Back to school: spotting warning signs of teen depression

Experts say anywhere from  5-8% of American teens live with depression. And, Dr. Taz Bhatia of the Atlanta Center for Holistic and Integrative Medicine says isolation is a major warning sign.   Dr. Bhatia explains, "If you have a child who was normally interactive, coming down for dinner every night, telling you what was going on, and suddenly that child is not talking to you very much, or going to their room a lot, that's your first red flag."
Other signs: your child is sleeping too much, apathetic, not eating, or is afraid to go to school or into new situations. For teens with severe symptoms, anti-depressants can help.  Research shows about 60% of depressed teens experienced improvement in their symptoms after their initial treatment. 
There are two anti-depressants approved by the Food and Drug Administration for use in pediatric patients. Prozac is approved for children age 8 and older. Lexapro is approved for teens 12 and older. But the FDA requires all antidepressants to carry a "black box" cautionary warning they can cause suicidal thoughts and behaviors in teens and young adults.  Still, Dr. Bhatia says, the drugs have their role in treating major depression.
Dr. Bhatia says, "Mild to moderate? Absolutely, pharmaceuticals should not be your first option.  Severe depression? Yes, they are. So, everything has a place, but it's again trying to understand where any individual child is on the spectrum of depression, and then meeting them there so that they can be functional and be successful no matter what they do."
Still, the teen brain is a work in progress, and it's not completely clear how anti-depressants affect brain development. But most experts believe the benefits of antidepressants outweigh the risks.  But Bhatia says finding the right medication can be tricky.
She says, “There's a lot of what I call ‘medication gambling’ going on with children. Because they will do well on one medication for a finite period of time, and then because there are side effects such as disrupted sleep, or it's no longer giving them that initial lift, they need a different medication and they keep switching.”
Dr. Bhatia says that’s not ideal for anyone.  “So, really what you want to do is get kids functional, get them successful, but really do the digging. To figure out where this depression is coming from and what we can do about it?” she says.
Research shows the most effective treatment for children is a combination of antidepressant medication and psychotherapy. In one major study, 75% of depressed teens treated with the combined approach experienced significant improvement in their symptoms.