Moody Teen

FAMILY MEDICINE® COLUMN

By John C. Wolf, D.O.Associate Professor of Family Medicine Ohio University College of Osteopathic Medicine

IS SHE DEPRESSED, OR IS IT JUST NORMAL TEENAGE MOOD SWINGS?

Question: My 15-year-old daughter is moody all the time. She is often cross with me, and she shuts herself into her room. I don't know if she is depressed or just a teenager. How can I tell?

Answer: Your question is a fitting topic to discuss at this time because the theme for National Osteopathic Medicine Week (November 12-18) is "Girls to Young Women 12 - 24." And, females of all ages are about twice as likely to suffer from depression than are males.

Adolescent years are times of significant physical, emotional and social changes. The associated emotional stresses often result in brief periods of melancholy. These periods of "teenage blues" often coincide with events such as breaking up with a boyfriend or girlfriend. At other times, however, they happen without an obvious cause. The important characteristic that distinguishes these spells from depression is the duration of symptoms. Feeling "blue" only lasts a few days while depression typically last for more than two weeks.

Depression is a serious illness that strikes individuals of any age. There are two basic types of depression. One is a condition where the person is in an almost constantly sad mood. The other type of depression is called "manic depression" and those with this condition have periods of feeling "high as a kite" and then may also have periods of feeling as "low as Death Valley." Doctors often refer to this condition as bipolar disorder. During the manic phase, these people have difficulty concentrating on any activity for more than a few moments, and their judgment is impaired. They typically have an unrealistic assessment of their abilities, thinking that they can do things that they really can't accomplish. They also often exhibit irritability and have problems with school, money, sex or drugs. During the depressive phase of their illness, these people experience all of the symptoms of a major depression.

A person in the midst of a major depression, feels sad, guilty and worthless. He or she can be irritable, with frequent bouts of anger and or sadness. This causes problems at school, work or home. Most sufferers also experience a change -- either an increase or a decrease -- in how much they eat and how long they sleep. Withdrawal from usual activities, such as association with friends, is common, too. The sufferer may even talk about death or consider suicide.

About 4 percent of teens have clinical depression, including bipolar disorder. Since most teens have brief spells of being sad, rebellious and effervescently happy, it can be difficult to determine if your child is one of the 4 percent needing special care. The most important factors are the severity and persistence of symptoms. Fortunately, the typical emotional swings of a teenager are brief episodes, while clinical depression lasts for two weeks or longer. The severity of the symptoms is also greater in depression.

Adolescents with depression are similar to other age groups with this illness. They respond very nicely to counseling, antidepressant medicine or, preferably, a combination of both. Most show improvement in as little as two weeks. Typically, however, it takes four weeks or more to get back to "normal."

"Family Medicine" is a weekly column.

To submit questions, write to: John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.

Past columns are available online at http://www.FamilyMedicineNews.org.