Lesson 6 of 7  - learn to parent effectively

Personality disorders among young adults

Two Research Studies
on Teen Depression

Evidence that U.S. families
aren't working well

The Web address of this article is http://sfhelp.org/parent/news/teen_depression.htm

Updated  04-21-2015

      Clicking underlined links here will open a new window. Other links will open  an informational popup, so please turn off your browser's popup blocker or allow popups from this nonprofit Web site. If your playback device doesn't support Javascript, the popups may not display. Follow underlined links after finishing this article to avoid getting lost.

      These globally-published research summaries on teen depression may mislead and misinform casual readers. Their main message is accurate - that millions of teenagers are "depressed," and need help. This supports the main premises in Lesson 1 in this nonprofit Web site.

      For perspective on depression, see this brief YouTube video. It mentions eight lessons in this self-improvement Web site: I've simplified that to seven.

      See my comments after the two summaries. The links and hilights are mine. - Peter Gerlach, MSW

+ + +

Panel advises depression screening for U.S. teens
The Oregonian - OregonLive.com via The Associated Press 3-29-09

An influential government-appointed medical panel is urging doctors to routinely screen all American teens for depression -- a bold step that acknowledges that nearly 2 million teens are affected by this debilitating condition.

Most are undiagnosed and untreated, said the panel, the U.S. Preventive Services Task Force, which sets guidelines for doctors on a host of health issues.

The task force recommendations appear in April's issue of the journal Pediatrics. And they go farther than the American Academy of Pediatrics' own guidance for teen depression screening.

An estimated 6 percent of U.S. teenagers are clinically depressed. Evidence shows that detailed but simple questionnaires can accurately diagnose depression in primary-care settings such as a pediatrician's office.

The task force said that when followed by treatment, including psychotherapy, screening can help improve symptoms and help kids cope. Because depression can lead to persistent sadness, social isolation, school problems and even suicide, screening to treat it early is crucial, the panel said.

The task force is an independent panel of experts convened by the federal government to establish guidelines for treatment in primary-care. Its new guidance goes beyond the pediatrics academy, which advises pediatricians to ask teen patients questions about depression. Other doctor groups advise screening only high-risk youngsters.

Because depression is so common, "you will miss a lot if you only screen high-risk groups," said Dr. Ned Calonge, task force chairman and chief medical officer for Colorado's Department of Public Health and Environment.

The group recommends research-tested screening tests even for kids without symptoms. It cited two questionnaires that focus on depression tip-offs, such as mood, anxiety, appetite and substance abuse.

Calonge stressed that the panel does not want its advice to lead to drug treatment alone, particularly anti-depressants that have been linked with increased risks for suicidal thoughts. Routine depression testing should only occur if psychotherapy is also readily available, the panel said. Calonge said screening once yearly likely would be enough.

The recommendations come at a pivotal time for treatment of depression and other mental health problems in children.

Recently passed federal mental health equity legislation mandates equal coverage for mental and physical ailments in insurance plans offering both. The law is expected to prompt many more adults and children to seek mental health care.

Yet at the same time psychiatrists specializing in treating children and teens are scarce. A separate report, also released Monday in the Pediatrics journal, says primary care doctors including pediatricians and family physicians will need to get more involved in mental health care.

That report is from the pediatrics academy and the American Academy of Child and Adolescent Psychiatry. The groups say pediatricians should routinely consult with child psychiatrists, including working in the same office when possible. And it says insurers should compensate pediatricians for any mental health services they provide.

Dr. Alan Axelson, a Pittsburgh psychiatrist who co-authored the second report, praised the task force recommendations and said pediatricians can play a key role.

Because children's families often get to know their pediatricians, having those doctors offer mental health screening can help make it seem less stigmatizing, Axelson said.

Most pediatricians aren't trained to do psychotherapy, but they can prescribe depression medication and monitor patients they've referred to others for therapy, he said.

Dr. Ted Epperly, president of the American Academy of Family Physicians, said his group strongly supports both Pediatrics reports.

While primary care doctors have full plates just dealing with physical ailments, many recognize the importance of providing mental health services -- and many already do, Epperly said.

It isn't always as time-consuming as it might seem; some screening questionnaires can be filled out by patients in the waiting room, Epperly said. Doctors can easily spot any red flags.

-- The Associated Press / 2009 Oregon Live LLC. All Rights Reserved.

+ + +

TV and video games increase
 teen depression risk: study

2/2/09 AFP via Yahoo News

WASHINGTON (AFP) Spending more hours watching television or playing video games as a teenager may lead to depression in young adults, according to a study published Monday.

Researchers looked at the exposure to electronic media of 4,142 adolescents who were not depressed when the study began in 1995, before DVDs and the Internet were widely used.

The teens reported an average of 5.68 hours of media exposure per day, including 2.3 hours of television, 2.34 hours of radio, 0.62 hours of videocassettes and 0.41 hours of computer games.

Seven years later, when the participants were an average of 21.8 years old, 308 of them (7.4 percent) had developed symptoms consistent with depression.

"In the fully adjusted models, participants had significantly greater odds of developing depression by follow-up for each hour of daily television viewed," wrote the authors of the study published in the Archives of General Psychiatry journal.

"In addition, those reporting higher total media exposure had significantly greater odds of developing depression for each additional hour of daily use," said the study, led by Brian Primack of the University of Pittsburgh School of Medicine.

Young women were found to be less likely to develop symptoms of depression than young men when exposed to the same amount of electronic media.

Depression, the leading cause of non-fatal disability worldwide, commonly begins in adolescence or young adulthood, the article explained.

The authors noted that time spent engaging with electronic media may replace time that could be spent on social, athletic or intellectual activities that could guard against depression.

Messages transmitted through electronic media may encourage aggression, inspire fear or anxiety and hamper identity development, they added.

Being exposed to media at night may also disrupt sleep important for emotional and cognitive development.

"When high amounts of television or total exposure are present, a broader assessment of the adolescent's psychosocial functioning may be appropriate, including screening for current depressive symptoms and for the presence of additional risk factors," the authors said.

"If no other immediate intervention is indicated, encouraging patients to participate in activities that promote a sense of mastery and social connection may promote the development of protective factors against depression."

Copyright 2009 Agence France Presse. Copyright 2009 Yahoo! Inc. All rights reserved.


      These two research summaries are available to millions of global viewers via Yahoo. As a veteran family therapist, several things stand out to me about these reports:

  • Neither study defines "depression," which is a catchall label for a spectrum of human attitudes and behaviors ranging between mild and temporary to severe and chronic.

  • Neither study notes the possibility that some (or much?) "depression" is really grief. As a whole, our media and hi-tech culture ignores and denies the wholistic and social importance of healthy grief.

  • The first study makes no attempt to assess why two million American teens may be "depressed," but advocates that doctors should "screen for it" when "psychiatric help" is available.

  • Neither article suggests that the primary responsibility for preventing teen depression lies with the child's parents and relatives, not doctors or politicians.

  • Both reports imply that "depression" is an individual malady, rather than a symptom of family dysfunction. "Family therapy" is not mentioned in either report. This omission is demonstrates that reputable human-behavior researchers (and media editors) cling to the obsolete "medical model" of personal psychological problems.

  • Both studies quote doctors opinions, which implies depression is a "medical illness" rather than a psychological condition. This reinforces the public's belief that medication is an appropriate treatment for depression, rather than personal and family therapy.

  • Neither study comments on the long term personal and societal effects of teens who get no help for significant depression - e.g. how it may affect their ability to conceive and raise wholistically-healthy children.

Bottom line - these two reports are examples of media coverage that promotes public unawareness and ignorance about "mental health." The lack of an informed oversight body to screen the quality and accuracy of what is published on this topic puts news-consumers at risk of being misinformed. 

For more perspective, see this article  for media professionals, and this one on depression. Also see these related research summaries. - Peter K. Gerlach, MSW

This summary was very helpful  somewhat helpful  not helpful    

Share/Bookmark   Prior page  /  Lesson 6  /  Print page 


 site intro  /    course outline  /  site search  /  definitions  /  chat contact