Teen Depression
Dr. Carol Glod
What advice do you have for parents or friends trying
to help a teen?
The most important thing is to get help. Get an evaluation from a professional
who understands depression and the other psychiatric orders. After the evaluation,
you can make a decision about what to do.
Do not blame yourself or blame the family. It is a very common notion to
think, "I did something wrong," but it is not a result of bad parenting.
If the child has diabetes, or mononucleosis, we don't say, "Well the
parents weren't there to take care of them," or "The parents did
something bad to them." It is the same with depression.
What challenges do you face in treating teens?
The first challenge is getting teenagers to self-identify, plus getting schools,
parents, and everybody else to recognize this illness. The second challenge
is finding the right treatment that will help. The third challenge is getting
teens to stick with treatment long enough to see the benefits. Sometimes treatments,
either counseling or medications, take a while to work. Finally, once teens
do respond to treatment, we need to decide how long treatment should last.
Usually, they need to stay with treatment at least for a few months, sometimes
a year, and sometimes longer.
Which is better: talk therapy or medication for teen
depression?
It all depends on the case. Generally, if it is a first episode of depression
(not too severe -- they are not suicidal) and there is an issue such as divorce
in the family, then a course of psychotherapy for six to twelve weeks is recommended.
However, we usually see teens that have had depression for months, if not
years, have not tried therapy, or have tried therapy that didn't work. At
this point, they may have developed other disorders, or are into drugs and
alcohol.
Depression is different in each individual and there are varying degrees
of severity. Most often we recommend two forms of treatment: psychotherapy
individually or in a group setting of teens, along with medication.
What studies are you conducting into teen depression?
We have two main
studies. The first is a clinical treatment trial comparing two antidepressants
to a placebo (an inactive sugar pill).
The second study looks at the brains of children and teens, ages twelve to
nineteen, who have depression, using MRI imaging studies. Ideally, down the
road, this will help us predict who will respond to which treatment based
on how their brain functions.
What is the benefit to the patient?
One of the benefits is they get a free evaluation. We screen for all of the
psychiatric disorders, including bipolar disorder, schizophrenia, attention
deficit disorder, anxiety, and alcohol or substance abuse. But the main benefit
is for them to help us understand more about the treatment of medications
in teenage depression so we can help other teens. Hopefully we can tailor-make
treatment down the road. Participants also get paid in both studies.
Can it be dangerous for a teen to participate
in a clinical study?
We exclude teens that should not be in a study. If somebody has psychotic
symptoms --for instance, they are hallucinating, or they have delusions --
or if they are actively abusing drugs, they can't be in the study. If they
are clearly bipolar, with manic and depressive episodes, we exclude them.
If they are seriously suicidal or in imminent need of help, we exclude them.
We don't want to risk that they might not get a treatment that works for them.
Which types of teens are most interested in participating
in studies?
I think that there are two types of people. Some people are interested in
science and believe in research. Some really want to help other teens that
have depression. They say, "Well I don't know if this is going to help
me, but I'll do it if it can help other people." Since September 11,
teens are looking for ways that they can help other people.
