It may help to keep the three different categories of depression in mind. First, a depressed mood can happen to almost anybody, for a day or even many days. You feel sad and low, and things just don’t seem to be going well. This kind of depression is very common and usually goes away on its own. Dysthymia is the next type. It is different, a low or sad mood lasting for months at a time. Finally, there is major depression. This is an illness with severe symptoms that lasts for a long time, usually needing treatment to go away.
The most widely held belief about the cause of depression is that a chemical in the brain responsible for the flow of messages between nerves gets depleted. This chemical is called a neurotransmitter. Nerves act very much like electric wires. The nerve impulse is, in fact, an electric impulse that flows along the nerves. There is one major difference in the transmission. Nerves are not continuous like electric wires. They have gaps called synapses and the nerve impulses cannot jump across the gaps. When an impulse reaches the synapse, a neurotransmitter, set loose to fill the gap, enables the current to continue across. In the brain, when neurotransmitters become depleted, an impulse cannot bridge the gap and depressive illness results. The action of neurotransmitters normally stops in one of two ways. Neurotransmitters may be returned to the first nerve (reuptake), breaking the connections between nerves. Alternatively, an enzyme called monamine oxidase (MAO) can break down monoamine neurotransmitters. The brain uses MAO to shut down neurotransitters once their purpose has been served. Antidepressants work on brain chemistry in different ways. To keep more neurotransmitters active, a MAO inhibitor (MAOI) can be used to stop the MAO enzyme. Selective serotonin reuptake inhibitors (SSRIs) and tricyclic block the reuptake of transmitters, so the neurotransmitter level at the synapse remains higher. Research is continuing into the exact link between the depletion and a depression.
Some of these typical symptoms of depression may be disguised in adolescents. Instead, a sudden drop in school performance might indicate depression. Symptoms may show up in sudden behaviour problems, such as being aggressive or defiant with authority.
There are many possible reasons. Genetics play a role: teens who have a parent with depression are more likely to become depressed themselves. If both parents have had depression, the teen is even more at risk. The surrounding environment can also be a factor. Family problems like violence or divorce, school problems, conflict with peers, or breaking up with a boyfriend or girlfriend are all examples of stresses that can trigger an episode of depression.
Certain changes in the brain are associated with depression. Nerve cells in the brain communicate with each other via a chemical signal called a neurotransmitter. If someone is depressed, they may not have enough neurotransmitters. Anti-depressant medications are thought to work by putting these neurotransmitter levels back to normal.
Depression can also be linked in one of two ways with drug or alcohol use. The drug itself, withdrawal, or social problems related to drug abuse can cause depression. Alternatively, a teen might try to manage depression alone by using drugs in an attempt to feel better.
Think about how important these years are for your teenager. This is a critical time for establishing friendships, getting ready for college or university and deciding on a career. The sad truth is that an adolescent struggling with depression can miss out on so much.
Worse, there is the risk of suicide. This is unfortunately very real for teens with depression. In fact, suicide is the third leading cause of death from age 15 to 19. Girls attempt suicide more often than boys, but boys are more likely to die because the means they use are typically more deadly.
Parents can watch for several key warning signs of suicide. Be concerned if a teenager seems to have lost hope and is not planning for the future. Other clues include giving away valued possessions or discussing suicide with close friends or family. Talk of death or suicide is not a conversation to ignore!
Get help! It is not a betrayal of trust to talk to a counsellor, doctor, teacher, or other trusted adult if you are worried about this possibility. Asking about or discussing suicide does not make a teen more likely to carry through with it. Talking can help. Excellent treatment is available for depression. Counselling is one important aspect. Evidence suggests that cognitive behavioural therapy (CBT), a specific type of counselling, is especially effective for teens. Often a teenager with depression interprets the world in a negative, pessimistic kind of way. With this therapy, the teenager learns to re-examine the way that he or she looks at the world.
Medication may be needed for some teenagers with severe depression. Anti-depressant medications available today are very safe and effective. A teen cannot become addicted to these medications and they do not change personality. An anti-depressant can help restore normal sleep patterns, energy levels, and level of concentration, supporting a teen working in therapy. As with any medication, there is a risk of side effects. Your doctor can help your teen and your family decide if this is the right option.
Remember, serious depression is different than just a low mood. It is not about being weak or lacking motivation. Depression is a medical illness associated with chemical changes in the brain. It can be life-threatening and, like any other major illness, needs to be treated.