31 Depression of adolescent children (2)

Overview of depression of adolescent children

For reference, some of the following content is the same as that of depression of children and adolescents (1).
Depression is one of the most serious mental illnesses that can occur to anyone from all walks of life, regardless of gender, young and old.
One in ten children and adolescents can develop depression.
Most children with depression get appropriate treatment soon, but some do not get treatments.
It is common for people not to receive adequate treatment even though they are encouraged to receive adequate treatment.

The causes, triggers, types, and incidence of depression in adolescent children

The cause of depression is unclear.
Depression is one of the most serious mental illnesses in childhood and adulthood.
Depression is caused by a combination of heredity, physiology, social, and mental factors, and life-long stress.
Depression can occur in adults, children, and adolescents, regardless of age, and can occur in both men and women of all ages.
Especially today, adolescent children are more prone to depression.
Although the cause of depression is not known for certain, it is believed that depression occurs when abnormalities in the brain metabolism of two brain biochemicals, norepinephrine, and serotonin.

Factors of depression in adolescent children

Adolescent girls are more susceptible to depression for a number of reasons, and the symptoms can take many forms.
Depression can be triggered by the death or separation of a parent, divorce, death of a family member, living in solitude far away from home, separation from a partner, and other reasons. In other words, depression is triggered by multiple factors.
Until a few decades ago, it was believed that children do not develop depression. However, depression is relatively more common in adolescent children and young people today.
Depression can also be triggered in newborns, infants, toddlers and school-age children before puberty.

Types of depression in adolescent children

Acute depression
Chronic depression,
Mild depression,
Moderate depression
Severe depression.
Depression can progress and recur. This type of depression is called recurrent depression.
Depression in adolescent children,
Adult depression.
Adolescent children can develop smiling depression.

Incidence of depression in adolescent children

According to the U.S. NCS statistics on the incidence of depression in 8,000 Americans aged 15-54 years-old,
In 14% of young people who experienced severe depression, depression started before puberty,
Eleven percent of young people who have experienced mild depression say that depression started before puberty ends.
Depression was found in 18% of 9,800 male and female students in grades 6, 8, 9, and 10 in the U.S.
It is reported that 25% of female students and 10% of male students had depression. (Source: US NICHHDD, Depression or Bipolar Disorder, Dwight L. Evans, MD and etc.)

Symptoms of depression in adolescent children

Figure 2-23. Very Depressed Teen Girl

The main symptoms of depression are feeling disorders and behavioral disorders, resulting in abnormalities in general health.
Symptoms of depression vary depending on age, sex, the severity of depression, and factors that cause depression.
When depression occurs in infants and toddlers, preschool-age children, school-age children, symptoms and signs of hyperactivity disorder can occur, and infants and toddlers who have had toilet training and may not have toilet training and become regressive behavior.
When adolescents become depressed, they can act rebelliously against their parents, siblings, family members, or authorities.
Especially when adolescent girls suffer from depression, their concept of body image is not good, become disappointed about everything themself,
They think their life has reached the point of failure,
Adolescents, who loved to study before becoming depressed, lost interest in the social life, physical and social activities that they had enjoyed without studying hard anymore. They no longer hang out with their close friends and spend time alone.
They may have attention deficit disorder and they can’t concentrate well,
Interpersonal problems can also arise.
Eating more than usual or limiting food intake above normal
They may be more interested in their weight.
When parents become depressed, their children are more prone to depression.
Depression can be triggered by habitual substance abuse, alcohol drinking, alcoholism.
They may have reckless, promiscuous, and complex sex,
Makes it easier to get stressed
Can commit violent behavior
Runaways, indiscreet sex, teenage pregnancy, and other problems can occur.
Conversation between parents and children can also cause problems,
School study problems can also arise.
Depending on the menstrual cycle, depressive symptoms may get worse.
Regardless of gender, helplessness, despair, desperation, self-deprecation, concentration deficit, daydreaming, boredom, fatigue, sluggishness, physical depression, degenerative behavior, substance abuse, teenage pregnancy, criminal behavior, suicide, etc.
And more symptoms of depression can occur other than above.
When adolescent children who have studied well become depressed, they often tarry, leave early, and absent from school for no reason, and grades begin to decline.
They complain excessively about everything, don’t feel well, and can be aggressive in everything.
They may not fall asleep well or may wake up frequently during sleep.
They can dream a lot or sleep too much.
They spend a lot of time alone and hate making friends.
In the meantime, they gradually lose interest in the work, they worked hard every day, and they try not to start anything at all.
Losing the taste of food and not eating well, or vice versa can lead to obesity by eating too much.
Complaining that the head hurts often or that stomach hurts and often can have constipation.
When a parent or a teacher asks anything, he or she can be upset or annoying.
They often cause hard-to-understand safety accidents, get angry with trivial things, and break things.
They can invade houses or destroy objects.
Sometimes they say they want to die, and sometimes they actually commit suicide.
Depression in adolescent children can be a major cause of suicide.
Adolescent children with depression sometimes drink alcohol too much and become addicted to drugs or habit-forming drugs.
Parents and most teachers who are unaware that their adolescent children are doing that type of behavior due to depression can be treated as bad behavior because they are bad children. This can lead to a number of problems between parents and children with depression and between teachers and students with depression.
Most adolescent children with depression will receive treatment for depression soon, but some do not know they are depressed, and of course, even adolescent children who are diagnosed with depression and are encouraged to seek treatment for depression do not receive treatment for depression.
Depression is the leading cause of suicide and is the third leading cause of death among adolescents and young people aged 15 to 24 years old. And it has already been mentioned as the third leading cause of suicide in 15-year-old adolescent children.
If a child or an adolescent suffers from severe depression, the depression is likely to recur within 5 years thereafter.
If depression is not properly treated, symptoms of depression become more and more severe without knowing, and depression penetrate deeply into the child’s daily life, eventually preventing a normal life.

Diagnosis of depression in adolescent children

Depression is diagnosed by medical history, symptoms and signs, and examination findings.
School grades gradually decline,
Daydreaming at home or at school,
Lose interest in everything,
Like to be alone,
Headache, abdominal pain, loss of appetite, sleep disturbance, destruction of objects, suicidal attempts and suicide, alcohol and behavioral disorders such as criminal behavior, emotional disorders, and thought disorders are very helpful in diagnosing depression.
Depression and other diseases are differentially diagnosed with blood, urine, brain waves(EEG), and thyroid function tests and other tests as needed.

Diagnosis of depression in pre-adolescent or adolescent children can be made if among the symptoms of depression in the following items ①~⑪, at least 5 or more symptoms of them are present at the same time and such symptoms persist for at least 2 weeks and more.

Treatment of depression in adolescent children

Treatment varies depending on the cause, severity, and symptoms of depression.
Even if depression is induced in adolescent children for various reasons and triggers, depression may not be diagnosed correctly early.
Also, depressed children may not be able to get the right expert help on time.
So, it is said that only 1/4 to 1/3 of adolescent children suffering from depression receive adequate treatment.
We must do our best to mentally stabilize depressed adolescent children and eliminate causes and triggers.
Parents should work with their doctor to consult with their depressed adolescent children to find out what triggers the depression.
When a parents’ child-rearing parenting is wrong and adolescent children become depressed, do not hesitate to apologize to the child, correct the wrong parenting method immediately, and if the adolescent child’s thoughts are correct, they must acknowledge the thoughts.
When a depressed adolescent child prays to commit suicide or says he will commit suicide, the depression should be treated as an emergency according to the doctor’s instructions.
This is because the majority of adolescent children who have committed suicide at least once in the past or who have said they will commit suicide will one day actually commit suicide (See suicide).
For this reason, when adolescents with severe depression say they will commit suicide or attempt suicide, they should be hospitalized for a while and treated with special attention to prevent suicide.
In addition, depression is treated with medication, psychotherapy, and counseling.
Among the various treatment methods for depression, the most important thing is to truly love a depressed adolescent child without condition and give focused attention love, and care.
Both children and their families with depression should seek counseling treatment by a psychiatrist.

Drugs to treat depression in adolescent children

Already mentioned for drug treatment for childhood depression in previously here again will be mentioned in more detail.
Drugs used to treat depression include Fluoxetine, Paroxetine, Sertraline, Fluvoxamine, Citalopram, Escitalopram, Antitriptylin, Imipramine, Trintellix and more.
Your doctor can choose one or more than one antidepressant medication to treat depression.
The following antidepressants and anxiolytic drugs in the following tables 1 an 2 can be treated according to the doctor’s prescription.
The rate of receiving antidepressant medication is higher in adolescent girls than that of adolescent boys.
Higher for adolescent girls (the number above is the number of children treated with antidepressant drugs out of 1,000 adolescent children 10-19 years old).

Antidepressants and Anxiolytics (Anxiolytics) (I)

Antidepressants and anxiety-relieving drugs (anxiety-relieving drugs), Common name	Brand name	Initial dose (12 years old or younger)	The maintenance dose (12 years old or younger)	Initial dose (12 years old or older)	The maintenance dose (12 years old or older) More)	Side effects and notes
Fluoxetine	Prozac	5-10 mg/1 day	10-30 mg/1 day	10 mg/ 1 day	20-40 mg/1 day, up to 60 mg/1 day, maximum 20-40 mg/1 day	It is the most effective antidepressant drug for childhood depression. If you have been treated with MAOI before 14 days, you cannot use this medicine, Side effects to the central nervous system, headache, nervousness, sedation, gastrointestinal disorders
Fluvoxamine	Luvox	25 mg Once every evening before bedtime 25 mg	100-200 mg/1 day	25-50 mg/1 day before bedtime 25-50 mg/	150-300 mg/1 day before bedtime	–
Paroxetine	Paxil	5-10 mg/1 day 10-20 mg/1 day	10-20 mg/1 day	10-20 mg/1 day	20-40 mg/1 day	Purpura, low sodium, may interact with many different types of drugs
Sertraline	Zoloft	25 mg/1 day	100-150 mg/ 1 day	25-50 mg/1day	150-200 mg/1 day	Purpura, low sodium, interactions with many different drugs
Citalopram	Celexa	–	10-20 mg/ a day	–	10-40 mg/1 day	Fluoxetine, which may interact with different types of drugs.
Venlafaxine	Effexor	37.5 mg/1 day	75-150 mg/1 day	37.5 -75 mg/1 day	150-300 mg/1 day	Side effects such as nausea, vomiting, dizziness, drowsiness, constipation, Serotonin-norepinephrine reuptake inhibitor
Nefazodone	Serzone	–	Depend upon the treatment effect is seen the dose may increase by 50 mg every 3 days. In children 12 years old and younger, the maximum amount is 300mg/1 day	–	children 12 years and older, the maximum amount is 600 mg/1 day	5-HT blocker. Nausea, vomiting, dizziness, genital erection, dry mouth, visual impairment

Table 59. Antidepressant and anti-anxiety drugs (anxiolytics) Anxiolytics (II)

Antidepressants and anxiety-relieving drugs (anxiety-relieving drugs), Common name	Antidepressant and Anxiety Relief (Anxiety Relief), Brand Name	–	–	Dosage (18 years old or older)	–	Side Effects and Notes
Bupropion sustained-release drug	Wellbutrin SR	–	–	100 mg twice a day for 3 days treatment, if no side effect, 100 mg 3 times a day (every 6 hours in small doses), max. One dose is 150 mg	–	If side effects such as central nervous system irritation, weight change, dry mouth, headache, gastrointestinal disorders, insomnia, convulsions, or visual impairment develop It cannot be used for treatment with this medicine.
Mirtazapine	Remeron	–	–	Begin treatment with 15 mg daily before bedtime and gradually increase every 1-2 weeks	–	Before beginning to use this medicine, CBC tests,, liver function tests should be performed and periodically thereafter. Side effects such as increased appetite, weight gain, dizziness, nausea, dry mouth, constipation, excessive sleep, increased or decreased blood pressure
Buspirone	BusPar	–	–	2.5-5mg/1 day, followed by 2.5mg/1 day incremental treatment every 3-4 days, the maximum amount is 20 mg/1 day. 5-10 mg/1 day for adolescent children, Every 3-4 days, 5 mg/1 day, increase treatment. Maximum 1 dose is 60mg/day	–	Tachycardia, headache, insomnia, confusion, dizziness, gastrointestinal problems
Trazodone	–	–	–	Children (1-18 years-old), Take 1.5-2 mg/kg as the total daily amount and take it orally 2 or 3 divide dose. If necessary, take 6 mg/kg every 3-4 days as the total amount per day, 3 divide doses per day, and take 1 dose 3 times. Adults 150 mg/day, 3 divide dose 3 times a day, if necessary, increase the amount of treatment	–	Side effects such as dizziness, irritation, dry mouth, diarrhea, anemia, weakness, and convulsions
Imipramine	Tofranil –	–	–	Children: 1.5 mg/kg is the total daily amount, and the total daily amount is 3 divided doses and taken orally 3 times a day. Depending on the treatment effect, 1-1.5 mg/kg can be increased to the total daily amount every 3-4 days, so the maximum daily dose is 5 mg/kg/24 hours. Adolescent children: Take 25 -50 mg/kg as the total amount per day and take orally a day for 3 divide doses. The maximum daily dose is 200 mg.	–	If having glaucoma and if to treat with this medicine such as MAOI products is contraindicated. Side effects dizziness, irritation, and dry mouth may occur.

Trintellix has an average rating of 6.0 out of 10 from a total of 489 ratings for the treatment of Depression. 47% of those users who reviewed Trintellix reported a positive effect, while 32% reported a negative effect. Update 12/16/2020

The new treatments for depression promise to relieve distressing symptoms, including suicidal thinking, faster than any previous treatment. They include ketamine, an anesthetic that is also abused as a street drug, and a derivative of ketamine called esketamine. These drugs have been shown to help relieve symptoms of depression within hours, but each dose only works for a few days. They also carry risks, including the potential for drug abuse. 12/20/2020