Adolescent Screenings and Evaluations

00:01 >> KATHRYN DELONGA: Hi, my name is Dr. Kathryn DeLonga. I am a licensed clinical psychologist and director of the psychological treatment program with the Mood Brain and Development Unit. Our lab is located within the Emotion and Development Branch of the National Institute of Mental Health at the National Institutes of Health in Bethesda, Maryland. I have nothing to disclose. All the opinions I am presenting are my own and they not intended as a substitute for medical or psychological diagnosis or treatment. And all this work is supported by the National Institute of Mental Health Intramural Research Program. 00:30 The Mood, Brain and Development Unit is a lab that studies adolescent depression and is led by Dr. Argyris Stringaris. We work to improve understanding and treatment of adolescent depression. In this short webinar, I�ll be talking a little bit about major depression�what it is, how frequently we see it in young people, signs and symptoms, and next steps if you think someone you care about may be experiencing depression. Major depression is an illness of brain circuitry and chemistry that causes and results from 01:00 changes in mood, thinking, motivation and behavior. The core symptoms of mood changes are irritability or sadness and difficulty feeling pleasure. And all these symptoms can be clustered into these groups. Some so changes in thinking, some changes in mood, and some physical symptoms. And sadness is something we all experience. It’s a normal reaction to a loss or a setback but then passes with time. Depression is different. There is a range of symptoms that might start sticking around, more days than not, for multiple 01:33 weeks at a time. Symptoms include: Feeling sad, anxious, or empty, feeling irritable much of the time, loss of interest or pleasure, feeling worthless, helpless, guilty, withdrawing from friends and family, grades dropping, risky behaviors, thoughts of death, suicide, or self-harm, difficulty concentrating, remembering information, or making decisions, eating or sleeping more or less than usual, feeling loss of energy, constantly tired, feeling restless, having 02:00 trouble sitting still, and aches, pains, headaches, stomach problems. And you might not experience all these symptoms or may not even have multiple ones at the same time, but for more days than not, for multiple weeks, you might experience a range of some of these things. Major depression is among the world’s leading causes of illness and disability. It’s one of the most common mental disorders in the United States. What we know is that it rises during adolescence. 02:30 In 2016, just under 13% of the US population ages 12-17 experienced at least one major depressive episode. In childhood, rates of depression are generally low, with equal numbers across boys and girls. In adolescence, a time of vast physical, brain, and social changes, there is a sharp rise in the rates of depression, particularly among girls. And while race or sexual orientation are not predictors of depression, social isolation, bullying and a persistent fear of being targeted or not feeling supported or accepted for one’s 03:01 race, gender identity or sexual orientation are. When we think about what causes major depression, we know that it’s a brain disorder that affects circuits and chemistry. We know that depression can be genetic – it often runs in families – but that it is a combination of genes and environment that contribute to a first major depressive episode, and that sometimes if parent or another family member in a household is depressed, a teen may be more vulnerable to depression. Stressful life experiences, such as abuse or being bullied or an injury can be factors 03:32 that lead to depression, and additionally medical or psychological factors–endocrine disorders, substance abuse, underlying anxiety or learning issues can all lead to major depression. Without treatment, recurrence is likely. We often think of adults with major depression as having an onset during the teenage years. Depression is something that can wax and wane but often does come back without treatment. 04:05 So what are some of the treatments. Treatment may include psychological or “talk” therapy – such as cognitive behavioral therapy, which addresses thoughts and behaviors or interpersonal therapy that addresses relationships, social skills, grief, and role transitions in life, or attachment-based family therapy. Additionally, for moderate or severe depression, sometimes medications can be helpful. 04:31 The strongest evidence currently in treating depression in adolescents is for the selective serotonin reuptake inhibitors or SSRIs such as fluoxetine or sertraline, and medication may be effective when paired with psychological therapy such as cognitive behavioral therapy or CBT as this has been shown to be protective against possible side effects of medication-alone. For things to consider when choosing a mental health professional, see: https://www.nimh.nih.gov/health/topics/psychotherapies/index.shtml 05:01 So what are the steps if you are interested in getting help. First is to talk with your parent or guardian, or trusted adult, OR text the word “safe” and your current location to 4HELP (44357) to be connected with a live mental health professional. Step 2 is to make an appointment with your doctor for an evaluation to ensure there is 05:30 no medical or safety issues that need to be addressed and to talk about what you are experiencing and ask for a referral to a mental health professional. If you are considering harming yourself or if you are in a crisis right now talk to your parents or a trusted adult. Reach out to trained counselors through these free, confidential resources, available 24 hours/day, 7 days/week: Call this toll-free number for the National Suicide Prevention Lifeline: 1-800-273-TALK (8255). The service is available to everyone – if you are in crisis yourself or concerned about someone else. The deaf and hard of hearing can contact the Lifeline via TTY at 1-800-799-4889. All calls are confidential. 06:00 You can also visit the Lifeline’s website at www.suicdepreventionlifeline.org. The Crisis Text Line is another free, confidential resource available 24 hours a day, 7 days a week. Text “Connect” to 741741 and a trained crisis counselor will respond to you with support and information over text message. Visit www.crisistextline.org. The Trevor Project has a 24/7 national crisis intervention and suicide prevention lifeline for LGBTQ young people at 1-866-488-7386. Or you can call 911 or go to your nearest emergency room if you have concerns for your safety. And if you know someone who you are worried about who might be in crisis right now. 06:31 Be there. Listen carefully to what the person is thinking and feeling. If you have concerns about their safety, ask, “Are you thinking of killing yourself?” Research has shown that asking at-risk individuals does not increase suicides or suicidal thoughts. Inquire about a plan. Remove access to lethal means such as making sure guns are locked away and making sure medications are locked away. 07:04 Help them connect to a crisis line counselor, health professional or trusted adult. Stay connected and follow-up. If you are someone watching right now who is experiencing depression, we encourage you to reach out for support. Depressive disorder is one of the most common mental disorders in the United States. 07:30 You are not alone. Sometimes living with depression can seem overwhelming, so build a support system for yourself. Talk to family members, friends, and your doctor. Reach out for help. And please feel free to visit us for more information and to learn more about some of our studies and treatment programs that we are offering for teenagers experiencing depression. Thank you for your time.