From The Orange County Register
By Jill Hamilton Contributing Writer
My brilliant and hilarious 14-year-old daughter, M, is depressed, clinically so. She started showing signs a year or two ago. But even though I am well-acquainted with depression and am quick to send people off to get meds (“It’s like having diabetes! Just treat it!”), I haven’t handled M’s situation correctly.
Part of it was not taking it seriously enough – depression runs in our family, she’s a creative type and, well, she’s in middle school. Who wouldn’t be depressed? Also, and I hate to admit this, I was hoping it might just wear off.
And even though I found the wherewithal to get help for her, it hasn’t been the straightforward path I expected.
I talked to Orange County experts on teen depression to figure out a better way to handle it. Here’s what I learned:
There’s a difference between depression and just being a sullen teen: “We’re all going to have ups and downs, but it depends on how severe and how frequent these symptoms get,” said Dr. Sina Safahieh, a child and adolescent psychiatrist on staff at Children’s Hospital of Orange County.
Safahieh lists the symptoms: depressed mood for more than two weeks; decreased or increased appetite and/or sleep; decreased energy or concentration; increased self-doubt and negative thinking.
I “knew” all this, but somehow hearing Safahieh tick off the symptoms so matter-of-factly made me get it. These were indeed the symptoms, and my daughter had them. Hers wasn’t a nebulous situation – it was pretty clear. This was something I needed to accept.
If your child expresses any suicidal thoughts, you need to get help immediately: “Any time any person, adult or child, has thoughts, intentions or plans to hurt themselves, it’s a sign of a much more severe depression that probably needs not only medical management but possibly an inpatient hospitalization, depending on how severe it is,” Safahieh said.
Take it seriously.
You don’t need to just “get help,” you need to get the right help: I first took M to a kindly therapist whom her sister had just started seeing. (Yes, two depressed children – the genes around here are not good that way.) The therapist prescribed cheery affirmations to both. My oldest daughter plastered her walls with them and – what do you know? – she felt better. A lot better.
But M was not so sold. She fights her darkness via a killer sense of humor. She wrote a parody song of one of those “Yay Me!” kind of ditties but called it “I Hate Me Just The Way I Am!” It was hilarious, a jaunty little tune with dark-as-night lyrics. Writing it cheered her tremendously. She told her therapist about it, and the therapist blanched, probably making a mental note to call social services STAT. She just didn’t get M. We pulled M out of therapy … and that’s OK.
“If you’ve seen a therapist for about a month and there’s not much of a connection, it may be a good idea to find someone else. We want effective results. It’s not going to happen overnight, but there does need to be progress,” Safahieh said.
Your child might need medicine: Despite the fact that both her father and I have been tremendously helped by meds for our respective depressions (yes, us too), I’ve been resistant to medicate M because, well, she’s still a kid.
But Dr. Shivani Chopra, a board-certified child and adolescent psychiatrist and founder of Premier Mind Institute in Newport Beach, said medication can be a safe, sensible route.
“A lot of our literature supports a combination of therapy and medications having the most beneficial outcomes,” Chopra said. “Of course, it varies because everyone’s different, and it depends on how severe their situation is.”
Chopra said SSRIs – selective serotonin reuptake inhibitors, particularly Prozac – are the first line of defense for teens. This is good news for M, who has wished aloud for some “Lexapro Jr.” Preferably chewable.
Medication isn’t necessarily a life sentence: “I’ve started teens on medication, then pulled them off, and many of them are still doing great,” Chopra said. “I look at medications as a way to allow therapy to be more effective. They’re learning a lot of techniques in therapy, so when we do pull them off medications, they’re able to use the coping skills to work through it. Sometimes we need to put them back on meds, but I’ve watched a lot of adolescents come off and stay off meds for a long time.”
There are promising advances with kids and depression: Safahieh uses a gene-mapping test that analyzes a patient’s saliva to determine which medicine is most likely to be effective. Other practitioners are trying transcranial magnetic stimulation, or TMS, which uses magnetic fields to stimulate nerve cells in the brain.
Jill Hamilton is the mother of two teenage girls and lives in Long Beach.
