Major Causes of Teen's Depression

As in most mental illnesses, we can't really talk about a single "cause" in depression. There are usually both constitutional (inborn) and environmental factors that contribute to the condition, and often there are one or more environmental stresses (such as school demands and frustrations, death of a loved one, a move, or separation or divorce of parents) that act as triggers for a particular depressive episode. As a parent, blaming yourself or your spouse for your son's or daughter's condition is unlikely to be helpful. It is worthwhile having a thorough assessment by a mental health professional, however, as this may clarify the diagnosis and uncover contributing factors that could be changed.

Some teens are initially thought to be depressed but are later found to be suffering from a medical condition that is producing mood changes. Thyroid problems and aheinia (low iron in the blood) commonly cause mood changes, but so too may other medical conditions. Use of certain medications (for example, birth control pills) or street drugs can also affect mood. If your teen hasn't had a recent physical examination, it is well worth pursuing one. Remember to tell the doctor about the mood changes so he or she knows what to look for.

Parents often inquire about blood tests or other examinations that could reveal whether or not their child's brain chemistry is abnormal. Unfortunately, measuring brain chemicals in the bloodstream is not reliable, as there is a cellular barrier or wall between the bloodstream and the brain. Thus, levels of brain chemicals in the bloodstream do not necessarily reflect similar levels in the brain. Brain structure is rarely abnormal in depression, so computerized tomography (CT scan) or magnetic resonance imaging (MRI scan) usually do not help. Brain functioning, as measured by positron emission tomography (PET scan), can be abnormal, but such scans are very expensive, and are usually only available as part of research protocols.

Reactions to traumatic events (so-called "post-traumatic stress disorder") can also mimic depression. Although we all try to protect our children as best we can, it's impossible to monitor teens twenty-four hours a day, so the possibility of a traumatic event should not be dismissed too quickly. Children with pre-existing mental health problems such as anxiety disorders or attention-deficit/hyperactivity disorder are also more vulnerable to developing depression in adolescence.

Note that some things that used to be considered causes of depression are now recognized as part of the illness (for example, pessimistic thinking, social withdrawal, or a tendency to ruminate on past mistakes). Depressed people typically withdraw and see the "glass half empty." Most brief, focused psychotherapies address these symptoms early, by encouraging constructive action and realistically positive thinking. Feelings often take longer to change.



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