The adolescent period is full of excitement as well as emotional, intellectual, and physical growth. The majority of kids can navigate these transitions well. However, sometimes kids will begin to feel the pressure of daily life and start to show signs of mental health issues. As a mother of a teenager and a pediatrician, I witness the pressures that impact adolescents on a daily basis.
It is estimated that about 1/5 of teens will suffer from depression at some point. Our pediatricians and nurse practitioners talk to kids about the pressures they are under at every well check-up. We ask about their academics, athletics, after-school jobs, and social pressures including exposures to drugs, alcohol, vaping, and sexual and/or gender identity issues.
Sometimes we encounter and address kids who are living with family crises/dysfunction and event poverty and abuse. On occasion, we are the first ones to recognize there is depression going on. Tragically at times, depression may lead to suicidal attempts. Suicide is preventable and this is our ultimate goal.
Several years ago, the American Academy of Pediatrics recommended that all kids 12 and older should be screened for depression with a validated screening at their yearly well-exams. The validated screen that we are presently using is called the PHQ-9 survey and consists of nine questions that screen for depression and suicidal thoughts. We will ask them to fill this out right before they start their check-up. At some point in the visit, we will ask them about their responses, and we will ask you as well if you have any concerns about your child’s mental health.
For instance, have you noticed recent changes in your child’s mood, energy level, appetite, or sleep habits? Does your child seem like they do not enjoy things as much they used to? Has your child been isolating him or herself recently? It is important for us to be able to talk with your adolescent confidentially, so we will ask you to step out of the room. The truth is that there are times when an adolescent will not feel comfortable revealing something about their physical or mental health to his/her parents, but know that they do need help and can trust us. By law, we are bound to keep their information confidential unless they reveal something that may be acutely harmful like thoughts of suicide.
It is our privilege and the most rewarding part of our profession to gain you and your child’s trust and allowing us to help you navigate through these very difficult circumstances and diseases.
Ultimately, depression is a treatable disease with therapy, sometimes medication, and support from family, community, and us, their medical home.