Depressed Like You: The Myth of Teen Angst

From a distance depression can seem like no big deal. After all, who doesn’t feel a little down in the dumps sometimes? But depression in America is a big deal and it’s projected to become an even bigger and more serious issue in the next two decades. The World Health Organization believes depression will be the most prevalent disorder in the Western world by the year 2020. Ominous statistics like these have caught the attention of researchers and led to a surge in the scientific study of depression

Much of the research that has been done on depression has not focused on adults, but on teenagers, and with good reason. According to research presented by the National Institute of Mental Health, one out of every 17 Americans struggles with a serious mental illness like depression. But what’s even more surprising is the recent discovery that one half of these Americans begin to exhibit symptoms by age of 14. Understanding the teenage brain, how it develops, and how depression affects it can help doctors, therapists, and family members stop teenage depression before it starts.

Are Teen Angst and Depression the Same?
Most parents expect to see their children become a little moody, sullen, or rebellious-what many people think of as “teen angst”-when they hit the big “one-three,” but new studies about adolescent depression shed a different light on old stereotypes. An extensive research project conducted by the Oregon Research Institute suggests that teenage depression is no different from adult depression. Researchers followed 1709 adolescents with major depressive disorder as they entered adulthood and found that, for most, the major depressive disorder continued.

Additionally, there were no major differences in symptoms or in symptom prevalence between teenagers and young adults. The Oregon Research Institute study did discover a few minor differences, however: Teenagers are less likely to complain of symptoms like fatigue, agitation, and poor appetite while young adults are more likely to complain about weight loss and insomnia.

The research conducted in Oregon is complemented by another study focusing on the treatment of adolescent depression. Researchers at the University of Texas, Southwestern found that the combination of cognitive behavioral therapy and switching to a new medication helped teenage patients who were not responding to their current medication. This result fascinated researchers because it was no different than the result of a similar study previously conducted with adult patients at UT-Southwestern. Dr. Emslie, one of the study’s principal investigators, explained the importance of these findings, “One major question of psychiatrists is whether depression is different in adolescence. This research suggests this disease is present in adolescence and very similar to what happens in adulthood. It’s important to identify and treat depression early.”

It’s clear that researchers like Dr. Emslie have a real reason to continually stress the importance of taking teenage depression seriously: eighty percent of teenagers suffering from depression do not receive adequate treatment. When left untreated, adolescent problems become adult problems: According to a study published in the American Journal of Psychiatry, half of the adolescents studied experienced some type depression again as young adults and another quarter were free from depression, but struggled with non-mood related disorders like drug and alcohol abuse. Only a quarter of the teenagers with untreated depression remained completely free from the illness as young adults.

While this research is troubling, other research suggests that the majority of teenagers who experience depression do not continue to experience the disorder as adults. A study conducted by researchers at UCLA Health Sciences found that sixty percent of teenagers who were depressed at age fifteen were not depressed at age twenty. This study takes a look at the many elements of depression and the many factors that affect individual experience of the illness. Simply struggling with depression as a teenager is not a guarantee that one will struggle with it as an adult; instead, many other issues come into play. For example, teenagers who are depressed at age 15 and have trouble maintaining normal social relationships are more likely to be depressed at age 20 than teenagers who are just depressed earlier in their lives. The study also found that women who are depressed at 15 are more likely to experience depression again at 20 than are men in the same situation.

Depression and Differences in the Teenaged Brain
Although adolescent depression may not differ significantly from adult depression, the adolescent brain is different from the adult brain and it seems possible that these differences may affect teenagers and their responses to depression. The National Institute on Mental Health recently released the results of their Longitudinal Brain Imaging Project. This project found significant differences between the teenage brain and the brains of children and adults. For example, the brain’s gray matter stops increasing in volume during adolescence and begins the slow decline that will happen through out adulthood. Dr. Giedd of the NIMH explains, “Adolescence is a time of substantial neurobiological and behavioral change, but the teen brain is not a broken or defective adult brain…these changes and the enormous plasticity of the teen brain make adolescence a time of great risk ad great opportunity.”

The structural changes cited by this study are associated with accompanying behaviors like increased risk taking and sensation seeking. Another study done by the NIMH suggests that the normal adolescent brain shows less activity in regions responsible for decision making, higher thinking, and the processing of reward related input. The study suggests that less activity in these brain regions may be responsible for risky behavior in teenagers.

The teenage propensity for risk taking and poor decision making can turn untreated depression into a dangerous game. A study released by researchers at the White House Office of National Drug Control Policy suggests that while the percentage of depressed teenagers is equal to the percentage of depressed adults, depressed teenagers are more likely to self-medicate with marijuana. Also, depressed teenagers are almost twice as likely as their non-depressed peers to use illicit drugs and more than twice as likely to become dependant on marijuana. The study also suggested that the use of drugs like marijuana can make depression worse.

All of this research serves to highlight the need for treatment of adolescent depression. In many cases depression is not just a phase, and in every case, it deserves to be taken seriously. If a teenager you know seems to be struggling with depression, encourage them to get help. The harder we work to solve the problems of adolescent depression, the happier we’ll all be-now and in the future.

References:

Adolescent Brains Show Lower Activity in Areas that Control Risky Choices. (2007, March 15.) Science Update, Nation Institute of Mental Health. http://www.nimh.mih.gov/science-news/2007/adolescent-brains-show-lower-activity-in-areas-that-control-risky-choices.shtml.

American Psychiatric Association (2000, September 26). Vast Majority of Depressed Teens Do Not Get Needed Psychiatric Treatment. ScienceDaily. Retrieved September 22, 2008, from http://www.sciencedaily.com/releases/2000/09/000926072448.htm.

Elsevier Health Sciences (2008, March 30). Teenager Risk-taking: Teenager Brains Really Are Different From Child or Adult Brains. ScienceDaily. Retrieved September 22, 2008, from http://www.sciencedaily.com/releases/2008/03/080328112127.htm.

Lewinsohn, Peter M., Seeley, John R., Pettit, Jeremy W., & Joiner, Thomas E. (2003). The Symptomatic Expression of Major Depressive Disorder in Adolescents and Young Adults. Journal of Abnormal Psychology, 112 (2), 244-252.

Transformative Neurodevelopmental Research in Mental Illness: Report of the National Advisory Mental Health Council’s Workgroup. (2007) http://www.nimh.nih.gov/about/ advisory-boards-and-groups/namhc/neurodevelopment_workgroup_report.pdf.

University of California – Los Angeles Health Sciences (2005, May 27). Teenage Depression Can Be Enduring, But Is More Often Short Lived. ScienceDaily. Retrieved September 22, 2008, from http://sciencedaily.com/releases/2005/05/050527235940.htm.

US National Drug Control Policy (2008, May 10). Teen ‘Self Medication’ For Depression Leads to More Serious Mental Illness, New Report Reveals. ScienceDaily. Retrieved September 22, 2008, from http://www.sciencedaily,com/releases/2008/05/080509105348.htm.

UT Southwester Medical Center (2008, February 28). Depressed Teens More Likely To Get Better With Switch To Combination Therapy. ScienceDaily. Retrieved September 22, 2008, from http://www.sciencedaily.com/releases/2008/02/080226162906.htm

VIB, Flanders Interuniversity of Biotechnology (2006, March 18). Researchers Lift A Corner of the Veil of Depression. ScienceDaily. Retrieved September 22, 2008, from http://www.sciencedaily.com/releases/2006/03/060318232853.htm.

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