Experts call teen depression a challenge

A 16-year-old Red Lion student had been treated with medication and counseling for a mental illness, yet he allegedly attacked another student last week.

His case could be viewed as illustrating the challenges of treating teenagers, whose bodies and worlds are changing. Or it could have been a response to being bullied, one local psychiatrist said.

The student's father said his son struggled with depression, attention deficit disorder and post-traumatic stress disorder. He had been receiving treatments and was taking two anti-depressants, the boy's father said.

The boy had complained about being picked on, but didn't have a history of fighting, his father said.

Treatment for mental illnesses such as depression can include using anti-depressants, individual counseling, family counseling, and if needed, as in the 16-year-old's case, in-patient psychiatric treatment.

Counseling challenges

Psychiatrists know teenagers are different from adults. Teenagers are dealing with hormones and new social pressures, said Dr. Douglas Chen said, a Springettsbury Township psychiatrist.

From imaging technology brain scans, doctors can tell that the teenage brain has not reached what is considered adult development in the prefrontal cortex, which sits in the forehead area, Chen said. That's where maturity and judgement decisions are made, he said.

Dr. Leslie Lundt, a psychiatrist who practices in Boise, Idaho, said pairing counseling whenever medication is prescribed for teenagers is important.

With teens, willingness to take part in counseling may create an obstacle, Lundt said.

"A lot of times the kids don't want to be in counseling so they don't want to talk," she said. "They are afraid you are going to rat on them to their parents."

For a counselor that can be a sticky issue. A counselor needs to explain to a teenager how confidentiality works, she said. If a teen says he's suicidal, the parents must be notified, she said.

And then a counselor needs to be able to work out teenage exaggeration during sessions. A teen might say, "I'm so angry I could kill someone," but he doesn't mean it, she said.

Medication not a guarantee

Individuals respond differently to drugs. But because of teens' biological changes and social pressures, there is even more of a need for doctors to have an open mind when treating teenagers with medication, Chen said.

Any illness - cancer, for example - can worsen even with treatment, he said.

Lundt said research has not been strong to support using anti-depressants in teenagers and children.

"We know that medicines, statistically, don't work as well in kids as in adults," she said.