Depressive Disorders In Young People

By Dr Patricia Garel
Psychiatrist
Sainte-Justine Hospital
Dr François Maranda
Psychiatrist
Sainte-Justine Hospital

Adults are not the only ones who suffer from major depression. The illness afflicts 1% of preadolescents (12 to 15 years of age), 7% of adolescents (15 to 18 years old) and 17% of adults (18 and over). Such high numbers mean that we need to learn more about depression so that we can quickly detect the symptoms in young people.

“Feeling Blue” vs “Suffering from Depression”

Feeling blue is not the same as suffering from depression. Feeling blue is a normal reaction to psychological or social factors that we all have to deal with at one time or another in our lives. The feeling passes quickly and does not keep us from enjoying certain activities or having fun at certain times, even when we do feel down in the dumps. The feeling can stem from a sense of dissatisfaction with school performance, conflicts with family or friends, or problems in day-to-day life.

Major depression is an illness characterized by a significant change in behaviour and a marked loss of interest in one’s usual activities. Young people suffering from depression spend most of their time alone or are unable to spend time on their own. They lack concentration, are sometimes afraid of everything or become irritable and aggressive. Some behaviours (substance abuse, running away, etc) can be manifestations of depression, and depression has to be ruled out first before we can talk about behavioural problems.

Factors That May Predispose Young People to Depression

• A family member suffering from mental illness;
• Loss of a parent in early childhood (death, divorce or abandonment);
• Chronic illness;
• Family members who have committed suicide, etc.

Symptoms of Depression

A diagnosis of depression is based on a variable set of symptoms observed over time and in a given context rather than on just one symptom. A young person suffering from depression may present some of the following symptoms:

• ongoing problems in dealings and relationships with relatives and friends;
• unusual irritability or apathy with regard to daily life;
• carelessness with regard to personal hygiene or keeping one’s room tidy;
• delinquent-like behaviours: skipping school, violent speech and actions, alcohol and substance abuse;
• major change in eating patterns;
• difficulty focussing and concentrating;
• sleep-related problems: insomnia or oversleeping;
• mood shifts: sadness, irritability, aggression;
• suicidal behaviour or overwhelming thoughts of suicide, the desire to die to put an end to unbearable suffering.

TREATMENT

Treating depression in young people usually involves two levels: biological and psychological.

Biological Treatment

The physician will prescribe one or more medications that act on the neurotransmitters, which are chemical substances through which neurons communicate and that ensure brain function. During a depressive phase, this communication is impaired. The aim of the medication is to re-establish that communication. However, it should be stressed that their effect is not immediate. It sometimes takes weeks before they reach their full potential. When effective, they allow young people to gradually regain balance in the following areas:

• sleep;
• appetite;
• energy;
• concentration (which sometimes takes a while);
• enjoyment in doing things;
• realistic projects;
• desire to go back to school, etc.

Psychological Treatment

Cognitive therapies geared to rectifying misconceptions and misperceptions that accompany depression are effective and complement pharmacological treatment. Other types of therapy (group therapy, analytical orientation therapy, etc.) may also be appropriate, depending on the individual.

RoleS of the VARIOUS PARTIES INVOLVED IN Dealing With Young People Suffering From Depression

Parents are often the first to notice sometime wrong with their child. They remain key observers although the parent-child relationship can sometimes bias their perception. Hence, it is important for them to share their fears and doubts with someone qualified. Parents always play an essential role in the assessment of, and caring for, their children.

The family physician is often consulted first because of the many physical symptoms associated with depression (tiredness, pain, etc.). He or she will establish a medical history, eliminate somatic disorders that may explain the condition (thyroid condition, infection, anemia, etc.) and continue the assessment with the young person and parents. The physician may request a consultation with a psychiatrist or initiate treatment after a reasonable amount of time.

Psychiatrists are physicians specialized in mental disorders. They are the key players in co-ordinating the available treatments.

School workers (nurses, psychologists and social workers) are often the first persons that young people go to. They play a major role in welcoming, supporting and guiding young people in distress, and they initiate the appropriate referrals.

Young people may also confide in a trusted teacher or confidante who will be able to advise and support them in getting help from a physician or organization.

The youth service branches of CLSCs (local community service centres) are specialized in dealing with the problems that young people encounter. You can go to them without hesitation.

Organizations like REVIVRE and Tel-Jeunes provide information and support to individuals and families. They can be consulted at any time for information on resources, guidance, assistance and support at various levels.

FAMILY AND FRIENDS CAN HELP!

Young people who feel unwell often confide in people close to them (friends, sisters, brothers, etc.). The latter can provide invaluable help in getting them through their ordeal and ensuring that they are not isolated or left alone. They can put them in touch with the right person who will be able to take the necessary action.

SOS

Depression is an illness that differs somewhat from other illnesses in that it impairs one’s judgment. Yet, like other illnesses, it must be explained, demystified and treated quickly. The challenges and treatment associated with the illness must be properly understood by young people and their families. There is no need to suffer unnecessarily or try to go it alone.

FOR YOUNG PEOPLE

REVIVRE offers a service specifically for young people between the ages of 14 and 25 that includes information, a crisis line, support, free and confidential one-on-one counselling, support groups, documentation and videocassettes on mood-related disorders. For more information, call us at (514) 529-3081, # 3 or e-mail us at servicesjeunesse@revivre.org.

FOR PARENTS AND RELATIVES

If you recognize signs or symptoms of depression in your child, consult a general practitioner or child psychiatrist. Detecting the illness and quickly getting treatment by qualified people is the most important thing to do.