Adolescent Depression

Depression affects 1 in 20 teens. How can adults identify the difference between normal teenage moods and a medical illness? The director of an adolescent depression program joins us on Chicago Tonight at 7:00 pm to talk about prevention and treatment.

Chicago Tonight talked with staff therapist, Frank Borunda, from the Community Counseling Centers of Chicago (C4) to learn more about adolescent depression and how parents can get involved.

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What is the difference between general sadness and depression?

When we talk about depression, from a clinical standpoint, we’re talking about a mood episode, something that happens abnormally that would make someone abnormally happy or sad. We look at how long it’s been going on. Five symptoms (out of 10) have to be met within a two-week period to constitute a depressed mood. Blues/general sadness aren’t impairing life or outside the normal realm such as performing poor on a test, having difficulties with an intimate partner, or bereavement.

*These are the ten symptoms listed on C4’s website from the Diagnostic Criteria, DSM-IV, American Psychiatric Association.

  • Depressed mood most of the day, nearly every day. (In children or adolescents, this can be an irritable mood.)
  • Reduced interest or pleasure in all, or almost all, activities most of the day, nearly every day.
  • Significant weight loss when not dieting, or weight gain (change of more than 5 percent of body weight in a month, OR decrease or increase in appetite nearly every day. (In children, this can be failure to make expected weight gains.)
  • Insomnia or hypersomnia (too little or too much sleep) nearly every day.
  • Physical agitation or lack of physical activity nearly every day (observable by others.)
  • Fatigue or loss of energy nearly every day.
  • Feelings of worthlessness or excessive inappropriate guilt nearly every day. (This is more than self-reproach or guilt about being sick.)
  • Reduced ability to think or concentrate, or indecisiveness nearly every day. (Either by subjective account or as observed by others.)
  • Recurrent thoughts of death (not just fear of dying); thinking about suicide (link here to suicide prevention section...) without a specific plan; a suicide attempt or a specific plan for committing suicide.

How do the symptoms differ between children and adults?

For children and adolescents, we have to take into consideration that a lot of normal changes are happening: physiological changes, brain activity and development, more of an inability to process certain emotions, hormonal imbalance around ages 12-13 and emotions fluctuate a lot. With adults, we look at different triggering factors, like financial loss and work.

Can people have a genetic predisposition?

Absolutely, in our assessment for young adults and children, we always want to know if there’s a family history of mental health problems. It could be general anxiety, or more severe like schizophrenia, but there are higher chances. It’s a transgenerational thing that occurs. Decreases in serotonin can cause an imbalance in the brain. Medication can be taken that creates dopamine to stabilize brain chemistry.

What are ways to treat depression?

Instead of just medication, we combine it with some type of therapy service. Individual therapy works on coping tools and mindfulness, almost like yoga, paying attention to physiological symptoms right before an episode. It’s individual work on ways to recognize when depression happens, if it’s a certain time of year, before a test, etc. Engaging in group activities and support groups, too, to let them now that there’s more people out there with the same types of symptoms.

What about preventive measures?

If someone notices symptoms in children -- difficulty concentrating in school, failing grades, they’re isolating themselves -- these are good symptoms, but it may be something else. It could be the result of bullying as well. The goal is being able to sit down and talk with the child. Have them see a school counselor or bring them in to therapy. Help the individual seek support and surround them with people who are there to listen without judgment, who will provide support to catch that person if they’re falling, so to speak. One symptom is isolation, and they may not want to be around anyone and that can lead to dangerous behavior, suicidal thoughts, and more of a chance to follow through with suicide plans. You need to find a support system. For kids, that can mean extracurricular activities to engage them with others, and educating families who maybe don’t know about depression. Provide them with information on what’s going on.

What is the difference between counseling and cognitive behavior therapy?

You could use a lot of different models. Cognitive behavior therapy is more like working on thoughts and focusing on the thoughts you’re having, and recognizing if certain thoughts keep coming in the head that are causing the depression. And also recognizing thoughts they have that precede an episode, and how to cope with that thought or stop it.

What is the goal of the parenting class that C4 provides?

It’s set up throughout the year to provide extra support for families with kids in treatment. It helps parents learn and develop skills to create structure, and set boundaries with their children, and how to listen and create a family environment. It’s also a support group, too, for the parents to interact with one another.

What’s your advice for parents who suspect their child may be struggling with depression?

The best thing to do is first attempt to engage the child or adolescent and see if they are willing to talk to them about what’s going on. If there’s an identifiable problem, they can find ways to provide support, maybe a group that specifically addresses the issue or therapy. Having communication, an open door policy and talking to the child is key.

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