You’ve undoubtedly seen recent news headlines about a federal panel recommending to the FDA that antidepressant drugs carry the strongest possible warning label for use in children and teens. This recommendation to the FDA shocked the medical community, especially those who work with depressed youth. The biggest issue from the treatment community’s point of view was not the warning label recommendation, but the way the media described the panel’s recommendation. The panel reported that 2% to 4% of children and adolescents who received antidepressants for the treatment of depression became suicidal, that is, had suicidal thoughts or attempted suicide of one kind or another. None of the 4,000 children and adolescents studied committed suicide. What the media did not report well is the fact that 15% of children and adolescents with depression who do not receive treatment commit suicide. This 15% will not only think about it, but will commit suicide. Then, what are we going to do? If the media had their way, it seems that no adolescent with depression would take antidepressants. As a result, the suicide rate for those who might be using the drug would increase from nearly zero percent to about fifteen percent. But at least we wouldn’t have to worry about bad drugs. Look, I understand that there are actually young people, even adults, who have become suicidal only after starting treatment with an antidepressant. Some, in fact, have taken their own lives. This is absolutely tragic. But so is the fact that untreated depression is a life-threatening illness. Fifteen out of every hundred young people with depression kill themselves. They should be allowed to receive treatment that drastically reduces the suicide rate and without any stigma attached to it by the media. Recently, a patient was brought to our counseling center named John (not his real name). John was rebellious, angry, withdrawn, and often in trouble, yet he was diagnosed and treated for depression. When we think of someone who is depressed, we generally imagine a sad, lonely, and tearful person. But teens with depression don’t look like adults with depression. Current studies show that there are as many depressed teens as there are depressed adults. However, depression manifests itself very differently in adolescents than in adults. Teens don’t often show sadness, self-deprecation, or talk about feeling hopeless like adults do. In diagnostic manuals, adolescents with major depression are described as negative and antisocial people. Feelings of wanting to leave home, or of not being understood and approved of increase. The adolescent often changes and becomes more restless, grumpy, or aggressive. The reluctance to cooperate in family businesses and withdrawal from social activities, with withdrawal to one’s own room, are frequent. School difficulties are likely to be affected by concentration. Sometimes there is a lack of attention to personal appearance and increased emotionality. Often there is also an increased sensitivity to rejection in love relationships. Male adolescents often become aggressive, agitated, and get in trouble at home, at school, or with the law. Teenage girls sometimes worry about the issues of death or dying, and they worry less and less about their appearance. Suicidal thoughts are common. Some studies suggest that 500,000 teens attempt suicide each year and 5,000 succeed. Increased use of alcohol or other drugs is common, along with other forms of “self-destructive behaviors.” Low self-esteem is common among teens, but especially among those who are depressed. Parents are often confused and frustrated when their teens start to act like this. Sometimes parents become harsh and disciplinary, or even put the adolescent down, which only serves to increase feelings of guilt and depression. Other times, parents feel helpless and wait for adulthood to come. Of course, neither course is correct. If you know of a teenager whose behavior has changed to resemble what was described above, inform the parents that help is available and encourage the family to seek help from a professional. With proper diagnosis and treatment, a depressed adolescent or adult can be of great help. If someone close to you suffers from depression, first understand that depression is a very emotionally painful condition. For some people with depression, it becomes a “terminal illness” due to suicide. Please take the situation seriously. 1) Get a medical evaluation. Symptoms of depression can be the result of a wide variety of illnesses, including thyroid problems, viral infections, and other factors. 2) Deprex is an amino acid and homeopathic medicine for the treatment of depression that we have seen work well with our patients. It may be worth trying as long as the situation is “stable” and there are no suicidal thoughts on the part of the depressed person. 3) Medications like Prozac can be very helpful for the most difficult cases. Consult your doctor. These drugs are often prescribed by family doctors, but in most cases they must be controlled by psychiatrists. 4) Increase your protein intake a bit. Use a protein powder supplement, such as a weight lifter. 5) Exercise daily. Just get out there and walk for about 15 minutes. 6) Seek advice from someone who is good at treating depression. This can do you a lot of good. However, always use a lot of wisdom and common sense when choosing a therapist. Some are good and some are not, so choose wisely.

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