So how can the physician determine when a patient should be diagnosed as
depressed or suicidal? Brown (1996) suggested the best way to diagnose is to
"screen out the vulnerable groups of children and adolescents for the risk
factors of suicide and then refer them for treatment." Some of these
"risk factors" include verbal signs of suicide within the last three
months, prior attempts at suicide, indication of severe mood problems, or
excessive alcohol and substance abuse. Many physicians tend to think of
depression as an illness of adulthood. In fact, Brown (1996) stated that
"it was only in the 1980's that mood disorders in children were included in
the category of diagnosed psychiatric illnesses." In actuality, 7-14% of
children will experience an episode of major depression before the age of 15. An
average of 20-30% of adult bipolar patients report having their first episode
before the age of 20. In a sampling of 100,000 adolescents, two to three
thousand will have mood disorders out of which 8-10 will commit suicide (Brown,
1996). Blackman (1995) remarked that the suicide rate for adolescents has
increased more than 200% over the last decade. Brown (1996) added that an
estimated 2,000 teenagers per year commit suicide in the United States, making
it the leading cause of death after accidents and homicide. Blackman (1995)
stated that it is not uncommon for young people to be preoccupied with issues of
mortality and to contemplate the effect their death would have on close family
and friends. Once it has been determined that the adolescent has the disease of
depression, what can be done about it? Blackman (1995) has suggested two main
avenues to treatment: "psychotherapy and medication." The majority of
the cases of adolescent depression are mild and can be dealt with through
several psychotherapy sessions with intense listening, advice and encouragement.
Comorbidity is not unusual in teenagers, and possible pathology, including
anxiety, obsessive-compulsive disorder, learning disability or attention deficit
hyperactive disorder, should be searched for and treated, if present (Blackman,
1995). For the more severe cases of depression, especially those with constant
symptoms, medication may be necessary and without pharmaceutical treatment,
depressive conditions could escalate and become fatal. Brown (1996) added that
regardless of the type of treatment chosen, "it is important for children
suffering from mood disorders to receive prompt treatment because early onset
places children at a greater risk for multiple episodes of depression throughout
their life span." Until recently, adolescent depression has been largely
ignored by health professionals but now several means of diagnosis and treatment
exist. Although most teenagers can successfully climb the mountain of emotional
and psychological obstacles that lie in their paths, there are some who find
themselves overwhelmed and full of stress. How can parents and friends help out
these troubled teens? And what can these teens do about their constant and
intense sad moods? With the help of teachers, school counselors, mental health
professionals, parents, and other caring adults, the severity of a teen's
depression can not only be accurately evaluated, but plans can be made to
improve his or her well-being and ability to fully engage life.