ROBERT M. NEWELL, PH.D.
FORENSIC AND CLINICAL PSYCHOLOGY
Specializing in Behavioral Healthcare for Children &
Adolescents, Families, Couples, and Adults.
WHAT EVERY PARENT NEEDS TO KNOW ABOUT
DEPRESSION AND MOOD DISORDERS IN CHILDREN AND ADOLESCENTS
Adults aren’t the only ones who get depressed—children and adolescents do, too. Research shows that about five percent of children and adolescents experience a clinically significant level of depression at any given point in time. Children and adolescents who are under emotional stress, who have experienced a significant loss, who have learning problems, who display behavior problems, and/or who have a family history of depression, are at a greater risk for becoming depressed.
Depression in children and adolescents can be especially debilitating because it interferes with normal development. The good news is that depression is a treatable illness, and with immediate and appropriate intervention, the devastating effects of depression on a child’s development can be minimized or eliminated. Effective treatment often includes a combination of both individual and family psychotherapy.
► CLICK HERE to read My Approach to Treatment with Children and Adolescents.
The essential feature of mood disorders (also referred to as affective disorders) is a persistent or episodic exaggeration of one’s mood state. The term “mood” refers to the subjective emotional state experienced by an individual over a limited period of time such as depression, mania, hypomania, euphoria, dysphoria, elation, anger, irritability, happiness, sadness, and so forth.
When children and adolescents are depressed, their behavior sometimes is different than that of depressed adults. Here are a few of the warning signs that you should look for in your child or teen that indicate that he or she might be depressed:
· Frequent tearfulness, or crying
· Feelings of sadness, guilt, hopelessness, or worthlessness
· A diminished interest in, or an inability to enjoy, activities that previously were fun
· Excessive feelings of boredom, or low energy
· Social isolation
· Feelings of low self esteem
· Hypersensitivity to rejection by others or failure
· An increased anger or irritability
· Difficulty with peer and family relationships
· Frequent physical complaints such as headaches or stomachaches
· Truancy from school, or poor school performance
· Difficulty concentrating
· A significant increase or decrease in appetite
· A significant increase or decrease in sleep
· Talking about or attempting to run away from home
· Thoughts or expressions of suicide, self harm, or destructive behavior
Bipolar Disorder in children and adolescents is characterized by an alternating pattern between emotional highs (mania) and lows (depression). The intensity of the symptoms vary from mild to severe. In addition to the symptoms of depression already mentioned, symptoms of mania may include:
· Feelings of euphoria, extreme optimism and/or inflated self-esteem
· Rapid speech, racing thoughts, agitation and/or increased physical activity
· Poor judgment
· Recklessness or unnecessary risk taking behaviors
· Difficulty sleeping
· Distractibility and difficulty maintaining focus
· Difficulty concentrating
· Increased irritability
It’s important to understand that the symptoms listed above can be due to a number of different disorders. Also, it’s important to know that children and adolescents who display behavior problems at home or at school actually may be depressed. However, because the child or adolescent may not appear to be sad or depressed, it can be easy for parents and other adults to overlook it, or to not recognize the other signs of depression in their child.
The diagnosis of a mood disorder can only be made by a qualified psychologist or psychiatrist. If your child or teen displays more than one of the above symptoms, you should seek help immediately. Children and adolescents who are experiencing mood problems are at an increased risk for committing suicide.
► CLICK HERE to learn “What Every Parent Needs to Know About Adolescent Suicide.” Early diagnosis and treatment are essential for children and adolescents who are depressed.
► CONTACT ME for help if you have any questions or concerns about your son or daughter.
Warning About the Use of Psychotropic Medication for Children and Adolescents
In March 2004, the Food and Drug Administration (FDA) issued a statement that Paxil should not be prescribed for anyone under the age of 18 due to an increased risk for suicide. Recent research studies found that Paxil was not effective for treating depression in children and adolescents, and that subjects who took Paxil were three times as likely to experience suicidal thoughts and to attempt suicide than were adolescents who took a placebo. Children and adolescents who are currently taking Paxil should not suddenly discontinue the drug due to possible withdrawal effects. If your son or daughter is currently taking Paxil, consult a medical doctor immediately.
In addition, the FDA asked pharmaceutical companies to include a stronger label warning recommending close observation of adult and pediatric patients for the following medications used to treat depression and suicidal ideations. The medications included in this new warning are: Prozac, Zoloft, Paxil, Luvox, Celexa, Lexapro, Wellbutrin, Effexor, Serzone and Remeron. The warning recommends that healthcare providers carefully monitor patients receiving antidepressants for worsening of depression or suicidality, particularly at the beginning of therapy or during dosage changes. The FDA specifies that while they have not concluded that symptoms including anxiety, panic attacks, hostility, akathisia, and hypomania, are a precursor to either worsening depression or the emergence of suicidal impulses, it is concerned that patients who experience one or more of these symptoms may be at increased risk for worsening depression or suicidality. In these cases, medication may need to be discontinued, although the FDA cautions that if a decision is made to discontinue treatment, certain medications (see labeling for individual product details) should be tapered, rather than stopped abruptly.
The attorney general for the state of New York recently initiated legal action against one of the large pharmaceutical companies. The allegation is that the company intentionally suppressed research data that showed that their drugs are ineffective, or even possibly even dangerous. The attorney general's civil suit accuses the drug giant Glaxo-Smith-Kline of committing fraud by concealing negative information about Paxil, a drug used to treat depression. The suit alleges that the company conducted five clinical trials of Paxil in children and adolescents, yet published only one study whose mixed results it deemed positive. The company suppressed two major studies for up to four years, although the results of one were divulged by a whistle-blower at a medical conference in 1999 and all of the studies were submitted to the Food and Drug Administration in 2002 when the company sought approval for new uses of Paxil. At that time it became apparent that Paxil was no more effective than a placebo in treating adolescent depression and might even provoke suicidal thoughts.
DR. ROBERT M. NEWELL
Copyright © 2004-2007 Robert M. Newell, Ph.D. All rights reserved.