Frequently Asked Questions
- Asking for Help
- Causes of Depression
- Diagnosis of Depression
- Substance Abuse Issues
- Talking to Your Student or Friend
- Treatment of Depression Including Medications
If you are worried about a friend, it is important that you tell an adult so that your friend can get the proper help. There are many adults at the school who would be good options including a teacher or counselor. The counselors are particularly knowledgeable about local resources for treatment.
No! Depression is a serious medical illness.
If a student has concerns about a friend, it is imperative to tell a trusted adult.
How do we tackle the distortion/glamorization of mental illness? Social media particularly romanticizes illness.
The best way to challenge distorted ideas is with education. ADAP and programs like it bring accurate information to students, parents, and teachers so that they can have a realistic idea about how dangerous depression can be.
What if I have concerns about someone else’s child? My child’s friend has some concerning behaviors…
One option is to call the child’s parents and share your concerns. If you do not know the parents well or are worried that they would not be open to hearing your concerns, contacting the school’s counselor is a good alternative.
Yes. Students often turn to teachers or counselors at their school to get help for themselves or a friend. Because they know the professionals at their school well, that is someone they often talk to first.
A good place to start is with the high school counselor because he or she will know about local resources. There are many options, including the counselor, your pediatrician, or a psychiatrist.
Increasing depression literacy is the first step in having youth recognize the symptoms of depression. Our studies show that ADAP increases depression literacy in students, and 46% of ADAP instructors have been approached by students about seeking help for themselves or a friend.
Can you talk about risk-taking and depression? Are people more likely to engage in risk-taking or less likely to engage in risk-taking when they are depressed?
Young people who are depressed sometimes care less about consequences and will engage in risky behavior more readily.
There is growing evidence that marijuana can trigger depressive episodes in people who are vulnerable to getting depression. Other studies have shown that people do not get better from depression, despite treatment, if they continue to use marijuana.
Substance abuse can be related to mood disorders or occur independently. Many people turn to alcohol and drugs when their mood is terrible because it will change how they feel for short periods of time. Long term, there is evidence that alcohol and other drugs worsen depressive symptoms and complicate the course of treatment.
Depression is a treatable medical illness. Individuals treated for depression can live perfectly normal lives. Living with untreated depression increases the risk for other psychiatric illnesses, substance dependence or abuse, suicide attempts, educational underachievement, unemployment, and early parenthood.
It can be very disruptive to have someone suffering with depression with the family. Someone with depression may be unkind to siblings and they often need a lot of parental attention to manage their emotions and behaviors.
One of the most important things someone can do is to not use substances that can destabilize mood, such as alcohol and marijuana. In addition, it is important that people get enough sleep, exercise regularly, and eat a healthy diet to contribute to their recovery.
One challenge is that we do not have a test to identify the best antidepressant for an individual. Another challenge is that it takes 4-6 weeks at a full dose of the medicine to see if there is a benefit.
Some people stop taking medication because they have side effects or because they feel it does not help. Other struggle with needing to take medication. With depression, some people forget to take it once they are feeling better because they are not having active symptoms that remind them that they need to take the medicine. Antidepressants are not like pain medicines where you only take them when you need them.
Research shows that antidepressants work effectively at reducing depressive symptoms and should be at the frontline of treating depression. Psychotherapy should also be incorporated into the treatment plan. The combination of medication and psychotherapy has been shown to be the most effective treatment for both teenagers and adults.
When depression is treated, how do you know if it was an isolated depression episode or if treatment should continue for life?
There are three groups of people who have depression: one group will have one episode and will never have it again; a second group will have episodes separated by long periods of time (up to 10-15 years) and do not need to be on medicine between the episodes; the third group has the return of depressive symptoms quickly if off medicine. The third group benefits from taking medication long-term. It is not possible to predict when people are having first episodes which group they will be in, so close monitoring and ongoing treatment is important.
In one large study, where multiple studies were combined, being on an antidepressant was associated with a very small increase (4% vs. 2%) in having suicidal thoughts or behaviors. This compared people taking an antidepressant to those taking a placebo. Nobody in these studies died by suicide. Therefore, we believe it is possible to have a brief increase in suicidal thoughts in a very small number of people. This does not mean that people should not be treated with antidepressants. It does show how important monitoring is when someone begins antidepressant treatment. What is very clear is that not being treated for depression is highly associated with death from suicide. Overall, there is a much greater risk of suicide from not being on antidepressants if you need them.
When someone is treated for depression, are they cured? Are you always actively ill? Are you on lifelong treatment?
Depression is an illness that is very treatable but we do not currently have a cure. That means that someone could have a recurrence of the symptoms in the future. Depression is episodic so people can have long periods where they are not actively ill. Regarding treatment, some people do best if they stay on medication treatment and others do not need to do this. It is a very personal decision that a person makes with his or her treatment team.
Depression is an episodic illness where most people have periods of illness separated by periods of being well.
What if I am worried that my student is depressed but they actually aren’t? Are we over-diagnosing depression or being overly cautious in identifying at-risk students?
Any time you are sharing concerns, there is a possibility that the student will not have depression. However, there is a much greater risk of missing an underlying depression or not taking action when it is needed. The process of evaluation addresses whether the person does or does not have depression. It is not up to the teachers to determine that. Rather, teachers will hopefully share concerns so that students and the parents can decide if they want to proceed with an evaluation.
Doctors look for a cluster of symptoms when diagnosing depression. The symptoms fall into three broad categories: change in mood, physical symptoms, and losing self-confidence. These symptoms must be present during the same two week period and cause significant distress or impairment in functioning. The symptoms cannot be due to the effects of alcohol, other substances, or another medical condition.
There are no clear ways to prevent depression. However, it is critical that it be identified early so that someone gets help as soon as possible to minimize negative consequences. For example, teens with untreated depression often start using drugs and alcohol and there are major problems that can result from those behaviors. So the best way for parents to support their children is to be aware of the symptoms and take action as soon as they are concerned.
Although stress can be a trigger for depression, many depressive episodes occur with no clear cause. Depression is a medical illness, so like asthma, you can have an episode triggered by an environmental trigger (like dust or being around another animal for asthma); some depressions are triggered by stress while many simply come out of the blue. Unfortunately, that feels out of control and it can be hard for someone to accept that someone could become ill without a cause.
Depression affects roughly twice as many women as men.
Is depression or bipolar disorder genetic or hereditary? Can someone get depressed without a family history?
Depression and bipolar disorder are both influenced by genetics. While mood disorders are hereditary, no one is immune to depression or bipolar disorder and it is possible to become ill even if there is no family history. It is also possible that a person with a family history of depression never becomes ill.