Moody ... Or

The Register Guard (Eugene, OR), May 18, 2003 | Go to article overview

Moody ... Or


Byline: Karen McCowan The Register-Guard

CORRECTION (ran 5/19/03): Area teen-agers interested in participating in the national Treatment for Adolescents with Depression Study can call 346-4987. An incorrect phone number was listed in Sunday's paper.

Imagine the Hult Center's 2,500-seat Silva Concert Hall, completely full of area teens.

That's roughly how many will begin exhibiting signs of major depression this year. As many as 8.3 percent of adolescents - about 2,300 in Lane County alone - develop the debilitating disease annually, according to the National Institute for Mental Health. That's a 60 percent higher onset rate than among adults.

Picture a sold-out Mac Court.

Its 9,087 seats would be completely filled by the 1 in 5 local teens expected to endure an untreated episode of major depression by the time they turn 20, according to the NIMH.

Consider two full LTD buses, each with all 45 seats taken and an additional 15 passengers standing in the aisles.

That's how many Lane County teens will attempt suicide this year. Most do not succeed - of 120 attempts last year, only 5 deaths occurred. But as many as 7 percent of teens with major depressive disorders take their lives as young adults, according to NIMH data.

This may be because only a fifth of adolescents with major depression seek treatment, say UO researchers now involved in a national study of how best to treat teens with depression. And, of those who do seek treatment, only half get adequate care.

Thousands of local adolescents are at risk of long-term mental health problems - or suicide - due to underdiagnosis and undertreatment of the disease, the UO researchers say.

How can this be, in a culture awash with sunny ads for antidepressants? Maybe the problem begins with our understanding of the word "depression."

Teen-agers are famously moody. At one time or another, almost all of them fit depression's stereotypical definition: sadness; gloom; dejection.

But one episode of sadness does not a case of depression make, say Anne Simons and Paul Rohde. They are the principal investigators in a local study of depressed teens that is part of the national Treatment for Adolescents with Depression Study (TADS).

Teen depression includes a cluster of symptoms: extreme irritability, changes in sleep or appetite, inability to concentrate, low energy level, frequent complaints of head or stomach aches, excessive guilt, suicidal thoughts or behavior, and an inability to experience pleasure.

And the availability of antidepressants does not equal effective treatment, the pair say. Most depressed teens still get no treatment at all. Those who are prescribed medication typically get too little follow-up and dosage adjustment.

All of this is more than a temporary problem. It's increasingly clear that effectively managing teen depression is crucial to later well-being. And not just because one study found that 20 to 40 percent of adolescents with major depression go on to develop bipolar disorder within five years.

"There is probably no good time to be depressed, but adolescence is a particularly bad time," says Simons, a UO associate professor of psychology. "For one thing, having a depressive episode as a teen is a risk factor for a host of other problems: dropping out of school, lowered life-long earning potential, poor partner choice, early pregnancy, self-injury, sucide. As an adult, you can probably weather an episode of depression with relatively little lasting damage if you have a supportive partner and an understanding employer. As a teen-ager, you can flunk out of school or get pregnant in the time it takes to get through an episode."

The insidious illness can be particularly devastating for young people because they haven't yet developed a self concept, adds Rohde, a senior research scientist at the Oregon Research Institute. …

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