The Knowledge Center

Our Knowledge Center Blog provides valuable insight into the world of psychiatry and psychology.

Adolescent Depression

Adolescence can be a challenging time for children (and their parents). Hormonal changes, physical development and increasingly complex peer relationships all contribute to psychological concerns and conflicts. Since adolescence is a time of shifting moods and changes in perceptions (‘you’re the worst parents…ever!”) it is sometimes difficult to understand which behaviors are “normal” and which behaviors represent the development of significant psychopathology.

Negative and destructive thoughts words and behaviors can be signs of depression. Children may isolate themselves at home and at school and withdraw from social relationships.  A lack of  pleasure in normally pleasurable activities (anhedonia) can be a salient symptom of depression.  The depressed teen’s behavior may be defiant and self defeating. Sleep disturbance is common – staying up all night and sleeping during the day.  Thoughts of suicide or verbalizations about suicide should always be taken seriously- these are not “normal” and it is not true that “everyone” has these thoughts. Thoughts and gestures may be used in a manipulative manner but should be an immediate focus of parental and professional attention.

Causal factors can include: Substance abuse; Medications; Diet; A family history of mood disorders; Prolonged stress and family discord (divorce, separation); Physical abuse; Emotional and/or physical neglect. These factors can lead to decreased grades, loss of interest in activities, oppositional and defiant behaviors, self injury, isolation, chronic sadness, changes in appetite and disruption of the sleep-wake cycle.

It is always better to “be safe than sorry.” Having your child evaluated for anxiety and depression is an important first step in treatment. An initial office visit with the parents and the child can identify significant symptoms and help to develop an effective treatment plan. A full psychological evaluation ( including a series of diagnostic tests) can be useful in identifying intellectual and personality issues relevant to the depressive process.  In addition, your psychologist may suggest a psychiatric evaluation to explore the need for appropriate medication management.

Recent studies (2017) indicate that time limited use of SSRI’s (selective serotonin medications) for treatment of anxiety disorders does not increase risk of suicidal thoughts or behaviors in the long term. Some studies have suggested that SSRI’s can potentiate suicidal risk. However, the combination of medication management and psychotherapy appears to be an effective treatment protocol for anxiety and depression.

The Columbia Counseling Center’s integrated treatment plans coordinate psychotherapeutic interventions, diagnostic evaluations and psychiatric treatment to provide state-of-the-art effective treatment plans -all within the confidential and caring atmosphere of the Center.  Coordination of care within one practice means that each child has a team of experienced doctors who are taking care of them and their families.  Call us today (410 992 9149) for your first appointment

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