Your daughter has been coming home from school and locking herself in her room until the next day.
Your son hasn’t complained about classes being tougher, but his grades have dropped greatly.
You walk by your child’s room and hear crying almost every night.
Just a phase? Possibly, but it could also be something more serious.
Signs like these could mean a teen is clinically depressed. And parents shouldn’t be afraid to take their child to a psychologist for a diagnosis.
According to the National Institute of Mental Health about 4 percent of teenagers have depression. Teens diagnosed with clinical depression can improve their condition with counseling and medication, said Jack Mihalovich, a child psychologist in West Palm Beach, Fla.
Serotonin and norepinephrine, neurotransmitters that are the brain’s message carriers, significantly influence the presence or absence of depression, Mihalovich said.
“Some people may become depressed when they have too much serotonin, while others may be depressed when they have too little,” writes clinical psychologist Jane L. Delgado in her book “Salud! A Latina’s Guide to Total Health” (Harperperennial, $20).
There are a few types of depressive illnesses, but major depression and bipolar disorder are the most significant ones, according to the National Depressive and Manic-Depressive Association.
Bipolar disorder, also called manic depression, makes people have severe mood swings. They feel either really high or really low, according to the National DMDA. It tends to run in the family. Major depression, on the other hand, occurs when a depressive mood — feeling extremely down — persists.
Not only is depression caused by an imbalance of neurotransmitters, but by environmental factors also. Mental and physical abuse, isolation from peers, failure to master schoolwork or a sport, death and divorce can be triggers, psychologists say.
Some physical and behavioral symptoms parents may notice include weight loss or gain, more or less sleep than usual, drug and alcohol use, a drop in academic performance and withdrawal, psychologists say.
“A problem with parents can be acceptance of the behavior,” said Carol Webster, a clinical psychologist in Plantation, Fla. “They consider it a phase.”
But Lorrie Rivera, a Cooper City, Fla., mom, did not ignore the signs in her 14-year-old son, Brian. Two years ago, she noticed a change in his behavior. She took him to a psychiatrist and he was diagnosed as bipolar.
“Brian was violent. He broke things,”Rivera said. “He tried to jump off the roof.”
Rivera said she was diagnosed as bipolar at the age of 38, which made it somewhat easier to recognize the signs.
Before Brian was diagnosed, he was ” a very affectionate, loving, funny kid,” Rivera said. “A little spoiled and wonderful in school.”
Rivera said she knows the difference between a manic episode — being either really high or really low — and Brian just being upset.
“If he hangs onto something and hangs and hangs on and just won’t let go, that’s indicative of an episode,” she said. “And it quickly escalates into violence.”
Some parents overlook aggressive behavior in boys, shrugging it off as boys being boys, Webster said. But that’s how some boys mask their depression.
Parental and societal expectations can also be overwhelming for some teenagers, Webster said.
“Everyone expects you to be fabulous and spectacular, like you have to one up the accomplishments of the next person,” she said. “That can make you terribly stressed.”
Mihalovich said teenagers have unrealistic expectations of themselves as well.
“In our society, children are given a lot and don’t have to have a mastery to get things,” he said. “They think things should come easily. Their sense of self worth is based on fantasy.”
Mihalovich also says fitting in is more important today than it ever has been. He said advertising has something to do with it.
“There’s an environmental pressure to adapt. What’s wrong with you if you don’t want a Mercedes or smoke Marlboros?
“When kids say, `I don’t fit in,’ I say, `So what? You’re not done yet,’ ” he said. “Kids don’t always fit in. They’re still blossoming.”
Parents may also hear their children say they feel worthless, useless or hopeless. These feelings could branch to suicidal thoughts, Webster said. And usually teens who commit suicide are depressed. Teen suicide has increased in recent years, Mihalovich said.
Mihalovich, who said he can usually tell in the first session whether a child is depressed, said it is crucial to seek counseling if you notice symptoms in your child.
“It’s having someone who’s interested in you,” he said. “Someone who’s objective. I function as a coach a great deal of the time. You don’t necessarily have to have a problem playing baseball to need a coach. You just do it better.”
In addition to counseling, medication is also needed in many cases. Mood stabilizers and antidepressants control the amount of the serotonin and norepinephrine in the brain.
Rivera said she has seen how medication has helped make a difference in Brian’s moods.
“He’s much better,” she said. “He still has up and down moods, but they’re not as violent or drastic as before.”
But Mihalovich says medicine alone will not help. “It doesn’t solve the problem with the family or the problem with the kid.”
Brian went to individual counseling, which turned into family counseling because of issues he mentioned, Rivera said.
If depression is left untreated, adolescents can go into downward spirals. Some drop out of school, join gangs because they see them as a family, self-medicate through substance abuse or get into the juvenile justice system, said Marcy Smith, a clinical psychologist in Plantation.
“You can’t guarantee success,” Smith said. “The proper medication and therapy will increase the probability of getting better.”
SYMPTOMS TO WATCH FOR
Following are signs of depression in teenagers:
Persistent sadness
Inability to enjoy previously favorite activities
Frequent complaints of physical illness, like headaches
Frequent absence from school or poor performance in school
Persistent boredom, low energy or concentration
A major change in eating or sleeping patterns
Symptoms of bipolar disease, or manic depression, in teens include:
Severe changes in mood compared to others of the same age and background
Unrealistic highs in self-esteem
Great energy increase and the ability to go with little or no sleep for days without feeling tired
Increased talking — talking too much, too fast, can’t be interrupted
Easily distracted
High-risk behavior, like jumping off a roof and believing they will not be injured
SOURCE: American College of Child and Adolescent Psychiatry and the National Depressive and Manic-Depressive Association
