Mood disorders, whether depression, bipolar disorder, or some variation of the two, are more common in teenagers than we generally think. The problem from a diagnostic point of view is that teenagers are inconsistent, moody, and often test limits. It’s the nature of the beast.
So how do you tell the difference? If your daughter or son shows evidence of moodiness, stays in bed too much, or on the other side, has flights on energy, sleeplessness and grandiosity, you might begin to think that this is no longer simply teenage moodiness. Mood disorders tend to run in families, so check your own past history on your side and on your spouse’s side. If your child is adopted, did the biological parents have these issues?
What defines mood disorders, indeed any disorder, is not just what they experience but also how it impacts their functioning. If a person walks around feeling depressed but isn’t suicidal, does well in school, has good friends, has a boyfriend of girlfriend and is generally enjoying life, this may simply be teenage angst. If, on the other hand, she tells you she’s feeling fine, but she’s having trouble getting out of bed in the morning, her friends are no longer calling, and she has lost interest in what used to give her pleasure, this well may be an actual depression.
The treatments for depression and mood disorders are very effective, but you must get the child seen. I generally recommend that parents tell their children that they’re coming in for an assessment – there’s no obligation that they continue to see me or to get treatment. This preamble generally lightens the load off them, allows them to feel less trapped, and paradoxically, lets them open up.
Once a depression, bipolar disorder, or it’s less severe cousins, dysthymia and psychothymia has been diagnosed, treatments include supportive psychotherapy, cognitive behavior therapy and prescribed medications. People often put off the notion of medication in teenagers, but many psychiatrists, including myself, will tell them that medication can be very effective- sometimes the most effective of all treatments. And when it is effective, it’s a godsend. We medicate children in order to give them the strength to overcome the obstacles that are affecting them so that in the future they are well. Treatment is not only concerned about relieving the unhappy mood, but also about understanding and dealing with the problem that may have triggered it in the first place – a breakup, a divorce, a move, a death, etc. Mood disorders are real, and like anything else in life, they are best handled in a straightforward way. Avoidance makes them worse and honest assessment and treatment often saves the day.