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CHILDRENS DEPRESSION: APPROACHES AND TREATMENT
A psychological approach is interpersonal therapy, based on the premise that the patient’s depression is rooted in relating with others. It aims at improving social functioning.
Many psychiatrists, faced with treating acute cases (e.g., a potential suicide), turn to powerful drugs to lift the young person out of depression. Dr. Gold says, however, that the physician first must have the patient thoroughly tested to rule out a physical disease. “We found one youngster complaining of leg pains that his psychiatrist thought might be another symptom of depression,” he notes. “It turned out that the boy had cancer of the bone.”
First comes the diagnosis, then the treatment, which may include drugs. The drug imipramine works very well for young people, says Dr. Gold. A new method measures the amount of the drug in the blood to determine whether the patient is taking the right dosage. Such measurements have revolutionized drug treatment for depression and made it successful in up to 80 percent of teenage cases. Lithium salts also help young people, but they are mainly prescribed for manic-depressives.
As do other physicians, Dr. Gold cautions that “you cannot just throw medication at a child.” Psychological treatment helps the child develop socially and emotionally while fighting the depression. Without such help, Dr. Gold adds, the young person falls behind peers in learning how to deal with others and problems.
Family history plays a big role in teen depression. If depression afflicts one of the parents, chances are two in five that the children will suffer the same disease. Bad life circumstances also can trigger or prolong depression. Physically or mentally abused children tend to be depressed. Children in families with marital discord also suffer from depression.
It is extremely important that the family participates in treatment; otherwise, the teen whose depression has been lifted by drugs or therapy or both might return to a family situation that could trigger the illness all over again.
“Depression is a disease,” says Dr. Gold. “It’s treatable. Untreated, it’s deadly.”
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