Mood swings, distractibility, sleeping until noon: These conditions come with the territory of being a teen. In some cases, though, they can be signs of something more serious. A recent national report found that rates of major depressive episodes among teens have risen in recent years, and many of those affected are not receiving treatment.
The September report from the Substance Abuse and Mental Health Services Administration found that in 2014, 11.4 percent of kids ages 12-17 had experienced a major depressive episode during the previous year. This percentage was somewhat higher than at any other time since 2004, the first year the data was collected. Rates for previous years ranged from 7.9 to 10.7 in 2013.
“It’s a real concern that high numbers of young people are experiencing major depressive episodes, whether the figure is 8, 9, or 11 percent,” said Gary Blau, chief of SAMHSA’s child, adolescent, and family branch. “When you look at why this is happening and what some of the factors may be, we only need to look at today’s world and the amount of pressures teenagers face : Bullying, issues of belonging, academic pressures . . . these factors can lead to enormous stress.”
The report was based on survey data from a nationally representative sample of more than 17,000 12- to 17-year-olds. Teens met the criteria for a major depressive episode if they had felt depressed or lost interest or pleasure in daily activities for a period of two weeks or longer, and had experienced additional symptoms such as low self-worth or trouble eating, sleeping, or concentrating.
Nearly three-quarters of the teens meeting the criteria reported severe impairment in a key area of their lives, such as school, social life, or relationships with family members. Girls were three times as likely as boys to have had a depressive episode — 17.3 percent vs. 5.7 percent. Biological differences and societal pressures may play a role in this, Blau said, as might a greater tendency among girls to discuss feelings.
One-third of teens who had experienced a major depressive episode during the past year had also used illicit drugs in that time frame, compared with15.2 percent of nondepressed teens. Teens who had been depressed were also somewhat more likely to smoke cigarettes daily (1.6 percent vs. 1.1 percent) and to have drunk heavily within the past month (1.8 percent vs. 0.9 percent).
A minority of teens meeting the criteria for a major depressive episode — 41.2 percent — received treatment. Fear of discrimination, cost, and lack of access are likely to prevent some who could benefit from treatment from seeking help, Blau said. Among SAMHSA’s initiatives, he noted, is working on telepsychiatry programs that could improve access to mental health services, particularly in remote areas.
“It’s also important for people to know that they are not alone, and that it’s OK to talk about [depression] and seek help,” Blau said. “There are practices out there, such as cognitive behavioral therapy, that have been proven to work. Treatment can help people get better.”
Parents, of course, can play an important role. Parents should check in if they notice certain changes in their kids, said Dr. Steven Schlozman, a child psychiatrist and associate director of The Clay Center for Young Healthy Minds at Massachusetts General Hospital.
“Parents might feel uncomfortable asking things like ‘You don’t seem to be yourself, is everything OK?,’ particularly when sullenness at times is a normal part of development,” he said. “But if you see a corresponding behavior such as loss of interest in things they previously enjoyed, you don’t want to let it pass. Check in and say you’ve noticed the change.”
Seeing a pediatrician can be a good first step for diagnosing depression and getting treatment, Schlozman added. Through the Massachusetts Child Psychiatry Access Project, a statewide program, primary-care doctors can connect with child psychiatrists and other specialists to get help in diagnosing and treating mental health conditions. Pediatricians can get advice on steps to take, or they can refer children for a mental health consultation.
Ami Albernaz can be reached at ami.albernaz@gmail