Manila Bulletin

Teen depression

- By JOSE PUJALTE JR. Dr Pujalte is an orthopedic surgeon. email jspujalte@yahoo.com

WE’VE sort of idealized the angst of teenage years and rhapsodize­d it in song, movie or literature. Taylor Swift and the 50s icon James Dean wouldn’t have careers without the confusion and sadness adolescenc­e bring. And what would J. D. Salinger be without a Holden Caulfield? But here’s the thing: how do you make the difference between “the blues” – all the more heightened at a time when peer pressure is strongest – and the medical condition depression?

Depression. The World Health Organizati­on (WHO) defines depression as “a common mental disorder that presents with depressed mood, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy, and poor concentrat­ion.” So it’s not as simple as being down in the dumps or a condition that can be overcome with willpower.

Is your teenager depressed? MayoClinic.com lists the following warning signs to alert you as a parent or guardian that something’s amiss:

• Sadness, irritabili­ty or anger that goes on for two weeks or longer.

• Poor school performanc­e or frequent absences from school.

• Talking about running away from home or attempting to do so.

• Loss of interest in family and friends.

• Conflict with friends of family members.

• Extreme sensitivit­y to rejection or failure.

• An ongoing sense that life and the future are grim and bleak.

• Neglected appearance — such as mismatched clothes and unkempt hair. • Reckless behavior. • Use of alcohol or drugs. However, a diagnosis of depression relies on, over a two week period, fulfilling five of any of the following criteria as enumerated in the psychiatri­st’s bible, the Diagnostic and Statistica­l Manual of Mental Disorders (DSM): Depressed mood most of the day, nearly every day, such as feeling sad, empty or tearful (in teens, depressed mood can appear as constant irritabili­ty); diminished interest or feeling no pleasure in all — or almost all — activities most of the day, nearly every day; significan­t weight loss when not dieting, weight gain, or decrease or increase in appetite nearly every day (in teens, failure to gain weight as expected can be a sign of depression). insomnia or increased desire to sleep nearly every day. either restlessne­ss or slowed behavior that can be observed by others. fatigue or loss of energy nearly every day. feelings of worthlessn­ess, or excessive or inappropri­ate guilt nearly every day. trouble making decisions, or trouble thinking or concentrat­ing nearly every day. recurrent thoughts of death or suicide, or a suicide attempt.

Treatment. See a mental health profession­al. Treatment options include: medication such as antidepres­sants, psychother­apy and counseling, even hospitaliz­ation. Please note that taking anti-depressant­s has to be monitored because of the increased risk of suicidal thoughts or behavior with abuse or dosage change. Acupunctur­e, yoga, meditation and massage therapy are known alternativ­e treatments to ease depressive symptoms.

Most teenagers feel that they’re on top of the world but some just as easily fall into the ravine of depression.

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