It is not uncommon for people to be sad. Many see it as just a bad day or a bump in the road and they snap out of it to resume their lives and leave the bump in the road behind. Some though, go from sadness to feelings of low self-esteem, pessimism, and hopelessness. Depression has no age, gender, and racial predilections, encompassing all age groups, both sexes, and all races (World Health Organization [WHO], 2009).
In teenagers, depression comes at a time when the identity crisis comes to the fore and decision-making becomes all-important in separating their identity from that of their parents (National Institute of Mental Health [NIMH], 2009). It is not a rare disorder. According to the World Health Organization, it is “a common mental disorder. ” People who suffer from depression usually think lowly of themselves, have feelings of guilt, and show little or no interest in those around them. They are unhappy and listless, feeling tired oftentimes. Eating and sleeping patterns are also altered (WHO, 2009).
Major depressive disorder (MDD), as defined in the DSM-IV-TR, is depression of at least 2 weeks with no instances of “manic, mixed, or hypomanic episodes. ” During the same period, the person may have difficulty doing his or her usual daily routine, unable to function. He or she may think of or attempt suicide (American Psychiatric Association, 2000). Thus, it is important to seek help for depression. Visiting the family doctor is a good start. He or she will be able to check whether the condition is caused by a medication being taken for another problem or it is because of a medical condition causing symptoms similar to depression.
If these are ruled out, then he or she will be able to refer the patient for further evaluation with a mental health professional (NIMH, 2009). Treatment for major depression includes medications (tricyclic antidepressants, selective serotonin reuptake inhibitors, and monoamine oxidase inhibitors) and psychotherapy. Another mode of treatment, electroconvulsive therapy delivers an electric current through the brain to set off a seizure. It improves the mood of those who are severely depressed or those who do not respond to treatment (MedlinePlus, 2009).
In an article by Paul Raeburn (2004( entitled “The Pill Paradox,” he stated that the medications used for treating depression are under fire due to concerns that the very drugs that should prevent suicide can actually cause them. In Britain, antidepressants, except Prozac, are prohibited for use in children. As for cognitive behavioral therapy, he mentioned that this had the same therapeutic outcome when compared to antidepressant medications. Interestingly enough, antidepressants and psychotherapy together was more effective (Raeburn, 2004).
Results from The Treatment for Adolescents with Depression Study (TADS) supported the observation. The study reported on the effectiveness of fluoxetine alone, cognitive behavioral therapy alone, and fluoxetine and cognitive behavioral therapy together, in teenagers (aged 12 to 17 years) suffering from MDD. It showed that although fluoxetine and cognitive behavioral therapy had the same outcome on improving the symptoms, those who were taking fluoxetine alone or in combination with psychotherapy improved faster than those who had cognitive behavioral therapy alone.
On the other hand, suicide ideation lingered and occurred more often in those on fluoxetine therapy alone. Thus, researchers concluded that combination therapy was the better treatment strategy as they complemented in terms of risks and benefits. Fluoxetine improved symptoms earlier and cognitive behavioral therapy decreased chances of suicide ideation (TADS, 2007). The greatest fear of anyone who has a loved one suffering from major depression is possibility of losing them to death by suicide.
Thus, at the end of the day, it is with this thought we push for newer advances, better studies, and more transparency from drug manufacturers. As Mr. Raeburn (2004) expressed in his article, he is just “making decision about my child’s care on the basis of conflicting reports. ” This was in 2004. More advances, more studies, and more transparency have become realities even if they have come at a snail’s pace.
REFERENCES American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders. Washington DC, American Psychiatric Association. National Institute of Mental Health (2009).
Depression. Washington, DC: National Institute of Mental Health. Retrieved from http://www. nimh. nih. gov/health/publications/depression/complete-index. shtml#pub9 Raeburn, P (2004, September). The Pill Paradox. Psychology Today 37(5). The TADS Team. The Treatment for Adolescents With Depression Study (TADS) Long-term Effectiveness and Safety Outcomes. Arch Gen Psychiatry. 2007;64(10):1132-1143. Vorvick, L (2008, December 15). Major Depression. Bethesda, Maryland: US National Library of Medicine. Retrieved from http://www. nlm. nih. gov/medlineplus/ency/article/000945. htm