You’ve no doubt seen the recent news headlines about a federal panel recommending to the FDA that antidepressant medications carry the strongest possible warning label for use in children and adolescents. This recommendation to the FDA shook the medical community, especially those who work with depressed youth. The biggest problem from the point of view of the treatment community was not the recommendation for the warning label, but the way the media portrayed the panel’s recommendation. The panel reported that 2% to 4% of children and adolescents who received antidepressants for the treatment of depression became suicidal, that is, had suicidal thoughts or attempted suicide of one kind or another. None of the 4,000 children and adolescents studied committed suicide. What is underreported in the media is the fact that 15% of untreated children and adolescents with depression will commit suicide. This 15% will not only think about it, but will commit suicide. Then, what are we going to do? If the media had its way, it seems that no adolescent with depression would receive antidepressants. As a result, the suicide rate of those who might be using the drug would rise from nearly zero percent to around fifteen percent. But at least we wouldn’t have to worry about evil drugs. Look, I understand that there are actually young people, even adults, who have become suicidal only after starting treatment with an antidepressant. Some, in fact, have even taken their own lives. This is absolutely tragic. But so is the fact that untreated depression is potentially a deadly disease. Fifteen out of every hundred young people with depression take their own lives. They must be allowed to receive treatment that drastically reduces the suicide rate, and without any stigma attached to it by the media. We recently had a patient brought into our counseling center named John (not his real name). John was rebellious, angry, withdrawn and often got into trouble, yet he was diagnosed and treated for depression. When we think of someone who is depressed, we usually imagine a sad, tearful, and lonely person. But teens with depression don’t look like adults with depression. Current studies show that there are as many depressed adolescents as depressed adults. However, depression manifests itself very differently in adolescents than in adults. Teens don’t often show pessimism, self-deprecation, or talk about feeling hopeless like adults do. Adolescents with major depression are described in diagnostic manuals as often becoming negative and antisocial. Increased feelings of wanting to leave home, or of not being understood and approved. The adolescent often changes and becomes more restless, moody or aggressive. Reluctance to cooperate in family businesses and isolation from social activities, retiring to one’s own room, are common. School is likely as concentration is affected. Sometimes there is a lack of attention to personal appearance and increased emotionality. There is also often an increased sensitivity to rejection in romantic relationships. Teenagers often become aggressive, agitated, and get into trouble at home, at school, or with the law. Teenage girls are sometimes preoccupied with issues of death or dying, and are increasingly concerned with their appearance. Suicidal thoughts are common. Some studies suggest that 500,000 teens attempt suicide each year and 5,000 succeed. Increased use of alcohol or other drugs, along with other forms of “self-destructive behavior,” is common. Low self-esteem is common among adolescents, but especially among those who are depressed. Parents are often confused and frustrated when their teens begin to act this way. Parents sometimes become harsh in discipline, or even belittle the teen, which only serves to increase feelings of guilt and depression. Other times, parents feel powerless and wait for adulthood to arrive. Of course, neither course is correct. If you know of a teen whose behaviors have changed to resemble what was described above, let the parents know that help is available and encourage the family to seek professional help. With proper diagnosis and treatment, a depressed teen or adult can be greatly helped. If someone close to you is suffering from depression, first understand that depression is a very emotionally painful condition. For some people with depression it becomes a “terminal illness” due to suicide. Please take the situation seriously. 1) Get a medical evaluation. Symptoms of depression can be the result of a wide variety of illnesses, including thyroid problems, viral infections, and other factors. 2) Deprex is an amino acid and homeopathic medicine for the treatment of depression that we have seen work well with our patients. It may be worth trying as long as the situation is “stable” and there are no suicidal thoughts on the part of the depressed person. 3) Medications like Prozac can be very helpful for the most difficult cases. Consult your doctor. These medications are often prescribed by family medicine doctors, but in most cases they must be supervised by psychiatrists. 4) Increase your protein intake a little. Use a protein powder supplement, like a weightlifter. 5) Exercise every day. Just go outside and walk around for about 15 minutes. 6) Seek advice from someone who is good at treating depression. This can do a world of good for you. However, always use great wisdom and common sense when choosing a therapist. Some are good and some are not, so choose wisely.