Teen depression and anxiety have been in the news a lot lately as there have been several local and national stories about suicides.

Today’s Healthy Actions column, which takes a look at a different medical topic each month, is particularly well-timed.

I spoke recently with two experts with Akron Children’s Hospital’s new Lois and John Orr Family Behavioral Health Center: Dr. Steven Jewell, director of pediatric psychiatry and psychology and Laura Gerak, director of psychology.

Q: Is there a difference between adult and child/teen depression?

A (Jewell): Historically, it used to be thought that kids don’t get depressed. Over the last 40 years or so, it’s become recognized that indeed we have found that depression does exist in kids. The symptoms are the same. What’s different is how they manifest.

Q: Can young children be depressed?

A (Jewell): I’ve had 4 and 5 year olds diagnosed with depression. (Gerak): In little kids, I hear them describe it as sadness. They’re sad all the time.

Q: What are some symptoms of clinical depression?

A (Jewell): There are three important domains of life: family, peers and school. If there is severe impairment in one of those areas or moderate impairment in two or more, then you deserve an evaluation because there’s a significant chance mental illness or addiction is impacting them.

Q: What are some examples of an impairment?

A (Jewell): Is your kid functioning in a way that is different than what they used to function? Has there been a downturn in their grades? That’s the most obvious. If I see a kid going along getting along with decent grades and all of the sudden falls off a cliff, that could be depression or addiction.

Q: How do I know it’s not just my teen being a teen?

A (Jewell): One issue is significant change. I would also just ask. We have a tendency to want to write off those changes to hormones, peer problems or drama. But ask them, “I’ve noticed it seems like we can’t have a civil conversation for the last six months and every time I open my mouth, you’re down my throat and what that’s about?” Or "You used to have so many friends and you were going out and now you’re just staying home all the time? Why?"

(Gerak): Teens and kids will also have a sense of agitation or crankiness or say “I just want to bite somebody’s head off.” Another major change is sleep — either too much or not enough.

Q: What about social media pressures?

A (Jewell): The irony is that this technology that was developed to help us connect is helping us disconnect. The more time you spend on social media, the less time you spend connecting with others and the more likely you are depressed.

The whole idea of “fear of missing out” (FOMO) — you might miss somebody’s picture, event or announcement. In a study of college students, 50 percent were asked to reduce their social media presence by 50 percent. Depression and anxiety came down for those who used it less.

Q: Could stress come from seeing only happy things on social media?

A (Jewell): There’s some argument about which is the chicken and egg. “I’m not as good as them, I’m not as pretty as them.” Is that depression driving the perception or perception driving the depression?

Q: Are there more mental health issues in kids/teens or are they being diagnosed more?

A (Jewell): Yes to both. The research shows there are more cases and we are also diagnosing them more.

Q: When may sadness over something such as a breakup or death need professional assistance?

A (Gerak): There’s a period of time that you have to let yourself go through sadness and it drifts away. If they’re not shaking it or when you see them stuck, like their feet are in cement, then you may want to seek some assistance.

Q: What about the stigma of mental illness?

A (Jewell): This is such a huge issue. ... We need to accept physical and mental illness equally. Your workplace needs to be welcoming of parents who say my kid has been diagnosed with cancer, but also my kid was diagnosed with depression and she’s having suicidal thoughts and I need to take time off.

Q: Where do you start if you have a concern?

A (Jewell): Go to your primary care physician. Many are quite skilled to deal with moderate mental illness, or they will make a referral. Treatment will depend upon the diagnosis and could range from talk therapy to medications. Taking medications gets you better. Counseling keeps you better. (Gerak): We’re also teaching skills. Sometimes people just want a pill. Both are valuable. There’s a time and place for both. It’s not just taking your pill in the morning, but learning how to cope.

 Q: What about anxiety and when is it a concern?

A: (Gerak): Someone can be high strung, stressed and a worry wart. In that case, we’re not going to bring them in for an assessment. But if they’re freezing up and can’t get to a practice or if they didn’t get an "A" on a test and they are wrecked not just for the rest of the day, but after, that is more of a concern.

A lot of it is teaching coping skills. With anxiety, everything is magnified, even with little kids.


 

Beacon Journal consumer columnist and medical reporter Betty Lin-Fisher can be reached at 330-996-3724 or blinfisher@thebeaconjournal.com. Follow her @blinfisherABJ on Twitter or www.facebook.com/BettyLinFisherABJ and see all her stories at www.ohio.com/topics/linfisher.