Depression at 14 years old. Causes and treatments for teenage depression. How to distinguish normal stress in a teenage girl from depression

Every age has its problems, and the happy time of youth is no exception. Read this article on how to recognize signs of depression in a teenager and prevent a suicide attempt.

According to statistics, more than 700 teenagers commit suicide every year in Russia, and more than a thousand try to take their own lives.

It is important for parents, teachers and all those who work with schoolchildren to be able to recognize the signs of depression, which often causes suicidal thoughts.

Causes

Sometimes it seems that youth is the best and happiest time in life. So what is depression like in teenagers? What problems could they have, you ask, if you don’t need to earn money, your parents are responsible for you, you’re young, healthy and still have a long way to go?

The following can poison your life:

• loneliness, lack of friends, love and understanding from parents;
• psychological violence in the family, constant humiliation, accusations and threats, rejection of successes and infringement of the individual rights of a teenager;
• traumatic events such as death of loved ones, parental divorce, physical violence;
• low self-esteem, caused by dislike of one’s own body, lack of success in school and personal life;
• a critical look at your own future;
• hormonal changes.

The cause of depression can be both a biological predisposition and mental problems: depressive or manic personality type, anxiety disorders.

Signs of depression in teenagers

Most often, the presence of mental ill-being is indicated by the same physical manifestations as in a normal illness:

1. Lack of appetite. If a teenager does not eat enough, he is not necessarily sick. The concern should be a sharp and prolonged decrease in the amount of food eaten, and a lack of interest in your favorite dishes.
2. General lethargy, loss of strength. The teenager does not want to do things that he usually took on with enthusiasm: he does not pay attention to hobbies, does not communicate with friends.
3. Insomnia or, conversely, drowsiness.
4. Headache, disruption of the gastrointestinal tract, weakened immunity.

The behavior of a teenager also indicates depression. You need to start worrying if your child:

• cries often, is sad every day;
• talks about his uselessness, that everything is stupid and useless;
• suffers from excessive feelings of guilt, takes any failure to heart;
• does not want to leave the house and communicate;
• irritable, angry and hostile for no apparent reason, and has a hatred for the well-being of others;
• cannot concentrate, does not work as well as usual;
• shows interest in tragic and dark subjects, paintings, and music.

A depressed teenager has difficulty making decisions. At the age of 16, a person decides on his specialty and prepares for admission. A depressed teenager shows no interest in his future, he is indifferent or extremely negative towards all proposals.

Symptoms of suicidal behavior

A teenager who wants to commit suicide behaves differently. He can either desperately strive for contact, complain loudly and seek sympathy, or withdraw deep into himself, answering sluggishly, monosyllabically in a quiet voice.

Alarm bells in such conditions are:

1. The desire for self-harm: the desire to hit oneself, causing scratches and wounds, irresponsible attitude towards medications, increased interest in their action and the consequences of an overdose.
2. Talk about the afterlife, the burden of life. The teenager directly or indirectly says that death is a blessing, deliverance from problems and endless suffering.
3. Lack of interest in one's own successes, belittling them.
4. Depreciation of previously significant things. The teenager stops asking for money, gives away expensive things, ignores his favorite activities, and is indifferent to his appearance.
5. Abuse of alcohol and other relaxing substances.
6. Increased interest in dangerous places. A teenager risks his life, indifferent to the consequences.

When to contact a specialist

You should ask a doctor for help if you notice that your child has:

• prolonged bad mood, apathy, sadness or severe anger;
• persistent physical discomfort;
• suicidal thoughts or motives in creativity appeared;
• desire to hurt yourself;
• antisocial behavior.

It is important to understand that even a demonstrative expression of a desire to commit suicide can have dire consequences.

If a child attracts attention to himself and jokes about his own death, this is not an indicator of his spoiledness and idleness, this is a bell that he is tormented by strong internal experiences.

Treatment of depression in children

In order to save a teenager from depression, parents need to accept that the child has problems and take them seriously. From the height of their own experience, it may seem to them that all these experiences are due to nonsense or, even worse, due to a bad character.

Teenagers are already prone to blaming and humiliating themselves. Parents must explain to the child that they love him in any case and he is not to blame for anything.

There are various treatment methods that combine well with each other:

1. Contacting a family or child psychotherapist. A specialist will help identify the causes of depression, strengthen the teenager’s self-esteem, help him begin to openly express his feelings, develop the ability to solve problems, and interact with society. Seeing a psychotherapist will prevent problems that a child may have in adulthood.
2. Phytotherapy. Calming herbs can help treat mild symptoms and relieve tension.
3. Improving family relationships. Parents should listen to their child more and spend time with him. You can find a common hobby, make joint forays into nature. Activity, sun and fresh air can also help cope with emotional decline.
4. Children's psychiatrist, if he considers it necessary, he can prescribe antidepressants for the child.

Prevention of teenage apathy

Teenagers experience many problems at school and with peers due to unfavorable relationships with their parents. Your child will be much happier if you follow a few rules:

1. You must have a trusting relationship. A teenager may hide his distress if he doesn't want to disappoint or scare his parents. It is necessary to explain to him that his internal state is much more important than his external well-being.
2. It is important to strengthen a teenager's self-esteem: do not criticize his personal qualities and appearance, praise him not only for his successes, but also for his attempts to do something.
3. You can't have high expectations for your child., he may not be able to bear such responsibility. He is an individual with his own destiny, and no matter how much you want him to win all the prizes, you cannot demand this.
4. Be interested in the child's life, but don’t try to control everything. In order for him to make independent decisions, already in childhood he should have freedom in choosing clothes, friends and hobbies.
5. Show by personal example how to solve problems. Children learn from their parents, so if you demand courage and openness, but you yourself are indecisive and withdrawn, the child will behave like you, but at the same time engage in self-flagellation for not meeting your expectations.
6. Love the child just the way he is.

Teenage depression is a common illness. It is especially painful, since the child does not yet have the strength and skills to cope with life's difficulties.

Sometimes a depressive state looks like whims and spoilage, but you cannot be deceived by this, no matter how much you would like to attribute everything to a bad character. In such situations, the child requires maximum of your attention and participation, even if you turn to a specialist.

Video: How to understand what is happening

In a recent study carried out by the Queen Elizabeth Medical Center in Western Australia on 400 young adolescents aged 10 to 14 years, 10% were considered clinically depressed, and more than half of the children were assessed by doctors as being prone to depression in the future. Depressed teenagers believed that happiness was achieved only through fame, money and beauty. Happy teenagers tend to believe that life satisfaction depends on successful personal relationships and setting worthwhile goals. What is teenage depression? Why does it occur and how to deal with it?

What is teenage depression?

Teenage depression is not just a bad mood - it is a serious problem that affects all aspects of a teenager's life. Teen depression can lead to problems at home and school, drug addiction, self-loathing, even violence or suicide. But there are many ways parents, teachers and friends can help cope with depression.

There are many misconceptions about teenage depression. During adolescence, many children are quite aggressive, difficult to communicate with, they are rebellious and want to be independent. Teenagers often have mood swings and are sad. But depression is something else. Depression can destroy the very essence of a teenager's personality, causing overwhelming feelings of sadness, despair or anger.

The incidence of teenage depression is increasing around the world, and we are increasingly aware of this when we look at our children or their friends. Depression hits a teenager's psyche far more often than most people realize. And while teen depression is very treatable, experts say only one in five cases of depression get help for teens.

Unlike adults, who have the ability to seek help on their own, teenagers typically have to rely on parents, teachers, and caregivers to recognize depression and get the treatment they need. So if you have teenage children, it's important to learn what teen depression looks like and what to do if you notice symptoms.

ICD-10 code

F33 Recurrent depressive disorder

F32 Depressive episode

Symptoms of teenage depression

Teenagers face a lot of pressure from adults, ranging from grades in school to control from mom and dad. And at this time, a hormonal storm takes place in their body, which makes the teenager’s psyche even more vulnerable and fragile than before. During adolescence, children begin to fiercely defend their independence. For them, it can be a drama that an adult would only smile sadly at it. Because adults are used to seeing teenagers often in an agitated state, it is not always easy for them to distinguish between depression and the whims and mood swings inherent in teenagers. If you notice these symptoms in your teen, they are likely depressed.

Signs of depression in teenagers

• Sadness or hopelessness for a long time
• Irritability, anger, or hostility
• Tearfulness
• Abandonment of friends and family
• Loss of interest in any activity
• Loss of appetite and poor sleep
• Anxiety and excitement
• Feelings of worthlessness and guilt
• Lack of enthusiasm and motivation
• Fatigue or lack of energy
• Difficulty concentrating
• Thoughts about death or suicide 

If you are not sure that your teenager is depressed, consult a psychologist with him.

Negative effects of teenage depression

The negative effects of teenage depression go far beyond melancholic moods. Many cases of unhealthy behavior or aggressive attitudes in teenagers are actually signs of depression. Below are some ways that teenagers can show adults that they are depressed. They act this way not out of harm, but in an attempt to cope with emotional pain.

Problems at school. Depression can lead to loss of energy and difficulty concentrating. At school, this can lead to poor attendance, arguments in classes, or frustration with schoolwork, even for children who previously did very well.

Run away from home. Many depressed teens run away from home or talk about running away. Such attempts are a cry for help.

Drugs and alcohol abuse. Teens may use alcohol or drugs in an attempt to “self-medicate” depression. Unfortunately, these methods lead to irreparable consequences.

Low self-esteem. Depression can provoke and intensify feelings of helplessness, shame, and give a feeling of the meaninglessness of life.

Internet addiction. Teenagers may go online to escape their problems. But excessive computer use only increases their isolation and makes them more depressed.

Desperate, reckless behavior. Depressed teenagers may engage in dangerous activities (eg, robbing a passerby on the street) or take desperate risks, such as dangerous driving, unprotected sex.

Violence. Some depressed teenagers (usually boys who are victims of aggression) become aggressive. Self-hatred and the desire to die can develop into violence and rage towards others.

Teenage depression is associated with a number of other mental health problems, including eating disorders.

Symptoms of Suicidality in Depressed Teens

1. Talks or jokes about suicide.
2. Says things like: “I would rather die,” “I wish I could disappear forever,” or “I have no choice.”
3. He talks about death admiringly, something like “If I died, everyone would regret it and love me more”).
4. Writes stories and poems about death or suicide.
5. Participates in dangerous, traumatic sports.
6. Saying goodbye to friends and family as if forever.
7. Looks for weapons, pills, or discusses ways to kill himself.

The problem of depression must be addressed, and the sooner the better. It is very important that your teenager shares his problems with you. The teenager may not want to tell them. He may be ashamed, he may be afraid of being misunderstood. Additionally, depressed teens find it very difficult to express how they feel.

If you think your child is depressed, you should trust your instincts. In addition, the situation is complicated by the fact that adolescents may not consider their behavior to be the result of depression.

Tips for talking to a depressed teenager

Teenager and suicide

If you suspect that a teenager may be suicidal, take immediate action! Take your child to a psychologist, psychotherapist, show him more attention and care.

Teens who are seriously depressed often talk about suicide or make “attention-seeking” suicide attempts. Some teenagers don’t really want to commit suicide and go no further than suicidal thoughts, but parents and teachers should always take such “beacons” very seriously.

For the vast majority of suicidal adolescents, depression or another mental disorder is an increased risk factor. Depressed teens who abuse alcohol or drugs have an even higher risk of suicide. Because the risk of suicide among depressed teens is real, parents and teachers should be vigilant for any signs of suicidal thoughts or behavior.

Methods for diagnosing teenage depression

Depression is very destructive to a teenager's fragile psyche if left untreated, so don't wait and hope that the symptoms will go away on their own. Seek professional help.

Be prepared to tell the doctor about your child's depression symptoms, including how long they last, how they affect your child's daily activities, and any symptoms that concern you. You should also tell your doctor about relatives who suffered from depression or any other mental disorder.

If there are no health problems that are causing your teen's depression, ask your doctor to refer you to a psychologist or psychiatrist who specializes in child and adolescent psychology. Depression in teens can be a challenging condition, especially when it comes to treatment. No one can perform a miracle on your child. You will need to work with the symptoms of depression for an extended period of time. If your child feels uncomfortable visiting a psychologist or psychiatrist, ask for a referral to another professional who may be a better fit for your child.

Difference between teenage and adult depression

Depression in adolescents can be significantly different from depression in adults. The following symptoms of depression are more common in adolescents than in adults:

Irritability, anger or mood swings - as noted above, it is irritability, and not the sadness inherent in adults, that often predominates in depressed adolescents. A depressed teen may be grumpy, hostile, easily upset, or prone to angry outbursts.

Unexplained pain - Depressed teens often complain of physical ailments, such as headaches or stomach pain. If a thorough physical examination does not reveal a medical cause for these pains, it may indicate depression.

Extreme sensitivity to criticism - Depressed teens suffer from feelings of inadequacy, which makes them extremely vulnerable to criticism, rejection and failure. This becomes a particularly serious problem at school when a child's performance declines sharply.

Withdrawing into oneself, withdrawing from people (but not everyone). While adults tend to withdraw when they are depressed, teenagers tend to maintain friendships but limit those friendships to a select few. However, teens with depression may socialize much less than before, stop interacting with their parents much, or start going out with other people.

Don't rely on medications alone

There are several treatment options for depression in teens, including individual therapy or group sessions. There is also a method of family therapy. Medicines come last, and this is only part of a comprehensive treatment, not a panacea.

Any type of psychological therapy is often good for treating mild to moderate depression. Antidepressants should be used as part of a more comprehensive treatment plan in more severe cases.

Unfortunately, some parents believe that antidepressants are the only way to cure their child. This is far from true; any treatment is individual and may vary depending on the results.

Risks of Teen Antidepressant Use In severe cases of depression, medications can help relieve symptoms. However, antidepressants are not always the best treatment option. They can have side effects such as addiction, sleep disturbances, increased fatigue and drowsiness. It is important to weigh all the risks before starting to prescribe antidepressants.

Antidepressants and the teenage brain

Antidepressants were developed and tested in adults, so their effects on young, developing brains are not yet fully understood. Some researchers are concerned that the use of drugs such as Prozac by children and teenagers may interfere with the normal development of their brains. Adolescent brains are developing rapidly and exposure to antidepressants can affect development, especially how a teen manages stress and regulates their emotions.

Antidepressants increase the risk of suicidal thoughts and behavior in some adolescents. The risk of suicide, according to specialist research, is highest during the first two months of treatment with antidepressants.

Teenagers who take antidepressants should be closely supervised by doctors and parents. Any signs that adolescent depressive symptoms are worsening should be a signal to reconsider treatment.

Warning symptoms include increased agitation, irritability or uncontrollable anger in your teen, and sudden changes in behavior.

According to psychotherapists who deal with adolescent depression, after starting antidepressants or changing their dosage, a teenager should see a doctor:

• Once a week for four weeks
• Every 2 weeks for the next month
• At the end of the 12th week of taking medications

Adolescent support as a treatment for depression

The most important thing you can do for your child is to let him know that you will always have his back. Now more than ever, your teen needs to know that you value, love, and care about them.

Be patient. Living with a depressed teenager in the same house is not an easy task. From time to time you may experience fatigue, despair, a desire to quit, or any other negative emotion. During this difficult time, it is important to remember that your child will definitely recover, you are already working on it. Your teen is suffering too, so it's best to be patient and understanding.

Encourage physical activity. Encourage your teen when they play sports or do yoga. Exercise can help relieve symptoms of depression, so find ways to keep your teen physically active. Something as simple as walking the dog or riding a bike can be helpful.

Encourage social activity. Isolation only makes your teen depressed, so encourage him when he wants to spend time with friends or you.

Participate in treatment. Make sure your teen follows all instructions and the doctor's instructions and does everything on time and completely. This is especially important when your child takes prescription medications. Monitor changes in your child's condition and contact your doctor if you think your child's symptoms are getting worse.

Learn more about depression. If you don't know much about the course of this condition, you need to read more about depression and then you too will become an expert. The more you know, the better you can help your depressed teen. Encourage your teen to learn more about depression too. Reading non-fiction books can help teens feel like they are not alone and give them a better understanding of what they are going through.

The road to restoring your teen's mental health can be a long one, so be patient. Enjoy small victories and don't worry about failures. Most importantly, don't judge yourself or compare your family to others. You are doing everything possible to rid your teenager of depression, and he is trying with you.

Psychologist.

Less than three decades ago, depression was seen as a predominant disorder in adults: children were considered too immature to develop depressive disorders, and teenage low mood was seen as part of "normal" teenage mood swings. Depression in children and teen depression is very real.

Depression in adolescents is associated with a number of adverse causes, including social and educational impairments, as well as physical and mental health problems. Although studies on the course and correlates of depression have identified important similarities in the development of depressive symptoms in adolescents, they have also identified age-related variations. As a result, researchers continue to evaluate the extent to which child, adolescent, and adult depression reflect the same underlying condition. This review provides a brief introduction to recent evidence in these areas.

It is only in the last two decades that depression in children has begun to be taken very seriously. A depressed child may pretend to be sick, refuse to go to school, cling to a parent, or worry that the parent may die. Older children may get hurt, get into trouble at school, be angry, rude, and feel misunderstood.

Because normal behavior varies from one age to the next, it is difficult to determine whether a child is going through a temporary "phase" or is suffering from depression. Sometimes parents begin to worry about how the child's behavior has changed, or the teacher says that "your child has changed, he is not himself." In this case, if the pediatrician rules out physical symptoms, he or she will likely suggest that the child should be evaluated by another specialist, preferably a psychiatrist who specializes in treating children.

One in seven teenagers experience depression every year. Depression is a treatable illness and is not just a couple of sad days. Teenage depression involves persistent feelings of sadness or irritability that make it difficult for a child or teen to function.

Children who are stressed by the loss of a loved one, or who have attention difficulties, learning difficulties, behavioral problems or an anxiety disorder, are at higher risk of depression. High social media use is also associated with an increased risk of depression. Depression also tends to run in families, especially when the family is united by some common negative event. It doesn't have to be the loss of a loved one. For example, there is an alcoholic or a psychopathic tyrant in the family.

Depressed children and adolescents may behave differently than depressed adults. Child and adolescent psychiatrists advise parents to become aware of the signs and symptoms of depression in their teens and younger children.

What teenagers and their parents need to know about depression. If one or more of these signs of depression persist, you should seek help.

Signs of depression in teenagers

• Frequent sadness, tearfulness and actual crying;
• Decreased interest in favorite activities;
• Hopelessness;
• Persistent boredom; little energy;
• Social isolation from friends and family;
• Low self-esteem and guilt;
• Extreme sensitivity to failure;
• Increased irritability, anger, or hostility;
• Difficulty with relationships;
• Frequent complaints of physical illnesses such as headaches and abdominal pain;
• Absenteeism from school or poor academic performance;
• Poor concentration;
• Major changes in eating and/or sleeping;
• Talking about running away or actually trying to run away from home;
• Talking about suicide or behavior associated with self-harm (self-harm).

Studies of depressed schoolchildren find about two-thirds of depressed youth have at least one co-occurring mental disorder, and more than 10% show two or more (attention deficit hyperactivity disorder [ADHD] or conduct disorder or something else) . In preschool studies, comorbidity rates are even higher, with three out of every four depressed preschoolers.

Treatment and prevention of depression in young people

Other factors influencing treatment planning will include the presence of comorbidities and maternal mental health. Surprisingly, there is little evidence regarding how to treat comorbidity in depression—is it better to treat depression or the comorbidity state, or both, and under what circumstances? Clinicians usually make individualized decisions by considering first the condition that is more chronic or appears to be the most serious. In the area of ​​maternal mental health, evidence suggests that treating depression in the mother may help alleviate depression in the offspring. Findings from a study of treated mothers with depression showed that remission of maternal depression was associated with significant improvement in children's depression.

Depression in boys and girls. Differences

Newborn depression

To report an error, select the text and press Ctrl+Enter

Article last updated 02/05/2020

Depression in children and adolescents is not just a bad mood, it is a serious emotional disorder that leaves an imprint on the development of a child or adolescent, his well-being, and quality of life.

On average, depression occurs in 2% of children and 5% of adolescents.

Since the symptoms of depression in a child differ significantly from the symptoms of the disease in an adult, very often the disorder is not diagnosed in a timely manner.

Causes

The most common causes of childhood and adolescent depression are:

• One of the causes of depression in children is intrauterine pathologies. Prolonged fetal hypoxia, intrauterine infections, and neonatal encephalopathy can lead to depression over time;
• Normal relationships in the family are the main factor in the formation of a mentally healthy child. But not all families go smoothly. Some children grow up in single-parent families, others - in families where one of the parents (or maybe both) abuses alcohol or uses drugs, others - in seemingly prosperous families, only the excessive guardianship of the parents does not allow the child develop normally, grow up, take responsibility;
• School is in second place after family in terms of social development . Here the child learns to communicate with peers, build relationships, here he gains knowledge. In the school microsociety, he can become successful or not, feel smart or so-so. Only parents accept their child as he is (and even then not always). At school you need to constantly learn something, conform, prove something. And not everyone succeeds. Insults and defeats received within the walls of school can cause depression in a child or teenager;
• Everyone knows the fairy tale about the ugly duckling, who later turned into a beautiful swan. So adolescence is the period of the “ugly duckling”. Don't forget about the hormonal changes that occur in a teenager's body. Changes in appearance and in the functioning of the body that accompany this, in combination with the influence of other factors, can also provoke the appearance of depressive disorders;
• Some people, including teenagers, are predisposed to developing depression. This predisposition is inherent in genes. This type of depression is called endogenous. It occurs rarely in children, but is more common in adolescents. It can arise for no apparent reason, or the factor itself can be insignificant (a bad mark in class, a short-term quarrel with a friend), and it seems that it should not have provoked the onset of depression, but that’s not the case. may periodically worsen;
• Childhood and adolescence are a time of learning about oneself and the world around us. Not everything works out. First love, exams, admission to college or university, not always successful, and also early pregnancies, marriages. In general, there are enough problems at this age, as well as reasons for affective disorder.

Main manifestations

Typical manifestations of depression, such as low mood, motor retardation and slow thinking, are not typical for children.

These symptoms occur at ages 12–14 years and older. However, the disorder can also develop in preschoolers; cases of depression in one-year-old children have been described, but their affective disorders occur in an atypical, masked manner.

Many parents see that something incomprehensible is happening to a child or teenager, but do not even suspect that it is depression.

How then can you suspect depression in a child, what symptoms will help with this? Let's take a closer look at the various manifestations of childhood and adolescent depression.

The most common symptoms of depression in children and adolescents are:

• loss of interest in life and the ability to get in the mood, moodiness, irritability;
• changes in appetite (can either decrease or increase);
• lethargy, loss of energy;
• sleep disorders (insomnia, nightmares or, conversely, excessive drowsiness);
• decline in academic performance, poor attitude towards school;
• aggressiveness, unusual before;
• isolation, reluctance to communicate with friends and peers;
• feelings of inadequacy, worthlessness, or guilt;
• suicidal thoughts or attempts;
• complaints about deterioration of health without objective reasons for this; upon examination, no significant deviations in the functioning of internal organs are detected.

Clinical picture

Suicidal thoughts occur in approximately 60% of children and adolescents suffering from depression, and 30% make suicide attempts, some of which result in death. This fact alone is enough to understand the inadmissibility of a wait-and-see attitude in the hope that depression in a child (teenager) will go away “on its own.” Such negligence can lead to fatal consequences.

In the first years of life, the main cause of depression in a child is separation from his mother. After six months, the child develops a pronounced attachment to his parents, especially to his mother, and the baby reacts hostilely to attempts to share him with them.

At such a young age, the main manifestations will be a monotonous, joyless mood, a sad-submissive facial expression. Such children attract attention by being slow, lethargic, and indifferent. There may also be causeless anxiety, moodiness, tearfulness, and negativism.

In children, the emotional manifestations of depression are weakly expressed, with motor and autonomic disorders coming first.

Symptoms of childhood depression characteristic of preschool age include disturbances in appetite (it can either decrease or increase), sleep disturbances (insomnia or drowsiness), enuresis (urinary incontinence), lethargy, lethargy, alternating anxiety with tearfulness. Such children may have a pained expression on their face, walk with their heads bowed, and may present various complaints that something is bothering them, pain (head, stomach, throat, etc.), although there are no pronounced problems with the internal organs.

At primary school age, depression in children can manifest itself with the following symptoms: loss of interest in games, isolation, lethargy, impaired attention and associated learning difficulties. Enuresis, decreased or increased appetite, and as a result, obesity, constipation, sleep disorders, nightmares, and fears can also occur with depression.

Symptoms that may occur in adolescents

Some teenagers may experience a typical picture of depression: low mood, motor retardation, slow thinking, while others may have an atypical course of teenage depression.

At this age, ideas of low value appear; a teenager may say to himself “I’m the worst in the class, I’m incapable, etc.”; suicidal thoughts may sound in fragments in statements: “Who needs me like that? Why did you give birth to me? Why should I live?

A depressive episode can be preceded by a long-term, unexpressed decrease in mood.

Motor retardation is not common.

Some parents do not notice the experiences and changes occurring in the teenager’s soul, but only pay attention to poor performance at school, conflicts, scold the teenager for this, punish them, and with such behavior they can further aggravate his condition and push the teenager to a suicide attempt.

Depression in adolescence is often masked by psychopathic behavior, alcohol and drug use. The teenager does not understand what is happening to him, he tries to suppress painful experiences with the help of alcohol or drugs, and this can lead to the occurrence of depression.

Teenage depression equivalents

In many adolescents, depression occurs atypically, with completely unusual symptoms coming to the fore, in which case they speak of teenage depressive equivalents.

There are 3 main equivalents:

• delinquent;
• hypochondriacal;
• asthenoapathic.

Delinquent equivalent

Changes in behavior and emotional state begin suddenly.

The teenager becomes gloomy, often conflicts with parents and teachers, is rude, and seems to “do everything for evil.” He abandons his classes and wanders the streets. He may find himself in an antisocial company and start drinking, but drinking alcohol does not give the expected feeling of euphoria.

The entire behavior of such a teenager bears a stamp of despair. Aggression directed at loved ones can give way to self-aggression and even suicidal attempts. If you try to find out what’s wrong with a teenager, whether depression is bothering him, he will deny its presence and define his mood as “usual.” This variant is most often observed at the age of 13-17 years.

Hypochondriacal equivalent

It manifests itself with various complaints about deteriorating health. Existing health problems are usually exaggerated. Teenagers willingly agree to examinations, even unpleasant procedures. They may avoid studying due to illness, sit idle, lie in bed, become irritable, and whiny.

Such teenagers often talk about illness, associate their bad mood with it and do not mind that they are sick from nerves. They will willingly take medications, but may exaggerate the side effects of medications. This equivalent can be observed in reactive depression in adolescents who have signs of hysterical or depression. Most often observed at the age of 15-18 years.

Asthenoapathic equivalent

The first symptoms of teenage depression are complaints of learning difficulties. The teenager has difficulty concentrating and learning new material. When trying to learn something or do something quickly, fatigue sets in, productivity deteriorates, and as a result the activity is abandoned.

The teenager himself becomes lethargic, inactive, and asthenia may develop. He doesn’t go anywhere, doesn’t communicate with anyone, sits at home, doesn’t look for entertainment, and may complain of boredom. Reacts to accusations of laziness from relatives with irritation.

Typical adolescent course of the disorder

Adolescents may already experience depressive disorders that resemble those in adults, most often melancholic or anxious depression.

Melancholy option

As a rule, it is observed in adolescents aged 15 years and older, mainly in girls. Depressive disorders are clearly presented: there is a depressed mood, inactivity, and hopeless melancholy. Such teenagers speak in a quiet voice, give short answers to questions, and do not go into details. The existing lethargy can reach the level of depressive stupor, when the teenager literally freezes in place and sits motionless.

Suicidal thoughts arise constantly, but motor retardation does not allow them to be carried out.

Melancholic depression that occurs in adolescence is characterized by ideas of self-blame, guilt towards family, friends, teachers (“it’s all my fault,” “it would be easier for all of you without me,” “I’ve only caused you nothing but misfortune”).

Symptoms such as insomnia, loss of appetite, and lack of menstruation (if it has already occurred) in girls may be present.

Alarming option

With this type of depression, the leading symptom is anxiety. The teenager himself cannot explain what worries him, worries him, and may often experience groundless worries about the fact that he may be attacked, killed, expelled from school, etc.

Anxiety may be combined with difficulty perceiving the environment, confusion, and minor disturbances in orientation may be observed.

Treatment

The main methods of treating depressive disorders in children and adolescents, recognized by the World Health Organization, are psychotherapy and the use of antidepressants.

Drug treatment

Among modern groups of antidepressants for the treatment of childhood and adolescent depression, selective serotonin reuptake inhibitors are most often used - these are drugs such as fluoxetine, paroxetine, sertraline, citalopram, fluvoxamine, escitalopram. These medications have an analgesic, calming effect, help cope with panic phenomena, and also overcome obsessive fears (phobias).

In terms of their effectiveness, these drugs are not inferior to other groups, however, the risk of developing side effects during their use is significantly lower than that of tricyclic antidepressants.

Rarely, however, the following side effects may occur with the use of selective serotonin reuptake inhibitors:

• disorders of the gastrointestinal tract (nausea, vomiting);
• sleep disorders (insomnia or increased sleepiness);
• headache;
• increased sweating;
• appetite disturbances (decrease or increase);
• irritability, increased impulsiveness.

In most cases, children and adolescents are prescribed only one antidepressant (monotherapy).

After starting to take the drug, the effect does not occur immediately, but after 1-2 weeks. If no improvement is observed after 4 weeks, then another drug is prescribed.

Psychotherapy

Cognitive-behavioral therapy as part of the treatment of childhood and adolescent depression is aimed at helping the child (adolescent) overcome emerging psychological difficulties and negative emotions, and thus contribute to his social adaptation.

The goal of individual psychotherapy is to teach a student to express his emotions, live them, talk about his traumatic experiences, and overcome them.

If there are difficulties in building family relationships in the family, and parents cannot find a common language with the child, then family psychotherapy can come to the rescue.

Today, the most effective treatment for childhood and adolescent depression is considered to be a combination of cognitive behavioral therapy with fluoxetine.

Parental help

When a child is depressed, his self-esteem decreases significantly; difficulties may arise in building relationships with peers and teachers, and academic performance may decline. And it is the parents who have rich life experience and know their child (teenager) well who should help him overcome the difficulties that have arisen. They should become a kind of “buffer” in the relationship between the doctor and the child, the school and the child, peers and the child.

If the student’s mental state allows, then treatment for depression should be carried out on an outpatient basis. The psyche of children and adolescents is very fragile, and the additional burden on it in the form of a stay in a psychiatric hospital is unlikely to be beneficial.

Of course, there are situations when inpatient treatment is indispensable. For example, with pronounced suicidal behavior, when parents fear that the child may attempt suicide at any moment, with psychotic depression, with severe, difficult to treat depressive disorder.

If the child is able to attend school, it is necessary to continue studying. After all, in the future you will still have to “catch up” with your peers, this will need to be done in an emergency mode, which can also become another stress.

It is better for parents to talk with teachers, warn about a difficult period in the child’s life and ask them to be as tolerant of him as possible, help, support, and promote productive interaction with peers. It is also necessary to warn teachers about maintaining confidentiality so that others do not find out about the disease.

In a state of depression, any person, no matter how old he is, feels useless, unloved, stupid, the worst. Parents inadvertently, with just one careless phrase from their lips, can further aggravate the mental state of their child. And this is not acceptable.

During an exacerbation of depression, parents must extremely monitor their statements, their behavior, and pay increased attention to the student. They are the ones who must support their child, no matter how old he is, instill in him the confidence that he is needed, loved, that he is the best for his parents. This attitude has a healing effect, inspires the child, helps him overcome mental illness.

Forecast

The likelihood of repeated episodes of depression once occurring in a teenager is quite high:

• in 25% of adolescents, depression returns within a year;
• in 40% - after 2 years;
• 70% - after 5 years.

20-40% of children develop over time. In most cases, it is possible to establish a burdened heredity (the presence of a mental illness in one of the relatives).

Children and adolescents who have developed a depressive disorder need increased attention and care from loved ones. Perhaps a depressive episode in their life developed only once, but there is no need to test their psyche or subject them to excessive stress.

Features of treatment in the UK

According to the latest trends in the treatment of depression in children and adolescents in the UK, preference is given to psychotherapy, both individual and group.

If after 4-6 weeks from the start of such treatment they do not receive an effect, as well as in severe depression, in the presence of concomitant aggravating risk factors (for example, mental illness in parents, the presence of obsessive suicidal thoughts), then proceed to drug treatment (or start with it ). At the same time, psychotherapy sessions continue.

For the treatment of adolescent depression (aged 12-18 years), an antidepressant such as fluoxetine is preferred. In children aged 5-11 years, this drug is prescribed with caution. In any case, fluoxetine is the drug with which it is recommended to begin the treatment of depressive disorders in children and adolescents.

If treatment with this drug is not effective or is poorly tolerated, then antidepressants such as citalopram or sertraline may be prescribed. UK doctors are of the opinion that paroxetine, venlafaxine, and tricyclic antidepressants, due to the high risk of side effects from their use, should not be prescribed for the treatment of depression in children and adolescents.

Prevention

Getting over your first depressive episode is very difficult. However, it is quite possible to prevent and reduce the intensity of subsequent depressive attacks. Therefore, parents must learn to recognize the first attacks of depression in a child in time, so as not to miss the opportunity to diagnose and treat the disease at the initial stage.

It is very important to systematically and long-term take medications prescribed by a doctor, even after the condition improves. It is also necessary to regularly attend psychotherapy sessions, avoiding absences. Parents should ensure that the child adheres to a healthy diet, engages in physical activity, and avoids drinking alcohol.

It is necessary not to forget about the possible risk, so one person should be responsible for the “dispensing” of medications in the family, in order to avoid confusion. You should not rely on your child in this matter. I repeat once again: only a doctor can stop the drug; you cannot stop treatment on your own, believing that your child has already been cured of depression, because a relapse of the disease may occur.

In the family circle, your child should feel love, support and protection. And this will be the best prevention of depression for any child and teenager, which can be provided by those closest to him.