Depression is a serious mental illness that is described as persistent sadness and sometimes irritability. The Centers for Disease Control and Prevention (CDC) calls it “one of the leading causes of disease or injury worldwide for both men and women.” The symptoms of depression are different for everyone. But the general symptoms include feeling hopeless, crying a lot, not being able to concentrate, as well as changes in appetite or weight, loss of interest in activities or changes in sleep quality. Depression can, literally, make it hard to get out of bed and complete duties that were once routine.
Depression is a complex disease. There is no single cause for it. The causes can be a chemical imbalance in the brain, stressful life events, a medication side effect, illness or family history. It is not just feeling “blue.” It is a medical condition that can be treated, like high blood pressure or diabetes. With treatment, many people can function very well.
The CDC reports that older adults have a higher risk of being depressed but that it is not a normal part of aging. Depression in older adults usually goes along with other medical problems, according to Charles F. Reynolds III, MD, Distinguished Professor of Psychiatry and director of the Aging Institute at UPMC and the University of Pittsburgh. He also notes that older adults have periods of vulnerability that are more common in their age group. These periods can be grief, major transitions in life (like retirement) and changes in/loss of health.
Adults are not the only ones who have depression. Young people can also suffer from it. Depression can be tricky to diagnose in young people, especially in adolescence. Adolescence is a time of change. It can be difficult to know if a young person is just changing or developing symptoms of depression. Young people can be irritable, but is that normal adolescence or a sign of depression?
“Doctors like to look at whether adolescents’ functioning is decreasing,” says Ana Radovic, MD, MSc, assistant professor of pediatrics at the University of Pittsburgh School of Medicine. “Meaning, are they doing what they’re supposed to be doing at their age? Are they going to school, doing the same activities, wanting to hang out with friends or having the same group of friends? They’re supposed to be having fun, even if they’re irritable sometimes.”
Dr. Radovic says it is especially useful for parents or caregivers to have a primary care doctor for their children. It helps to have someone who has a lot of experience observing many young people help care for your child. A primary care doctor can also look at your child without the emotional attachment of a parent or guardian and possibly be more objective about how the child is doing. Dr. Radovic encourages parents (or adolescents themselves) to talk to a health care provider if they have concerns about a young person in their life.
“What’s important for parents, caregivers and schools to know is that research shows a healthy lifestyle can help with mental health problems,” says Dr. Radovic. “Making sure young people get the sleep they need, nutrition, social support and a caring therapeutic relationship (as with a health care professional) are all ways to help them be healthier.”
In addition to self-care, doctors will help guide adolescents to any treatment they need. Dr. Radovic says that a doctor will look at the symptoms and their severity and make treatment decisions with the young person and sometimes his/her parent or guardian. Treatment can include medication and/or cognitive behavioral therapy (“talk” therapy). Dr. Radovic says that people still sometimes have negative beliefs about medication and therapy. She points out that people may be nervous about giving their children medication but says the risks are usually very small. It is important to remember that some of the risks of depression are poor school performance, risky behavior and thoughts of suicide. Dr. Radovic also refers to therapy as more of “coaching” and likens it to physical therapy. She says, “If you hurt your ankle, you could do exercises alone, and it would probably heal. But if you worked with a physical therapist, you could get it back to full strength.”
Dr. Radovic says that only one-third of depressed adolescents will get treatment—sometimes because of negative beliefs about treatment. So, she and her colleagues developed two websites for young people (sova.pitt.edu) and parents/caregivers (wisesova.pitt.edu) to get support and find people with whom they can share experiences.
If you or someone you know is struggling with depression, Dr. Radovic says talking with someone cannot hurt. “A lot of people are afraid of getting help,” she says, “but most are grateful that they did. There are laws to protect confidentiality. And just because people are depressed doesn’t mean it will last forever. Treatment can help prevent people from feeling worse.”
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