Teen Depression

[Anonymous]

Some of you should grow up and stop the blame game. We need to honestly look at the many causes of depression and deal with it. Short term meds may be needed for severe mental illness, but they do not make you "healthy".

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

It is well articulated but not necessarily accurate. There is really no one in the medical community who would call depression a chemical imbalance. That is a term that was developed years ago partly to move the perception of depression away from personal weakness/character and partly by the the pharmaceutical companies who wanted to tell you they could re-balance your chemicals. It isn't accurate and is a frustration for people who do research on mental illness as it is a pervasive view in the general public. Depression is neurobiological however that doesn't mean that no other factors other than neurotransmitter re-uptake are at play. While the etiology is still in its infancy in being understood, we do know that there is no one 'cause'. Just like there isn't one cause for all heart disease or one cause for all cancer. There is absolutely zero evidence that everyone with depression was born with a chemical imbalance. The serotonin theory is only one of many, many theories in understanding depression. The fact that SSRIs work to alleviate symptoms of depression tells us nothing about the cause of the illness. The drugs just treat symptoms. Just like ibuprofen alleviates the symptoms of pain, however if you have pain alleviated by ibuprofen that doesn't mean the cause of your pain was a ibuprofen deficit. Until now our understanding of mental illness has been symptoms driven (see DSM), that approach has just about run its course and taken us as far as it can. The NIMH is now moving away from that and in the next few years we will hopefully start to have a much better picture of mental illness. Also environmental factors and situational factors are two entirely different sets of factors, and both absolutely play a role in illness, including mental illness. Posters saying those play a role are not wrong in any way. Those factors have both a physiological and psychological impact. Environmental and psychosocial factors being at play does not mean that someone just couldn't cope with their environment/situation.

It is good that depression isn't a chemical imbalance. SSRIs are only effective in alleviating symptoms for 50-60% of people, naturalistic recovery is about 50% (people who get better in a year with no treatment), and initial placebo effect is about 40%.

Here is a position statement from the Director of the NIMH on moving away from the DSM and symptom driven diagnoses. http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml

Nevertheless, many are helped by medications. It is cold comfort indeed to read from DSM after seeing the tragic effects of teen depression.

Oh absolutely, the medications that we have currently have saved many lives and do help many, many people. The alleviating of symptoms means that people can function, and that makes life manageable. Mental illness is now talked about with recovery and remission language - no longer seen as automatically being a life long or chronic illness.

Having a high naturalistic recovery also can be misleading - while about half of people will recover in 12 months without treatment, the impact of having been depressed for 12 months can be devastating - it can ruin relationships, make people lose jobs, deeply ingrain cognitive distortions, and lead to self harm and suicide.

The DSM has played a critical role in organizing symptom profiles and moving the field forward - it is exciting that we are moving past that, but the contributions of the DSM will always be part of the history of understanding mental illness. It has also helped to validate and give names to illnesses and that in itself is a positive.

Before moving into research I worked for ten years on an adolescent inpatient psychiatric unit, and have seen the tragic effects. I just think it is really important that people know that understanding and addressing environmental and psychosocial factors are extremely important in treating depression. It is not just a chemical imbalance and the only option to treat it is medication.

Thank you,
Thank you,
Thank you.

So few people in this field
are willing to speak the truth.

[Anonymous]

Anonymous wrote:Some of you should grow up and stop the blame game. We need to honestly look at the many causes of depression and deal with it. Short term meds may be needed for severe mental illness, but they do not make you "healthy".

Why aren't the kids themselves speaking out about the real issues? Do they not trust any adult? Do they know there'll be repercussions to their brutal honesty? Are they afraid?

[Anonymous]

Anonymous wrote:

Anonymous wrote:Some of you should grow up and stop the blame game. We need to honestly look at the many causes of depression and deal with it. Short term meds may be needed for severe mental illness, but they do not make you "healthy".

Why aren't the kids themselves speaking out about the real issues? Do they not trust any adult? Do they know there'll be repercussions to their brutal honesty? Are they afraid?

This sock puppet posts every few days to revive the thread. Enough already.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

It is well articulated but not necessarily accurate. There is really no one in the medical community who would call depression a chemical imbalance. That is a term that was developed years ago partly to move the perception of depression away from personal weakness/character and partly by the the pharmaceutical companies who wanted to tell you they could re-balance your chemicals. It isn't accurate and is a frustration for people who do research on mental illness as it is a pervasive view in the general public. Depression is neurobiological however that doesn't mean that no other factors other than neurotransmitter re-uptake are at play. While the etiology is still in its infancy in being understood, we do know that there is no one 'cause'. Just like there isn't one cause for all heart disease or one cause for all cancer. There is absolutely zero evidence that everyone with depression was born with a chemical imbalance. The serotonin theory is only one of many, many theories in understanding depression. The fact that SSRIs work to alleviate symptoms of depression tells us nothing about the cause of the illness. The drugs just treat symptoms. Just like ibuprofen alleviates the symptoms of pain, however if you have pain alleviated by ibuprofen that doesn't mean the cause of your pain was a ibuprofen deficit. Until now our understanding of mental illness has been symptoms driven (see DSM), that approach has just about run its course and taken us as far as it can. The NIMH is now moving away from that and in the next few years we will hopefully start to have a much better picture of mental illness. Also environmental factors and situational factors are two entirely different sets of factors, and both absolutely play a role in illness, including mental illness. Posters saying those play a role are not wrong in any way. Those factors have both a physiological and psychological impact. Environmental and psychosocial factors being at play does not mean that someone just couldn't cope with their environment/situation.

It is good that depression isn't a chemical imbalance. SSRIs are only effective in alleviating symptoms for 50-60% of people, naturalistic recovery is about 50% (people who get better in a year with no treatment), and initial placebo effect is about 40%.

Here is a position statement from the Director of the NIMH on moving away from the DSM and symptom driven diagnoses. http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml

Nevertheless, many are helped by medications. It is cold comfort indeed to read from DSM after seeing the tragic effects of teen depression.

Oh absolutely, the medications that we have currently have saved many lives and do help many, many people. The alleviating of symptoms means that people can function, and that makes life manageable. Mental illness is now talked about with recovery and remission language - no longer seen as automatically being a life long or chronic illness.

Having a high naturalistic recovery also can be misleading - while about half of people will recover in 12 months without treatment, the impact of having been depressed for 12 months can be devastating - it can ruin relationships, make people lose jobs, deeply ingrain cognitive distortions, and lead to self harm and suicide.

The DSM has played a critical role in organizing symptom profiles and moving the field forward - it is exciting that we are moving past that, but the contributions of the DSM will always be part of the history of understanding mental illness. It has also helped to validate and give names to illnesses and that in itself is a positive.

Before moving into research I worked for ten years on an adolescent inpatient psychiatric unit, and have seen the tragic effects. I just think it is really important that people know that understanding and addressing environmental and psychosocial factors are extremely important in treating depression. It is not just a chemical imbalance and the only option to treat it is medication.

Thank you,
Thank you,
Thank you.

So few people in this field
are willing to speak the truth.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I really hate this idea that something must be wrong in a family if a child has depression. Most kids with depression come from loving, stable homes. My DC had serious depression. I've had serious depression. There's obviously something genetic going on here.

But what, if anything, were triggers or stressors? Or did it just come out of no where (besides genetics)?

It could be a failure of the person in communicating their wants and needs.
My husband had serious teen depression and as an adult I noticed that his adult depressive episodes seem to be related to his not being great at communicating. Communicating things he doesn't like, things he'd like to change, stuff that bugs him, his hopes his ideas.
His mom was an alcoholic and completely unavailable which might have had something to do with it, I don't know. Maybe at that age not - but clearly she had similar issues (and still does).
I try to keep the lines of communication open. It seems to help. It is not easy. One time he had kind of a little breakdown and I was surprised at the stuff he shared then they I had never heard before. We are much better at communicating now but sometimes I snoop on his phone not to see if he's having an affair but to see what he is thinking about sometimes. Sometimes I still get the stonewalling DH.

With a teen that doesn't communicate - it's hard because (and yes I have one of these at home) they can be totally secretive about so many things. So it's like an endless game of trying to do right by them while being screamed at (I now just acknowledge that 'I suck' and I got myself a mug that says 'worst mom ever'. Someone buy me the tshirt? Nothing I do is good enough for the teen) one minute and hearing snippets of her life other minutes. Teens are all stonewalling all the time. That doesn't help.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I really hate this idea that something must be wrong in a family if a child has depression. Most kids with depression come from loving, stable homes. My DC had serious depression. I've had serious depression. There's obviously something genetic going on here.

But what, if anything, were triggers or stressors? Or did it just come out of no where (besides genetics)?

It could be a failure of the person in communicating their wants and needs.
My husband had serious teen depression and as an adult I noticed that his adult depressive episodes seem to be related to his not being great at communicating. Communicating things he doesn't like, things he'd like to change, stuff that bugs him, his hopes his ideas.
His mom was an alcoholic and completely unavailable which might have had something to do with it, I don't know. Maybe at that age not - but clearly she had similar issues (and still does).
I try to keep the lines of communication open. It seems to help. It is not easy. One time he had kind of a little breakdown and I was surprised at the stuff he shared then they I had never heard before. We are much better at communicating now but sometimes I snoop on his phone not to see if he's having an affair but to see what he is thinking about sometimes. Sometimes I still get the stonewalling DH.

With a teen that doesn't communicate - it's hard because (and yes I have one of these at home) they can be totally secretive about so many things. So it's like an endless game of trying to do right by them while being screamed at (I now just acknowledge that 'I suck' and I got myself a mug that says 'worst mom ever'. Someone buy me the tshirt? Nothing I do is good enough for the teen) one minute and hearing snippets of her life other minutes. Teens are all stonewalling all the time. That doesn't help.

You are so right. We should all have that "I suck" mug/shirt.

[Anonymous]

Going back to the first page or so, yes, absolutely a concussion can trigger depression or adverse behavior changes. Following a moderate concussion this happened to my child, but at the time concussions were not taken very seriously once the CT scan was done and no bleeding in the brain was detected. We were given no advice on what to look for afterwards and struggled mightily with a child whose behavior changed radically in not good ways.

If your child has a concussion, please take the recovery very seriously and fight with the school about avoiding mental overload in the aftermath. Schools now seem aware of sports-related steps they need to take but remain clueless about academic impacts.

[Anonymous]

Anonymous wrote:Going back to the first page or so, yes, absolutely a concussion can trigger depression or adverse behavior changes. Following a moderate concussion this happened to my child, but at the time concussions were not taken very seriously once the CT scan was done and no bleeding in the brain was detected. We were given no advice on what to look for afterwards and struggled mightily with a child whose behavior changed radically in not good ways.

If your child has a concussion, please take the recovery very seriously and fight with the school about avoiding mental overload in the aftermath. Schools now seem aware of sports-related steps they need to take but remain clueless about academic impacts.

This is excellent advice. Thank you. I think HS sports need to be reevaluated.