Depression in Children and Adolescents Fact Sheet
9 years ago
About 11 percent of adolescents have a depressive disorder
by age 18 according to the National Comorbidity Survey-Adolescent Supplement
(NCS-A). Girls are more likely than boys to experience depression. The risk for
depression increases as a child gets older. According to the World Health
Organization, major depressive disorder is the leading cause of disability
among Americans age 15 to 44.
Because normal behaviors vary from one childhood stage to
another, it can be difficult to tell whether a child who shows changes in
behavior is just going through a temporary “phase” or is suffering from
depression.
YESTERDAY
·
People believed that children could not get
depression. Teens with depression were often dismissed as being moody or
difficult.
·
It wasn’t known that having depression can
increase a person’s risk for heart disease, diabetes, and other diseases.
·
Today’s most commonly used type of
antidepressant medications did not exist. Selective serotonin reuptake
inhibitors (SSRIs) resulted from the work of the late Nobel Laureate and NIH
researcher Julius Axelrod, who defined the action of brain chemicals
(neurotransmitters) in mood disorders.
TODAY
·
We now know that youth who have depression may
show signs that are slightly different from the typical adult symptoms of
depression. Children who are depressed may complain of feeling sick, refuse to
go to school, cling to a parent or caregiver, or worry excessively that a
parent may die. Older children and teens may sulk, get into trouble at school,
be negative or grouchy, or feel misunderstood.
·
Findings from NIMH-funded, large-scale
effectiveness trials are helping doctors and their patients make better
individual treatment decisions. For example, the Treatment for Adolescents with
Depression Study (TADS) found that a combination treatment of medication and
psychotherapy works best for most teens with depression.
·
The Treatment of SSRI-resistant Depression in
Adolescents (TORDIA) study found that teens who did not respond to a first
antidepressant medication are more likely to get better if they switch to a
treatment that includes both medication and psychotherapy.
·
The Treatment of Adolescent Suicide Attempters
(TASA) study found that a new treatment approach that includes medication plus
a specialized psychotherapy designed specifically to reduce suicidal thinking
and behavior may reduce suicide attempts in severely depressed teens.
·
Depressed teens with coexisting disorders such
as substance abuse problems are less likely to respond to treatment for
depression. Studies focusing on conditions that frequently co-occur and how
they affect one another may lead to more targeted screening tools and
interventions.
·
With medication, psychotherapy, or combined
treatment, most youth with depression can be effectively treated. Youth are
more likely to respond to treatment if they receive it early in the course of
their illness.
·
Although antidepressants are generally safe, the
U.S. Food and Drug Administration has placed a “black box” warning label—the
most serious type of warning—on all antidepressant medications. The warning
says there is an increased risk of suicidal thinking or attempts in youth
taking antidepressants. Youth and young adults should be closely monitored
especially during initial weeks of treatment.
·
Studies focusing on depression in teens and
children are pinpointing factors that appear to influence risk, treatment response,
and recovery. Given the chronic nature of depression, effective intervention
early in life may help reduce future burden and disability.
·
Multi-generational studies have revealed a link
between depression that runs in families and changes in brain structure and
function, some of which may precede the onset of depression. This research is
helping to identify biomarkers and other early indicators that may lead to
better treatment or prevention.
·
Advanced brain imaging techniques are helping
scientists identify specific brain circuits that are involved in depression and
yielding new ways to study the effectiveness of treatments.
TOMORROW
·
Years of basic research are now showing promise
for the first new generation of antidepressant medications in 2 decades, with a
goal of relieving depression in hours, rather than weeks. Such a potential
breakthrough could reduce the rate of suicide, which is consistently one of the
leading causes of death for young people. In 2007—the most recent year for
which we have statistics—it was the third leading cause of death for youth ages
15 to 24.
·
Research on novel treatment delivery approaches,
such as telemedicine (providing services over satellite, Internet, phone, or
other remote connections) and collaborative or team-based care in medical care
settings will improve the quality of mental health care for youth.
·
Sophisticated gene studies have suggested common
roots between depression and possibly other mental disorders. In addition to
identifying how and where in the brain illnesses start before symptoms develop,
these findings have also encouraged a new way of thinking about and
categorizing mental illnesses. In this light, NIMH has embarked on a long-term
project—called the Research Domain Criteria (RDoC) project— aimed at ultimately
improving the treatment and prevention of depression by studying the
classification of mental illnesses, based on genetics and neuroscience in
addition to clinical observation.
National Institute of Mental Health Science Writing,
Press & Dissemination Branch 6001 Executive Boulevard Room 8184, MSC 9663
Bethesda, MD 20892-9663 Phone: 301-443-4513 or 1-866-615-NIMH (6464) toll-free
TTY: 301-443-8431 or 1-866-415-8051 toll-free FAX: 301-443-4279 E-mail: [email protected]
Website: http://www.nimh.nih.gov