years (symptoms, reactions and behaviors are different); and teenagers respond to psychotropic medications differ from adult reactions (at times with increased tendency toward negative side-effects, including suicidal ideation),” Reiss said.”
Also, treatment should be comprehensive and look into deeper issues that the teen is having.
“Depression is not a specific disorder but a wide spectrum of problems, psychological and physiological, and the treatment of depression at any point in life must be based upon a full and comprehensive of all biological, psychological and psychosocial factors, as well as issues of personality and temperament,” Reiss said. “Treatment that is purely ‘symptom based’ is superficial and often a band-aid approach that can be temporarily helpful but often be counter-productive or even dangerous in the long run.”
Bangor University. Almost half of depression in adults starts in adolescence. Web. March 7, 2012.
Coffey, Chip. Email interview. March 7, 2012.
Reiss, David. Email interview. March 7, 2012.
Reviewed March 8, 2012
by Michele Blacksberg RN
Edited by Jody Smith