Helping the Depressed Adolescent

Depression may be even harder to recognize in an adolescent than in a younger child. Feelings of sadness and hopelessness associated with depression may be perceived as the normal emotional stresses of growing up. Some depressed youngsters act out their distress, becoming inappropriately angry or aggressive, running away, or becoming delinquent. Such behaviors, too often dismissed as adolescent storminess, are signs or problems and sometimes cries for help or attention.

For example, bipolar disorder (also called manic-depressive illness) often emerges during adolescence. It is manifested by episodes of impulsivity, irritability, and loss of control, sometimes alternating with periods of withdrawal. This behavior also can be confused with the emotional ups and downs of adolescence.

The clue to depressive disorder in an adolescent is persistent signs of change or withdrawal. Has the once outgoing youngster become withdrawn and antisocial? Is the former good student failing subjects or skipping classes? Has the happy-go-lucky kid been moping around for weeks? Is the easy-going teenager inappropriately irritable? If the answer to any of these questions is “yes,” it is time to ask more questions. Is the youngster feeling unable to cope, demoralized, friendless, possibly suicidal?

If so, it is important-vital, in fact-to get the youngster help. A depressed adolescent may or may not be willing to see a mental health professional often youngsters have mixed feelings about getting help and may resist treatment if they sense similar ambivalence in their parents. Or they may play on parental guilt. They seem to have an uncanny ability to know what makes parents feel guilty and are particularly adept at pushing “guilt buttons.” It is all too easy for loving parents to give in to strong resistance, but this only does the youngster a disservice. Sometimes, it is wise for parents to seek advice on how best to help their depressed child. If the youngster is destructive of self or others, it is essential to get help. Leesha is a case in point.

Leesha

Once a happy child and good student, Leesha became withdrawn, listless, and disinterested in school during her junior high years. She could no longer summon the energy and enthusiasm she once took for granted. Her pervasive sadness discouraged friendship, and she found herself socially isolated. She began to skip classes and then, to avoid her mother’s “nagging,” started staying away from home until the in the evening.

Leesha’ s mother became increasingly upset and eventually confided her concerns to her pastor, who had a doctorate in family counseling. After his invitation to Leesha and her father to meet with him was turned down, he encouraged Leesha’s mother to seek help for herself; and she decided to accept his counseling. With his help, she 1earned much about herself and her relationship with her family. The pastor also convinced her that Leesha had an illness-probably a form of depression-that required appropriate treatment She then begged Leesha to see a psychiatrist recommended by the pastor. Leesha wanted help, but feared her father’s disapproval. He , believed that only “crazy” people needed psychiatrists, that getting help was a sign of weakness and, besides, that Leesha was just going through a phase.

The tension between her parents mounted. Her father often stayed out late and came home drunk. One day, her parents received a call from the local hospital. Leesha had attempted suicide.

On the advice of the treating physician, Leesha’ s parents admitted her to a psychiatric hospital As part of that hospital’ s program, they were expected to join families of other patients in group counseling. Leesha’s father, more frightened by his daughter’s suicide attempt than the prospect of joining a therapy group, reluctantly participated. He was relieved to find that his problems were not unique, but shared by others in the group. Also, the help and understanding he received from the group enabled him to give Leesha needed love and support during her treatment and after her recovery.

Leesha and her parents were lucky that she survived her suicide attempt. Perhaps, if both parents had strongly insisted she get treatment earlier, a good deal of guilt and pain could have been avoided. However some teenagers resist treatment no matter what. This is when mental health professionals advise parents to get tough, particularly if the child is using alcohol or drugs, running away, getting into trouble, or is suicidal.

Getting tough does not mean physically or verbally abusing children or putting them on the street. In fact, if a youngster runs away, efforts to find the child should begin as soon as possible. Sometimes parents are tempted to “teach the runaway a lesson” by not looking for the youngster for a day or two. This is not wise. If youngsters manage to avoid danger, they will not avoid feeling rejected, an emotion that only exacerbates depression.

Getting tough with youngsters means seeing to it that they get appropriate treatment. Such treatment may be provided on an outpatient basis while the child lives at home or with a relative. Or the youngster may be better off in a psychiatric hospital, drug rehabilitation program, behavior modification program, or a residential treatment center. Sometimes, various treatments have to be tried to find the one that works best.

Finding the right treatment is usually predicated upon a complete psychiatric and physical diagnostic assessment. A depressive disorder is not a passing bad mood, but rather an illness that should and can be treated. For information about treatment programs, see Helping Resources.