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Published on May 08, 2017

Helping teens cope with depression and anxietyHelping teens cope with depression and anxiety

Depression affects people of all ages, but it is especially prevalent in teenagers.

In 2015, the National Institute of Mental Health estimated that 3 million adolescents in the U.S. between the ages of 12 and 17 had at least one major depressive episode in the previous 12 months. That represents 12.5 percent of the population in that age group. The Institute also reports that about a 21 percent prevalence of anxiety disorders in the same age group.

The statistics don’t surprise child psychiatrist Bart Main, MD at the Centers for Behavioral Health of Cape Cod Healthcare.

“I’m seeing a lot more anxiety and there is certainly no shortage of patients,” he said. “But I don’t think we have clear scientific evidence what this is due to.”

Dr. Main has some theories and one of them is the prevalence of social media. The amount of time teenagers spend on these platforms makes them psychologically vulnerable, he said. Websites like Facebook and Instagram are like a continuous on-going popularity contest that can hurt a teen’s self-esteem. Snapchat can be used as a weapon to bully, and leaves no evidence behind.

“What a really unique way to harass somebody,” said Dr. Main. “You send them a picture that disappears in six seconds. They can’t recover it. They can’t show it to anybody. They can’t prove it was there, but it still hurts them.”

Monitor Social Media

Children and teenagers usually don’t have the self-control to self-monitor their screen time, so Dr. Main recommends that parents remove all electronics at least a half hour before bedtime so the kids won’t be tempted to use them.

His second recommendation is for parents to have access to all of their children’s social media accounts so they can periodically check what their child is up to.

“The child should not have any trepidation about sharing this life experience with their parents,” he said.

Family dinners are a good way for parents to check in with their kids and get a sense of their mood and mental health. There’s no need to interrogate children about their day, Dr. Main said. Just spending time together is enough.

Adolescents are under more pressure today than previous generations were, he said. Ten years ago the graduation rate from college was only 40 percent and high school was 65 percent. Today there is an expectation that every high school student must get at least a two-year degree or they won’t be able to find a job.

“That puts enormous pressure on at least half of the kids who wouldn’t usually have gone to college,” he said.

What To Watch For

According to Dr. Main, the symptoms of depression are:

  • Changes in sleep patterns
  • Changes in appetite
  • Difficulty concentrating
  • Low energy
  • Reduced motivation
  • Lack of pleasure in activities that used to be enjoyable

Symptoms of anxiety are:

  • Shying away from certain situations or activities
  • Complaining they are nervous
  • Acting withdrawn

Some kids who are anxious are camouflaging it by self-medicating on marijuana, Dr. Main said. While alcohol was more common with older generations, his current patients say that marijuana is easier to obtain.

“Weed is an extremely effective anti-anxiety drug,” he said. “But the problem is that in the not fully developed mind marijuana can cause people to become paranoid. It increases the rate of psychosis by 400 percent.”

Three anti-depressants have been approved by the FDA for use in children: Prozac, Zoloft and Lexapro. Anti-depressants can be very helpful when taken in conjunction with psychotherapy, he said.

The metaphor that Dr. Main uses with families is that an anti-depressant is like the cast on a broken leg. The use of medication is the cast and you wear the cast (or take the medication) so you can walk around on a broken leg (or control anxiety).

Psychotherapy is the actual healing part of the process and once the anxiety is dealt with and the metaphorical leg is healed, the child no longer will need the medication, he said.

At its worst, depression can lead to suicide, which is now the second leading cause of death among 15 to 29-year-old people according to WHO.

Dr. Main is on the board of Calmer Choice, a prevention program in area schools that teaches young people how to effectively and safely manage stress. He calls the program a psychiatric inoculation that prevents against future disease.

“It teaches kids about how their brain works and about their subjective emotional experience,” he said. “It helps them learn to observe themselves and hesitate before they act so they can actually make rational choices rather than emotional choices. Educating children that emotions are fluid and temporary is really good prevention for the feelings of desperation and being overwhelmed in older people that lead to drastic actions.”