Adolescent Depression: A Guide for Parents

by Francis Mark Mondimore MD

Overview

Until recently, psychologists and psychiatrists believed that adolescents did not experience true depression in the way that adults do. Medical experts now realize that young people can and do get seriously depressed, and that depression and bipolar disorder may be more serious and more difficult to treat in adolescents than in adults. Depression may also be harder to recognize as an illness, both because moodiness is considered universal among teenagers and because parents often resist having their child treated for a psychiatric illness that they think—and often hope—will be "just a phase."

In Adolescent Depression: A Guide for Parents, Johns Hopkins psychiatrist Francis Mondimore helps parents understand that serious depression in adolescents is an illness—an illness that can be effectively treated. He describes the many forms of depression and the many ways it can appear in young people—from intensely sad feelings to irritability, anger, and destructive rages. And he answers parents' questions, including: What are the danger signals of serious depression in teenagers? How are mood disorders diagnosed? How do medications work? What about talking therapies? How does depression relate to other problems, such as drug abuse, ADHD, and eating disorders and other self-injurious behavior? Of the one in five adults who go through a period of serious depression during their lifetime, many had their first experience of depression as teenagers. This comprehensive and compassionate guide detailing the symptoms, treatments, complications, and causes of adolescent depression provides parents with the information they need to ensure that their children receive the best possible treatment and become happy and healthy adults.

Product Details

ISBN-13:	9781421404127
Publisher:	Johns Hopkins University Press
Publication date:	10/01/2002
Series:	A Johns Hopkins Press Health Book
Sold by:	Barnes & Noble
Format:	eBook
Pages:	304
File size:	4 MB
Age Range:	18 Years

About the Author

Francis Mark Mondimore, M.D., is a psychiatrist and member of the clinical faculty of the Johns Hopkins University School of Medicine. His books include Depression: The Mood Disease and Bipolar Disorder: A Guide for Patients and Families, both available from Johns Hopkins.

Francis Mark Mondimore, M.D., is a psychiatrist on the faculty of the Johns Hopkins University School of Medicine and director of the Mood Disorders Clinic at Johns Hopkins Bayview Medical Center. His books include Borderline Personality Disorder: New Reasons for Hope; Depression, the Mood Disease; and Adolescent Depression: A Guide for Parents, all published by Johns Hopkins.

Table of Contents

	Preface	xi
	Acknowledgments	xv
	Introduction	1
Part I	Symptoms, Syndromes, and Diagnosis	5
1.	Depression: Some Definitions	7
	Normal and Abnormal Moods	9
	The Symptom of Depression	9
	The Syndrome of Depression	10
	Associated Symptoms of Depression	16
	Mood Disorders: Real Illnesses	17
	The Chemistry of Mood	18
2.	Normal Adolescence and Depression in Adolescence	21
	More on Symptoms	21
	More on Adolescence	23
	When Is Depression "Serious"?	29
3.	The Mood Disorders of Adolescence	33
	Psychiatric Diagnosis	33
	Major Depressive Disorder	35
	Dysthymic Disorder	43
	Bipolar Disorder	46
	More on Diagnosis	55
	The Importance of Treatment	59
4.	Mood Disorders: A Summary of Diagnostic Categories in the DSM	62
	What Is the DSM?	62
	A "Multiaxial" Diagnostic System	64
	Mood Disorder Categories in DSM IV	67
	Controversies in the Use of the DSM	71
Part II	Treatment	73
5.	Medication Issues in Adolescence	75
	Pharmaceuticals and the FDA	76
	Dose Adjustments and Other Differences for Young People	78
	How Psychiatric Medications Work	79
6.	Antidepressant Medications	89
	Tricyclic Antidepressants	89
	Selective Serotonin Reuptake Inhibitors	95
	Other New Antidepressants	97
	Monoamine Oxidase Inhibitors	98
	Antidepressant Therapy: Some General Considerations	100
7.	Mood-Stabilizing Medications	103
	Lithium	103
	Valproate (Depakote)	113
	Carbamazepine (Tegretol)	116
	Lamotrigine (Lamictal)	119
	Other Mood Stabilizers	121
	What Do Mood Stabilizers Treat?	122
8.	Other Medications and Treatments	124
	Antipsychotic Medications	124
	Benzodiazepines	129
	St. John's Wort	129
	Omega-3 Fatty Acids and Fish Oil	131
	Electroconvulsive Therapy	134
	Other New Treatments	141
9.	Counseling and Psychotherapy	145
	The "Biology-Psychology" Split in Psychiatry	145
	Is Psychotherapy Alone Sufficient?	147
	Is Psychotherapy Always Necessary?	149
	Matching the Psychotherapy to the Patient	150
	Choosing a Therapy and a Therapist	157
	The Psychiatrist-Psychotherapist: An Extinct Species?	158
Part III	Variations, Causes, and Connections	161
10.	Attention-Deficit/Hyperactivity Disorder	163
	What is ADHD?	163
	Treatment Issues	167
	Mood Disorders and ADHD	167
11.	Alcohol and Drug Abuse	171
	Adolescent Substance Abuse	171
	Alcohol Abuse	174
	Marijuana Abuse	176
	"Ecstasy" and "Club Drugs"	177
	Mood Disorders and Substance Abuse	180
	Treatment Issues	182
12.	Eating Disorders	185
	Anorexia Nervosa	188
	Bulimia Nervosa	189
	Understanding Eating Disorders	191
	Mood Disorders and Eating Disorders	193
13.	"Cutting" and Other Self-Harming Behaviors	195
	Self-Mutilation	195
	Adolescent Suicide	199
14.	The Genetics of Mood Disorders	205
	Genes, Chromosomes, and DNA	205
	Genetic Diseases	207
	What We Know	212
	The Search Continues	212
Part IV	Getting Better and Staying Well	215
15.	Strategies for Successful Treatment	217
	Diagnosis, Diagnosis, Diagnosis	218
	Choosing the Treatment Team	221
	Eliminating Pathological Influences: Mood Hygiene	228
16.	The Role of the Family	238
	Recognizing Symptoms	238
	Getting Involved in Treatment	239
	Safety Issues	241
	Arranging Hospitalization and Involuntary Treatment	243
	Getting the Support You Need	246
17.	Planning for Emergencies	249
	Know Whom to Call for Help	252
	Insurance Issues	254
	More on Safety	257
18.	Looking Ahead	259
	Resources	263
	Suggested Reading	263
	Support and Advocacy Organizations	264
	Internet Resources	265
	Notes	267
	Index	283

What People are Saying About This

Sallie P. Mink

This is Dr. Mondimore's best book yet, thorough and comprehensive. He provides information that is vital for parents, pediatricians, and general practitioners trying to understand the behavioral symptoms of mood disorders in adolescents.

— Sallie P. Mink, Director of Education, Depression and Related Affective Disorders Association (DRADA)

Neal D. Ryan

This well-written book is both comprehensive and scientifically rigorous. Dr. Mondimore makes the complex concepts and terms involved in the diagnosis and treatment of adolescent depression enormously accessible to the layperson.

— Neal D. Ryan, M.D., Western Psychiatric Institute and Clinic, University of Pittsburgh

Anthony J. Drobnick

Dr. Mondimore has clearly succeeded in his goal of providing parents with a sophisticated summary of everything that is currently known about adolescent mood disorders. His writing combines a keen clinical skill in the care of patients with a comprehensive and sensible review of the research literature. In our clinic at Johns Hopkins Hospital, we spend a lot of time simply educating parents about these conditions, and we have badly needed a book to recommend to families. Dr. Mondimore's book more than satisfies this urgent need. This is an outstanding work that surpasses anything else I have read for parents on clinical depression and bipolar disorder in teenagers.

— Anthony J. Drobnick, M.D., Director of the Adolescent Affective Disorders Consultation Clinic, Johns Hopkins Medical Institutions

Editorial Reviews

3 Stars from Doody

"This is Dr. Mondimore's best book yet, thorough and comprehensive. He provides information that is vital for parents, pediatricians, and general practitioners trying to understand the behavioral symptoms of mood disorders in adolescents."

Sallie P. Mink

"An outstanding work that surpasses anything else I have read for parents on clinical depression and bipolar disorder in teenagers."

Anthony J. Drobnick

"This well-written book is both comprehensive and scientifically rigorous. Dr. Mondimore makes the complex concepts and terms involved in the diagnosis and treatment of adolescent depression enormously accessible to the layperson."

Neal D. Ryan

"I heartily recommend this book to parents and relatives of adolescents who have or may have mood disorders. It... helps parents to understand the complexities of the problem [and] is optimistic of the likelihood of improvement with correct diagnosis and treatment."

Journal of Clinical Psychiatry - Marcia Slomowitz

"This is an intelligent and well-written work with a substantial amount of detail especially about medications and how they work."

Metaphysiology Online Book Reviews

"Clear, medically precise terminology, drawings, and diagrams."

Healing Magazine

"The book is comprehensive and thorough at almost 400 pages, providing a wealth of information on depression and its relevance to this vulnerable group."

Nursing Times

"If you have a depressed teen in your household, this book is a must-read."

Examiner.com

I heartily recommend this book to parents and relatives of adolescents who have or may have mood disorders. It is written clearly and simply... and with a style that helps parents to understand the complexities of the problem that is optimistic of the likelihood of improvement with correct diagnosis and treatment.

— Marcia Slomowitz, M.D.

Journal of Clinical Psychiatry

"Because of its specialization, this book will provide significantly more applicable information than any general psychology text that covers a variety of mental health disorders."

American Reference Books Annual

"As I prepared this brief review, I found myself advising families to obtain their own copy of Dr. Mondimore's well-written, clear, and valuable book."

American Journal of Psychiatry - Nancy A. Durant

As I prepared this brief review, I found myself advising families to obtain their own copy of Dr. Mondimore's well-written, clear, and valuable book.

— Nancy A. Durant, M.D.

American Journal of Psychiatry

Reviewer: Laura Gavanescu, MD (Rush University Medical Center)
Description: This is a comprehensive update of a book that characterizes the essential issues and concerns that parents should be aware of to help determine the presence of depression in their teenaged children. The previous edition was published in 2002.
Purpose: The authors emphasize the importance of parents recognizing that clinical depression in adolescents does occur and can be a serious medical problem if dismissed as typical teenage mood variance and not met with formal assessment and treatment.
Audience: This book is intended for parents and guardians of teenaged children as well as other lay persons responsible for the well-being of teenagers. It serves to answer the many questions they may have about clinical depression, warning symptoms, diagnoses, and treatment options.
Features: The first part, on symptoms, syndromes, and diagnosis, makes readers aware of how clinical depression in a teenager can be a serious problem that is just as important as other medical problems. It describes our best understanding of normal adolescence and then explains the several types of clinical depression. It concludes with a simple historical review of the DSM that is often the source of diagnoses. The second part, on treatment, is a simple yet comprehensive overview of both psychopharmacology and medical treatments for depression along with their methods of action, side effects, and common concerns. It also discusses psychotherapeutic approaches and how they complement these treatments. Part three, on variations, causes, and connections, addresses some of the complexities of clinical depression when it is comorbid with ADHD, autistic spectrum disorders, substance use disorders, eating disorders, self-injurious cutting, and the influence of genetics. The fourth and final part reads like a concise compendium of professional advice for parents who have just made the decision to seek care for an adolescent with signs of clinical depression.
Assessment: This is an exceptionally thoughtful book for parents that is so well done that it not only comprehensively covers the essentials they must understand about depression and its treatment without using technical jargon, it anticipates and addresses many of the questions parents may have about a clinically depressed adolescent, providing an honest depiction that is quick to highlight the limits of professional knowledge. The book could be enhanced in two ways. First, it would benefit from addressing more of the influence of social acceptance and identity challenges of adolescence that pertain to gender, race, socioeconomic class, body image, and cultural assimilation, to name a few. Second, it is clearly stated that the book was written after DSM-5, so there is no good reason for its prediction that the multi-axial diagnostic format would remain, its use of outdated diagnoses of childhood from DSM-IV, and its failure to accurately note how names of some disorders of childhood have changed. Despite this, it remains an excellent resource to keep parents informed while they are seeking care for a clinically depressed adolescent.

Doody's Review Service