Depression in adolescents is treated with medication. Depression in teenagers: how to recognize. What to do about teenage depression

Often adults perceive a bad mood in teenagers as a transitional age, regular whims. At one time, psychotherapists did not attach much importance to the topic of treating depression in adolescents, but the huge number of cases of suicide that children and adolescents have committed over the last period all over the world has forced us to reconsider this issue and study it in more detail. A study conducted by Australian researchers found that among 400 adolescents aged 10 to 14 years, ten percent had clinical depression, and about half were prone to depression in the future. What is depression in children and adolescents? Why does it occur and can it be prevented?

The period between the transition from childhood to adulthood is the most emotional and controversial. At this moment, the teenager is subject to various influences from the world around him; he can often become disappointed in friends, life situations, and people. His psyche is still very unstable and vulnerable. A profound restructuring of the body occurs - sexual maturation, which is characterized by an increase in the activity of the central nervous system and the development of the activity of the endocrine glands. At this moment, the processes of excitation in adolescents prevail over inhibition, as a result of which they often react inadequately to the comments of adults, peers, and surrounding events. All young people are subject to these changes, only the intensity of the process is different for each of them.

Depression in adolescents is a severe psychological disorder that is characterized by a sharp decline in mood, negative statements or intentions, emotional distress, and often thoughts of suicide. This psychological condition is considered a serious illness that adults must pay attention to, as it can lead to psychological disability or mortality. Depression in children and adolescents is quite common, but it is not always possible to recognize it in time. Between the ages of 11 and 16, children tend to withdraw into their own world, isolate themselves from family and friends, and be alone. Sometimes, in order to identify a serious problem in time, the basic attention of parents is not enough. Like any disease, depression has its own causes and symptoms, so the task of adults is to help the child in a timely manner and not to miss the onset of the development of the disease.

The main signs of depression in teenagers are:

irritability over trifles, anger, tearfulness, rudeness, malice;
worries, worries, anxiety, melancholy, restless sleep, loss of appetite;
fatigue, lack of strength, emptiness, apathy, decreased performance;
feeling of guilt, closedness, cessation of communication with friends, loved ones, desire to be alone;
problems with concentration, forgetfulness, irresponsibility, low self-esteem;
headaches, heart, stomach pains;
refusal or abuse of food;
insomnia at night and excessive activity during the day;
thoughts of death and suicide, which can also manifest themselves in creativity, drawings, statements, self-mutilation, and committing reckless acts that are unsafe for life;
consumption of alcohol, cigarettes, drugs, promiscuity.

Parents and teachers simply must pay attention to the symptoms of depression in teenagers. And if at least three points of signs of depression are observed in a child, it is important to direct your attention to this and contact a qualified specialist.

Depressive states in adolescents are also characterized by eczema, intestinal colic, anorexia, night cries, and enuresis. Such children are more likely to suffer from colds and infectious diseases. Adults should be wary of a teenager’s lack of a smile, a constantly melancholic expression on his face, frozen facial expressions, and crying for no reason. Children prone to depression may sit motionless for a long time and lie with their eyes open. It can sometimes be difficult to distinguish between capriciousness, bad character, and teenage rebellion. However, if a teenager’s bad mood does not leave him for several weeks, he needs to seek help, since the consequences of worsening the condition in depressed teenagers can be very dire: aggressive attacks, drug addiction, vagrancy, suicide attempts.

Causes of depression in teenagers

As a rule, depression does not arise out of nowhere. There are always certain factors that influenced its emergence and development. The main reasons that can trigger teenage depression include:

Hormonal changes in the body. As a result of the chemical processes occurring, a teenager may experience a state of anxiety, nervousness, and mood changes. Hormonal changes in the body in adolescents are considered to be the main cause of depression.
Rethinking the outside world, inconsistency of ideas about the real world, teenage maximalism, egocentrism and categoricalness.
Unfavorable family environment: quarrels in the family, divorce of parents, alcoholism, drug addiction, coldness and inattention of parents, illness and death of loved ones.
Problems with appearance and perception of oneself as an ugly duckling. It is especially pronounced in girls.
Social status and wealth. Often the cause of depression is the inability to dress beautifully, vacation abroad, or have a fashionable gadget.
Personal experiences: unrequited first love, separation from a loved one. The first sexual contacts can shock a teenager and cause disappointment. The lack of sex education leads to him making mistakes, and this affects his self-esteem and leads to isolation.
Failures in school life make a teenager deeply unhappy. Bad grades reduce a teenager's self-esteem and isolate him from his peers.
High demands from parents cause the child to fear punishment, feel guilty and worthless.
Heredity. If any of your relatives suffered from depression or other mental disorders.

Sometimes there can be several reasons, and together they only aggravate the situation. Children need friends, close people whom they can trust, open up and communicate with. In search of self-affirmation, a teenager finds solace in online communication on the Internet, which narrows his range of interests. The child hides from real life, which further aggravates his condition. Teenagers who were injured during childbirth, suffered from hypoxia, encephalopathy, intrauterine infection, are very sensitive to climate change, and are characterized by seasonal depression.

The role of parents in solving the problem

Most adults, faced with such a situation, in a panic ask themselves the following questions: depression in a child - what to do? How to help a teenager? The role of parents at this difficult stage for the child is simply invaluable. They must show maximum attention, tact, and caution, because the teenager’s future may depend on them. Parents should talk to teachers about the problem and during this period try to protect the child from ridicule, harsh criticism, and surround him with attention and care. It is very important to tell a teenager how much he is loved and appreciated, to communicate more with the child, not to leave him alone with his problems, to always be there, to support, to help the teenager, to become a true friend. However, there are situations when parents themselves are unable to cope with the current situation. How do you understand that the moment has come when you need to seek help from a specialist? There are certain signs that adults simply must pay attention to:

Isolation of a teenager from others, the desire to constantly be alone.
Visible signs of self-harm.
Obsession with the theme of death, the afterlife.
Refusal to eat for more than five days.
Aggression, conflicts, breaking the law, immoral behavior.
Progressive apathy towards everything that surrounds the teenager.

Between the ages of 10 and 12 years, depressed children tend to experience deteriorating health and eating and digestive disorders. They become withdrawn and lose interest in everything. From 12 to 14 years of age, children experience some inhibition, as a result of which they may begin to study worse and spend more time on the street. They develop a fear of being punished, anger, aggression, and protest arise. However, the most problematic period is considered to be the age from 14 to 19 years, when they begin to think about the meaning of life and their upcoming choice of profession. It is adults who should be there during this time period, suggest the right decision and act as advisers. Parents must provide emotional support, listen and hear their child, organize the correct daily routine, provide a nutritious balanced diet, and fill the teenager’s life with positive emotions. Love, patience and care can work real miracles.

Treatment of teenage depression

It is important to understand that depression is a serious illness that must be treated by specialists. There is no need to try to solve this problem yourself, especially if it has begun to become progressive. A depressive state destroys the fragile psyche of a teenager, so you shouldn’t hope that the problem will solve itself. A psychotherapist or psychiatrist will conduct the necessary tests, studies, analyze the expressed symptoms and prescribe the necessary treatment. The therapeutic program consists of the following components:

psychological tests, therapeutic studies, laboratory tests, neurological examination;
vitamins, antidepressants, hormones if necessary, immunocorrectors, painkillers and stimulants;
psychotherapeutic individual and group sessions.

With a mild form of depression, the teenager should remain in his usual routine, attend school, and do everyday activities. Treatment of severe cases of depression with suicide attempts occurs only in specialized institutions under constant supervision. Qualified specialists will prescribe the best treatment option, which will be aimed at getting out of depression. Sometimes a course of psychological consultations is enough to identify the main problems of a teenager, teach him to deal with negative thoughts and control himself. If the situation in the family is difficult, then such consultations are carried out separately with the teenager’s parents. If you have family members who have suffered from depression or any other disorder, it is important to tell your doctor.

To lift a teenager out of a deep depression, antidepressants are often prescribed. Any medications can be taken only as prescribed by a doctor to avoid negative consequences. The mechanism of their action is to equalize the amount of dopamine, serotonin and norepinephrine in the teenager’s body. The lack of these substances leads to the emergence and development of a depressive state. Treatment with antidepressants in adolescents has not yet been fully studied, so before you start taking them, you need to weigh everything carefully. These medications are unsafe for a young body, so the choice of drug and dose should be made only by qualified specialists. The fact is that it is necessary to take a teenager out of depression with the help of antidepressants very carefully, since in the first two months their use can increase the risk of suicide. Antidepressants also tend to have side effects in the form of sleep disturbances, increased fatigue, drowsiness, and addiction to them. Under no circumstances should you self-medicate! This is very dangerous for a teenager's health!

Patients should be closely monitored and treatment should be reconsidered if their condition worsens. In order to lift a teenager out of severe depression, the latest generation of antidepressants with a minimum number of negative side effects are successfully used: Pyrazidol, Azafen, Amitriptyline. Herbal sedatives and tranquilizers are also successfully used, such as Tenoten, Adaptol, tinctures of peony, motherwort, and valerian. The most successful way to treat depression in adolescents is a combined method, when psychotherapy is used together with medication.

Teenagers who are surrounded by attention from all sides and provided with support and acceptance, regardless of the situation, recover much faster from depression. A balanced diet, a healthy lifestyle, physical activity, walks in the fresh air, positive emotions, healthy relationships with family and friends, and doing favorite things guarantee a mild course of teenage depression. Teenagers can be brought out of a depressed state much faster if there is a positive atmosphere of love and mutual understanding in the family.

Adolescence is always an anxious time, with many physical, emotional, psychological and social changes accompanying their lives.

Unrealistic expectations can create a strong sense of rejection and can lead to deep disappointment. When things go wrong at school or at home, teens often overreact. Many young people believe that life is not fair. They feel confused. Even worse, teenagers are bombarded with conflicting messages from parents, friends, and society.

Today's teenagers see a lot of unnecessary things - on TV, at school, in magazines and on the Internet. They are also forced to learn about the threat of AIDS, even if they are not sexually active.

Teens need adult guidance more than ever to understand all the physical and emotional changes they are experiencing. When teens have mood problems, it may indicate serious emotional or mental health problems that need to be addressed. Perhaps they have teenage depression. Parents or their guardians must take action.

What to do about teenage depression

When teens feel like their mood is going down, there are ways they can manage their feelings to avoid serious depression:

Try making new friends. Healthy relationships with peers are central to teenagers.

Participate in sporting events, engage in interesting activities, or find a hobby.

Join organizations that offer programs for youth. Special programs are aimed at the needs of adolescents and provide assistance in developing additional interests.

Reach out to trusted adults for help.

But sometimes, despite all efforts, teenagers suffer from depression. Many factors can trigger this disorder. Research shows that some depressed people have too much or too little of certain substances in their brains. Additionally, a family history of these emotional problems may increase the risk of developing depression. Other factors that can lead to the disorder are difficult life events (such as death or divorce), side effects from certain medications, and negative thought patterns.

Signs of Teenage Depression

Teenage depression is common. Recent research shows that one in five teenagers suffer from mood disorders. This is a very serious problem that requires immediate, appropriate treatment.

Depression can be difficult to diagnose in teenagers, but some symptoms include:

These symptoms may indicate depression, especially when they persist for more than two weeks:

Poor performance at school

Leaving the circle of friends

Sadness and hopelessness

Lack of enthusiasm, energy and motivation

Anger and rage

Reaction to criticism

Low self-esteem or guilt

Indecision, lack of concentration

Anxiety and excitement

Changes in eating or sleeping

Substance abuse

Suicidal thoughts or actions

Teens may experiment with drugs or alcohol or become promiscuous to avoid feelings of depression. Adolescents may also express their feelings through hostile, aggressive, and risky behavior. But this behavior only leads to new problems.

Treatment of Teenage Depression

It is critical that depressed teens receive prompt, professional treatment.

Therapy can help teens understand why they are depressed and learn to cope with stressful situations. Depending on the situation, treatment may consist of individual consultations, group psychotherapy or family counseling. Medications that may be prescribed may be necessary to help teens feel better.

Some of the most common and effective treatments for depression in teenagers are:

Psychotherapy provides an opportunity to explore events and feelings that are painful and disturbing.

Cognitive behavioral therapy helps teens change negative patterns of thinking and behavior.

Interpersonal therapy focuses on how to develop healthy relationships at home and at school.

Medications relieve some symptoms of depression.

Depressed teenagers need to be supported and helped so that they take a big step towards recovery.

Facing the Risk of Teen Suicide

Sometimes teenagers feel so depressed that they feel there is no meaning to life. Every year, almost 5,000 young people, between the ages of 15 and 24, kill themselves. The suicide rate in this age group has nearly tripled since 1960.

Research shows that suicide attempts among young people may be based on long-term problems caused by a particular event. Suicidal teens may view a temporary situation as a permanent condition. Feelings of anger and resentment combined with exaggerated guilt can lead to impulsive, self-destructive behavior.

Warning Signs

Threats of suicide, direct and indirect

Obsession with death

Poems, essays and drawings that relate to death

Lately, Vera has become extremely unpredictable. Not only did she wear a short skirt and tights in the winter (beauty requires sacrifice), but before the exams she completely turned into a nervous and always irritated person - she was rude to teachers, quarreled with her peers, and when she realized that won't pass physics, attempted suicide. Friends got in the way...

It is known that the physical and mental state of adolescents develops especially intensively: the body changes, the emotions , there is a desire to prove to everyone that they are right, and under the influence of stress, the behavior of adolescents becomes extremely unpredictable.

According to scientists, teenage girls are 3 times more likely to suffer from depression than boys. It is believed that this is due to more developed emotionality.

How to distinguish normal stress in a teenage girl from depression?

Important criteria are the duration of manifestation and severity. Duration is understood as a prolonged change in mood and behavior, lasting several weeks, months, or even years. Heaviness is understood as a change in the child’s quality of life.

For example, a girl not only refuses to be friends with one or two peers, but also stops communicating with everyone, does not want/is afraid to leave the house, and dreams of moving away from everyone.

The second example is when a girl doesn’t just stop eat after six , but actually refuses to eat, causes vomiting if she has eaten too much. He buys tons of magazines with dystrophic models, spends hours looking at their photographs, and constantly asks to buy new clothes in order to become like them. Throws tantrums if demands are not met.

It is important for parents to recognize deviations in behavior from the norm and take timely action.

How to recognize?

So if your daughter:

Suddenly I gave up all the hobbies that I loved very much before (I didn’t switch to similar ones, and I gave up on them);
Refuses to go out with friends/parents, does not want to leave the house;
I started studying worse , it became more difficult to perceive educational material;
Started to quarrel with parents/siblings more often;
Irritated for no apparent reason;
Suffering from fatigue and at the same time insomnia or, conversely, excessive drowsiness;
Eating more than usual or torturing himself with diets. Complains of abdominal pain;
Constantly says phrases like “I’m tired of everything”, “I’m fed up with everything”, “I’m tired of everything”, “Nobody understands me”, “Everyone is like that (universal insult)!”, hints/threatens suicide, enthusiastically talks about the suicides of others, for example , says that “the blood from the vein flows beautifully.”

It's worth taking action - this is teenage depression.

Causes of depression in teenage girls

Sex-role socialization that accompanies puberty. The influence of others (the media, peers) forces girls to strive to be more attractive. Sometimes the desire to become ideal becomes self-destructive. Eating disorders develop (anorexia, bulimia).
Social change - transitions from elementary school to middle and high school.
Decreased self-esteem. Usually, at the age of 9-10, girls have a positive attitude towards themselves, as if they have the attitude “I am a princess! Everyone loves me". As they grow older, their self-esteem declines. One third of girls emerge from adolescence with the flawed “I’m nothing, I’m not cool, I’m ugly, etc.”, less confidence in themselves and their abilities, and a low level of aspirations.
Stress, problems communicating with peers, family conflicts.
Experienced physical and/or sexual abuse, parental neglect.
High intelligence quotient (IQ above 180). It is believed that children of high intellectual level are less fit and happy than children whose intelligence is lower. In addition, the negative influence of society is always added. For example, in some schools, talented children are often ridiculed and humiliated. Their classmates follow the unspoken rule “Being smart is unfashionable.” The desire to go against everyone is regarded as a betrayal of the team. And since children with high intelligence often cannot protect themselves, they immediately become outcasts and become depressed.
Hereditary predisposition , permanent residence with loved ones who suffer from depression.
The presence of serious physiological diseases, taking certain medications (steroids, painkillers).

How not to get depressed yourself, thinking that “I am a bad mother”

Once the children wrote an essay on the topic “Your best friend.” One student, coming up to me, whispered, “My best friend is my mother,” and cried from her frankness. I'm sure any mother would be happy to hear something like this.

If your daughter cannot tell you this, if you notice signs of depression in her, it is easy to fall into depression yourself under the slogan “I am a bad mother.” Having listened to teachers, read books, and watched her daughter, the mother develops a treacherous feeling of guilt, which makes the situation even worse. How can you avoid falling into this depression yourself?

What causes depression in teenage girls?

1. You need to realize that your child is a living person. He can experience both positive and negative feelings. This is fine. If a mother tries in various ways to avoid her daughter’s manifestation of these feelings, or even worse, turns a blind eye to it, she does not accept them.

What to do? Sometimes you really want to answer your daughter: “These are all little things, they will pass” or “It’s not serious, grow up first.” A more advantageous option would be if you say: “I see that you are sad/bad/you don’t want to see anyone. If you want to talk, I'm always here."

2. You also need to realize that your child cannot be perfect. No matter how much I would like to raise him like this. In fact, an attempt to “create an ideal child” is nothing more than an attempt to realize yourself as you once failed to become.

What to do? Firstly, you should not compare your daughter with other children like: “You have depression, but others don’t, other girls are so cheerful and sociable.” Your daughter and other children are in completely different environments and react to them as their nature requires. If a person feels bad, he defends himself with depression. And that's okay too.

Secondly, you should separate yourself from the opinions of society. If someone praises their children and attacks you, it means that this someone has arranged psychotherapy for themselves. He has problems and he decided to rise in his own eyes by using you. These are his problems, not yours.

3. You need emotional interest.“I’m always at work, when should I take care of my daughter?” - many mothers say. If it seems to you that you have paid/are paying little attention to your child, think about whether your adult daughter needs your maximum presence nearby? Most likely no. Firstly, it is impossible, and secondly, it will quickly get boring.

What to do? In fact, your child does not need your presence so much as emotional interest in you. Not so much intellectual knowledge, but personal communication - joint activities, games, sports, fooling around, heart to heart conversations , throwing pillows and other pleasant little things.

In some ways I may be exaggerating, but the meaning is clear. Becoming your child's best friend is the greatest achievement possible. How to do this is described below.

How to prevent depression or how to help a teenage girl get rid of it?

1. Give your daughter a good, healthy sleep, make sure she walks in the fresh air more often, preferably in sunny weather. Sun stimulates the production of the happiness hormone - serotonin, which is responsible for good sleep, mood and appetite.

2. Include physical activity in the girl’s daily routine.- housework, oriental or modern dancing, sports, joint outdoor games, trips to nature, to the beach. With the help of active physical activity, endorphin is produced - the hormone of joy, which helps free your head from unnecessary thoughts and puts you in a positive mood.

3. Organize proper nutrition. Bananas, citrus fruits and chocolate (in moderation) are known to be the best antidepressants. Bananas are rich in serotonin, chocolate - phenylethylamine ( improves mood , increases concentration), the taste and smell of citrus fruits energize, invigorate, and help to concentrate.

4. Be your child's best friend. Eliminate the girl's loneliness. Don’t give her any reason to think that she is alone in this world, that no one needs her, that she is uninteresting. Chat with your child on topics that interest her, tell stories from your life, now or later they will definitely be useful to her.

If she resists (maybe you haven't communicated much before), closes the door, protests, tell her you want to talk about yourself. Don’t hide your problems from your daughter, share with her, discuss them together. The child should feel needed and irreplaceable. Teach your daughter to communicate with you - by listening to you, she will learn to share her secrets with you in return, and will see in you a person she can trust.

Individual or group psychotherapy. She will help the girl find out what exactly is going wrong in her life and how she can change the situation for the better. For example, how to get rid of problems at school, how to build good relationships with peers.
Taking antidepressants. Sometimes the doctor prescribes medications to help restore psychological and emotional balance.

Olga VOSTOCHNAYA,
psychologist

The intense rhythm of life, the high demands of reality, strict standards of compliance with society, and the incessant flow of diverse information have become familiar phenomena for many contemporaries. However, the existing way of things in society is an intense, continuous, long-term stress factor for the human body, accumulating its negative impact on the psyche.

The brain of many adults has adapted to the effects of certain stressors and is able to provide adequate protection for the body, using various mechanisms of “defensive” reactions. However, the completely unformed, fragile, immature psyche of children and adolescents often becomes defenseless against many stress factors. In addition, the addition of hormonal chaos during puberty does not have the best effect on the emotional sphere of a teenager, often resulting in a variety of borderline neurotic reactions or transforming into mental pathologies, often manifesting itself in the form of depression.

During the puberty period, a large-scale revaluation and replacement of ideals occurs: the teenager stops idealizing his ancestors, strives to distance himself from his parents, but in most cases he is not psychologically ready to commit such a symbolic “murder” of former idols. True physiological “imbalance” of the emotional background is manifested in constant changes in mood: attacks of tearfulness, periods of blues, moments of oppressive melancholy, which are replaced by a phase of psychomotor excitement and euphoric jubilation.

In adolescence, even minor difficulties are perceived as insurmountable problems that bring unbearable pain. The death of parents, a dysfunctional atmosphere in the family, a break in relationships with their “first love,” unsatisfactory performance at school, social isolation, and failure in their endeavors cause a strong negative emotional reaction in children, forming depression and often pushing them toward an act of despair—attempting suicide.

According to numerous sources of statistical data, depression in adolescents of varying severity is observed in 60-80% of adolescents, and in most cases, melancholic states lasting more than two weeks require professional medical assistance. In childhood and adolescence, the problem of suicidal behavior has become the subject of close attention of scientists around the world. According to the American Psychiatric Association, suicide is the leading cause of death among children and youth: every year more than 500,000 members of the younger generation make suicide attempts, of which 5,000 cases result in death.

Pubertal disorder carries a high risk of developing depression in adulthood. Research conducted at the Maudsley Hospital showed that the consequences of depression in an adult are often long-term problems with adaptation in society, persistent difficulties in personal relationships, and an increased risk of suicidal behavior (in more than 44% of sample participants).

Depression in children and adolescents: causes

Numerous factors influencing the formation of depression have been established and confirmed. In the majority of clinically recorded cases, the disorder, which arose in the age period from 12 to 25 years, is of a hereditary nature (genetic predisposition to pathologies of the mental sphere). Depression in children and adolescents is much more common in cases where one or both parents in the family suffer from this illness in a severe form and periodically undergo psychotherapeutic treatment.

The second most important factor provoking depression in adolescents is a dysfunctional atmosphere in the family. Growing up in a single-parent family, drinking parents, the lack of a unified strategy for raising heirs, frequent quarrels and showdowns between relatives, and excessive, unfair demands on a child have a huge negative impact on the child’s psyche.

The impetus for the development of the disorder in a teenager is a variety of factors, which are based on the influence of the environment when the child’s personal identification is flawed (inadequate or incorrect self-image). Misunderstanding of loved ones, insufficient level of academic performance at school, low social status of the family, lack of authority among peers, distorted sexual orientation, inability to achieve visible heights in sports are strong arguments for the mind to respond to what is happening with depression.

Juvenile age- a crisis period of psychological maturation, coinciding with large-scale hormonal changes during puberty. Hormonal changes cause a malfunction in the functioning of neurotransmitters that control the emotional sphere, and the resulting deficiency of certain chemicals triggers the development of depression. During puberty, the adolescent complex clearly manifests itself:

teenagers are hypersensitive to how others evaluate their appearance and abilities,
their behavior combines extreme arrogance and ultimatum judgments,
spiritual sensitivity and attentiveness coexist with callousness and callousness,
shyness and modesty alternate with swagger and vulgarity,
the desire to be recognized by society coexists with demonstrative independence and love of freedom,
non-acceptance of generally accepted norms and rules, denial of authorities goes in step with the creation and deification of idols.

An important factor in the formation of the disorder is the instability and conflict of self-esteem, which has a rigid (inflexible), highly fluctuating, disorganizing nature. A low level of self-esteem, the formation of self-esteem under the influence of external assessments, a negative connotation of a retrospective, current and prognostic view of one’s personality is an ideal platform for mental pathologies.

Depression in Teens: Symptoms

Often, symptoms of depression in adolescents include changes in behavior and frequent mood swings. A child suffering from a disorder avoids social contacts, breaks off relationships with friends, and prefers to be alone. The following are the leading symptoms of depression in teenagers:

Frequent pain syndromes: headache, discomfort in the epigastric region;
Difficulty concentrating, absent-mindedness, forgetfulness, excessive distractibility;
Inability to independently develop the right decision;
Irresponsible attitude towards one's responsibilities;
Decreased appetite or excessive need for food;
Scandalous, rebellious behavior;
Feeling of oppressive melancholy;
Unreasonable anxiety;
Feeling of hopelessness and futility of the future;
Insomnia, interrupted sleep, daytime sleepiness;
Sudden loss of interests;
Consumption of alcoholic beverages, drugs;
Irritability, aggressiveness;
The occurrence of obsessive thoughts about death.

The diagnosis of teenage depression is made on the basis of interviews conducted by a psychiatrist with the child and his environment, taking into account the results of psychological tests specially adapted for childhood. The stage and severity of the disorder, the presence of a risk of suicidal actions and, accordingly, the construction of a treatment regimen are determined after a detailed study of the clinical picture of the disease.

Teenage depression: treatment

Today, many methods for treating depression in adolescents have been developed and are successfully used, including the prescription of pharmacological drugs and psychotherapy sessions.

In cases where depressive disorder is mild and not burdened by suicidal thoughts and socially dangerous behavior, the first choice of treatment is cognitive behavioral therapy. An illness that has a real reason for its formation - an obvious dysfunctional situation in the family - is successfully overcome after family psychotherapy sessions. The work of a professional psychologist with children with low self-esteem, indecisive, suspicious and timid adolescents is aimed primarily at developing adequate self-acceptance, new personal standards, an active life position and a sense of self-worth.

In cases where a teenager experiences acute or prolonged depression, there is a need to use medication or a combination treatment regimen, often carried out in an inpatient setting. Prescribing antidepressants, antipsychotics and anxiolytics to patients of childhood and adolescence is a serious and responsible task, since some drugs of these classes can provoke the emergence or intensification of symptoms of other mental disorders. For example: trade names of SSRIs with active substance Fluoxetine are preferable for depressive states that occur with motor retardation and increased drowsiness, while they aggravate symptoms in patients with psychomotor agitation, suffering from insomnia or experiencing panic anxiety, often causing manic manifestations. If you follow all the letters of the law, then there is a license for the use of antidepressants in the age group up to 15 years only for Amitriptylinum. However, in practice, other more modern “gentle” psychotropic drugs are used in effective therapeutic dosages, which have a minimum of side effects.

In order for a teenager to experience the effective benefits of prescribed medications, he must not only strictly comply with all medical prescriptions, but also become an active participant in the process of overcoming depression.

Recently, reports of suicides among teenagers have increasingly appeared in the press. The most common causes of suicide are depression. Such conditions do not develop in an hour or a day. Depression is a long-term condition. The duration of depression is most often more than two years, however, shorter-term conditions can also occur (from 2 weeks to 2 years).

Causes of depression in children

The following factors contribute to the development of depression:

1. Pathology of the early neonatal period: chronic intrauterine fetal hypoxia, birth of children with asphyxia, the presence of neonatal encephalopathy, intrauterine infections. All of these conditions lead to brain damage.

2. Family climate: single-parent family, conflicts in the family, “overprotection” by mothers, lack of care on the part of parents, lack of proper sex education on the part of parents. Very often, in single-parent families, children cannot tell their parents about all their problems, especially for families where the daughter is raised only by the father. In such families, children withdraw into themselves, the whole burden of problems falls only on their shoulders, and sometimes they cannot cope with this burden. Frequent conflicts in the family lead to ideas in the child that he is a burden for his parents, that without him their life would be much easier. In the presence of “overprotection” on the part of the mother, children are not able to adapt to the environment and society; without the lack of support from the mother, they become completely helpless. Adolescence is a period of experimentation, especially sexually. In the absence of sexual experience, very often problems and failures may arise during the first sexual contact. If the child is sufficiently informed sexually, this circumstance will not cause a negative reaction in the teenager, however, in the absence of sex education, this situation can negatively affect the teenager, which will lead to his isolation.

3. Adolescence. As mentioned above, adolescence is a period of experimentation. In addition to the previously described problems, hormonal and structural changes in the body occur during this period. Girls get their first periods, boys have nocturnal emissions (night ejaculation), body shape changes, and juvenile acne appears. Due to an excess of hormones, children become more aggressive, and leaders appear in their environment who dictate one way of life or another. If you do not correspond to this image, you cannot get into the social group, which means you find yourself left out of social life. All this can lead to the child’s alienation from society and the emergence of thoughts that he is not like everyone else.

4. Frequent change of place of residence. A child should have a social circle and friends. With frequent changes of place of residence, a child cannot make full-fledged friends with whom he could spend his free time and share secrets.

5. Problems in learning. The modern educational process is too overloaded with subjects; not every child is able to cope with the school load. Falling behind in the school curriculum isolates the child from his classmates, making him very vulnerable mentally.

6. Availability of a computer and the Internet. Advances in technology have made it possible to unite the entire world, narrowing it down to a computer monitor, however, this has had a negative impact on the ability of young people to communicate. Children's range of interests is narrowing, they are unable to discuss anything with their peers, except how much he "pumped up" his hero or how many "bots" he "killed" yesterday. Children become shy when meeting in person; it is difficult for them to find words, because on the computer it is so easy to hide behind a couple of emoticons. At the same time, their only form of communication is chatting.

Depression in a child can develop as a result of exposure to acute or chronic stress (death or serious illness of loved ones, family breakdown, quarrel with loved ones, conflicts with peers, etc.), but it can begin without any apparent reason against the background of complete physical and social well-being, which is usually associated with disturbances in the normal course of biochemical processes in the brain. There are so-called seasonal depressions, the occurrence of which is associated with the body’s special sensitivity to climatic conditions (often manifests itself in children who have suffered hypoxia or received various injuries during childbirth).

Symptoms of depression in a child

Adolescence is the most susceptible to depression. There are early (12-13 years), middle (13-16 years) and late (over 16 years) depression.

Depression presents with the classic triad of symptoms: low mood, decreased mobility, and decreased thinking.

The decrease in mood throughout the day with depression is uneven. Most often, in the morning the mood is more upbeat, and children are quite willing to go to school. During the day, mood gradually decreases, with the peak of low mood occurring in the evening. Children are not interested in anything, they may have a headache, and in rare cases, an increase in body temperature. Children complain that everything is bad for them, that they have constant problems at school, conflicts with teachers and students. No success makes them happy; they constantly see only the negative sides even in the best things.

In addition to low mood, so-called outbursts of very good mood occur. Children joke and have fun, however, such an elevated mood does not last long (from several minutes to an hour), and then is replaced again by a depressed mood.

Decreased mobility manifests itself in a reluctance to move; children either constantly lie down or sit in the same position, most often hunched over. Physical labor does not arouse any interest in them.

The thought process in children is slow, speech is quiet, slow. Children find it difficult to select the necessary words; it becomes problematic for them to build an associative series (for example, wedding-bride-white dress-veil). Children answer questions after a pause, most often with only one word or simply a nod of the head. There is a fixation on one thought, most often with a negative connotation: no one loves me, everything is bad for me, nothing works out for me, everyone is trying to do something bad to me.

Children's appetite decreases, they refuse to eat, and sometimes they may not eat for several days. They sleep little and are troubled by insomnia, as fixation on one thought interferes with the process of falling asleep. Children's sleep is superficial, restless, and does not allow the body to fully rest.

Thoughts of suicide do not arise immediately; most often, their occurrence requires a long period of illness (from a year or more). The thought of suicide is not limited to one. Children come up with a plan of action, think through options for leaving life. This variant of the course of the disease is the most dangerous, as it can easily lead to death.

In addition to psychological disorders, somatic symptoms very often occur. Such children often seek medical help with complaints of general malaise, weakness, pain in the chest, heart, abdomen, headache, and possibly increased body temperature, which is often regarded as a persistent (circulating) infection in the body.

Due to the presence of psycho-emotional disorders, children begin to fall behind in school, they lose interest in any entertainment, children stop engaging in hobbies, even if they previously devoted all their time to it.

As mentioned earlier, the course of the disease is long and can last for years. Therefore, if a child lives in a family with his parents, it is quite easy to notice the symptoms. It’s another matter if the child lives in a dormitory. During the day, fellow students see him as usual, without changes, since the deterioration of his condition usually occurs in the evening, and in the evening the child is most often alone in the dorm room, where no one sees him. For the administration, such a child is of no interest, since he does not violate the order.

What should parents pay attention to?

First of all, it is necessary to talk with the child, take an interest in his life, problems at school. It is necessary to pay attention to intonation, plans for the future, and optimistic views on the future. Pay attention to whether your child has friends and be interested in what he does after school. It is necessary to pay attention to how much time the child spends not doing anything. For some children, this is laziness, but even the laziest child can be forced to do something by bribing him, but a child with depression is not interested in anything, neither gifts nor encouragement.

Closedness and lack of friends can sometimes also be observed during masturbation, when children try to be alone and avoid prying eyes. Frequent mood swings can occur when a child takes drugs. In this case, other signs of drug addiction are also noticed: preference for wearing clothes with long sleeves, photophobia, increased irritability, inability to concentrate on one activity (restlessness), detection of syringes, needles, and strange bags.

Screening a child with depression

Treatment of children with depression

In severe cases, when a child expresses suicidal thoughts, especially when he has a specific plan for ending his life, treatment should be carried out only in a hospital, in the department of borderline conditions.

For milder forms of the disease, treatment can be carried out at home. Throughout the course of treatment, the child must live a normal life: go to school, do housework, and go shopping.

In pediatric practice, the drug Adaptol has proven itself very well. This drug is very well tolerated, has no side effects, and does not cause drowsiness. The drug normalizes sleep, improves mood, and increases the body's resistance to psycho-emotional stress. It is necessary to take the drug in a dosage of 300 mg, 1 tablet 3 times a day. The duration of treatment is from 2 weeks to a month. In case of severe symptoms, adaptol should be taken at a dosage of 500 mg 2-3 times a day for 3 weeks, and then switch to a dosage of 300 mg and continue taking it for another 1 month. This drug, in addition to psycho-emotional symptoms, also relieves somatic manifestations of depression: pain goes away, temperature normalizes. The use of adaptol for frequent headaches, heart pain, and frequent increases in body temperature is one of the ways to accurately establish a diagnosis and identify patients with depression from a group of children.

You can also use a drug such as tenoten on an outpatient basis. Tenoten is a homeopathic medicine that blocks certain proteins in the brain. It reduces anxiety, improves sleep, and normalizes appetite. The drug helps improve concentration and normalize memory.

In severe cases, antidepressants are used: amitriptyline, pyrazidol, azafen. These drugs should be used only under the supervision of a doctor, and preferably only in a hospital.

But no treatment for depression in children will be complete without positive changes in his family; parents must accept the “real child”, his needs and aspirations instead of their own expectations, instead of the “dream child”. When conducting psychotherapy, they work to strengthen the child’s self-esteem, develop his ability to express his feelings, share them, cope with problems step by step and constructively influence the current situation.

Prevention of depression in children

To prevent the development of depression in children, it is necessary to organize psychological assistance in schools and colleges; children need to be explained the need to visit a psychologist if problems arise. It is necessary to improve the climate in the family, try to do some activities with the whole family (picnics, hikes in the forest, sports games). Be interested in your child’s life, show how interesting what he is interested in is for you. Try to know your child's friends, however, it is necessary that this be unobtrusive, everything should happen in the form of a conversation, when the child himself tells you everything. Pay attention to your child’s behavior, notice any new addictions your child has.

The child will not be able to get out of depression on his own. Therefore, the task of parents is to pay attention to changes in the child’s personality in a timely manner and seek medical help.

The child should be outdoors more often, be active in daylight and rest in complete darkness. This has a beneficial effect on the entire body and normalizes biorhythms.

Pediatrician Litashov M.V.