Dr. Jane Anderson, a Clinical Professor of Pediatrics at the University of California, San Francisco, discusses the increasing number of adolescents diagnosed with depression, and how parents can help.
Thanks for joining us this week for Family Policy Matters. Depression is an increasingly common mental diagnosis in America today. Perhaps more concerning is that a growing number of adolescents, particularly young women, are being clinically diagnosed as suffering from some major form of depression.
Today we are joined by Dr. Jane Anderson, a clinical professor of pediatrics at the University of California, San Francisco. Dr. Anderson recently retired as a practicing pediatrician after 33 years. She is a Board member of Medical Servants International, the National Physician Center, and the American College of Pediatricians.
Dr. Anderson, welcome to Family Policy Matters.It’s great to have you with us on the show.
JANE ANDERSON: Thank you so much Mr. Rustin for having me.
JOHN RUSTIN: Dr. Anderson, adolescent depression is certainly not new, but the growing extent to which we see it in American society today is. In a general sense, to what do you attribute the increase of depression we’re seeing among adolescents and teens in our country?
JANE ANDERSON: It certainly is increasing. At first, people thought maybe we were just making the diagnoses more effectively. But I think that’s clearly been proven not to be the case. Depression truly is on the increase, especially among adolescents. I think a lot of it has to do with our culture and society. It’s obviously not the only cause, but I think a lot of the lifestyles that are prevalent today; a lot of the use of social media, the use of a lot of computer time, screen time, decreased sleep, decreased outdoor activity, as well as, really, the lack of meaning. A lot of the teens don’t have meaning for their life. They don’t know what they’re here for. I think that all plays a role, as do many other things such as, there are biochemical influences. I think nutrition plays a huge role. There’s a relationship between processed foods and an increased risk of depression. So, I think it’s a lot of what we typically call our “normal” society in America.
JOHN RUSTIN: We know that risk factors for teen depression include physical, emotional, psychological and environmental factors. In your practice and in your experience, do these factors affect young men and young women differently? And if so, in what ways?
JANE ANDERSON: I think they do. This may sound very politically incorrect, I apologize, but young women are tuned and were created to be in relationships and they look for love, and they often therefore become sexually active as they are looking for love and relationships, and when those relationships break up it can lead to depression. Not all, but some of the increased risk for women is related to how they were designed, to be in relationship, and the heartbreak of broken relationships. Part of it is, probably, also related to hormonal influence and I don’t think we understand all the impact of hormones on our bodies. But there are estrogen receptors and testosterone receptors in the brain, and again what role they have, we’re just beginning to learn. Different areas of the brain do grow differently and function differently in women, and maybe this estrogen influence also has a role in an increased risk of depression for young women. So I think there are many factors that lead to young women being at a slightly greater increased risk than young men.
JOHN RUSTIN: What are some possible warning signs, Dr. Anderson, of childhood depression that parents should be on the lookout for?
JANE ANDERSON: This will sound overwhelming to people and I don’t want it to be, because it will sound like in one sense it’ll be: Oh, normal teenagers do that. They feel sad at times. They feel hopeless at times. They might be irritable or moody at times. That’s all sort of normal teenage behavior. So what were looking for is more of a pattern that is pervasive, pervasive feelings of sadness or guilt or hopelessness. And I think that’s often manifest in behaviors that the parents can notice, like changes in teenager’s sleep— they’re sleeping too much, they’re not sleeping at all—or changes in their appetite—they’re not eating or they’re eating too much, or especially if they start isolating themselves and things that they used to find so interesting—and they were out there in society and participating in sports or drama or clubs after school—if they start withdrawing from activities and don’t find things pleasurable that they used to, to me that’s one of the biggest warning signs. And then, changes in school performance and absences from school. And then of course, the things that are really blatant: drug use, alcohol use, or if they say they’re thinking of hurting themselves. Parents should never, ever, ever ignore a statement that says: I’m planning to hurt myself or I’m considering it. That is never to be ignored.
JOHN RUSTIN: There’s no doubt that the environment in the home can be a significant factor in the likelihood that a young person may experience childhood depression. What role does the relationship, for example, between a child’s parents in the home have, with respect to the potential for a child to experience depression?
JANE ANDERSON: That is just a fascinating question, and it’s really a pivotal question because there are many different ways—parents relationship with each other, and then also their relationship with the child—can impact that child’s emotional and mental wellbeing. So the risk factors, first, would be that a parent who has experienced their own depression, places their child at an increased risk for depression. So if a parent knows they have had depression, or they are suffering with it themselves, one, please get help, then two, be more alert for signs in the teenager. It doesn’t mean the teenager is doomed and they’re definitely going to be depressed, but it does place them at increased risk, so parents should be aware and paying attention to that. Secondly, there’s a whole new area of research, and maybe you’ve discussed it on your programs in the past, called the Adverse Childhood Events data, which shows that children who have experienced adverse or negative effects during their childhood will have long-term poorer medical wellbeing as well as emotional and mental wellbeing in the future. So a child who’s experienced physical abuse or sexual abuse, parental divorce, and forms of neglect, will have increased risk for depression as a teenager and later in life. So, we’d like to encourage all parents to make sure they are maintaining a good healthy relationship between themselves. The parent/child bond is crucial. One of the largest studies that was done started in 1994 and it was called the National Longitudinal Study on Adolescent Health, and it’s often referred to now as the Ad-Health Study. They followed over 40,000 adolescents through their high school years, very carefully, and they’re still following them as adults decades later. One of the first things they found is that the teenagers who navigate their teenage years with the most healthy behaviors and did not participate in high-risk behaviors—the teenagers who navigated their teenage years most successfully were those teenagers who were well-connected and bonded to their parents. So one of the best things parents can do is start as young as two and three and make sure you are connecting with your kids. And you can do that in so many different ways. Family meals are a crucial part of staying connected. The more meals families eat together with their children, the less likely the child is to have depression, the less likely the child is to participate in other high-risk behaviors during their teen years, and they do better academically as a bonus. Chores actually have been shown to be beneficial. Parents might be pleased to hear that. I like to emphasize volunteering. Families who volunteer together bond together, but they’re also teaching their children and their teenagers: Your life has meaning. Here you are, serving another human being in whatever way you’re volunteering. It’s a great way to promote the parent/child bond, as well as help the teen know that they have meaning in their life.
JOHN RUSTIN: What, Dr. Anderson, should parents do if they do suspect that their child may be suffering from depression, and at what point do you believe that professional intervention may be appropriate and/or necessary?
JANE ANDERSON: I would say at the first suspicion: earlier, sooner rather than later. At any point that a parent is even concerned or questioning: Might my child be depressed? First thing you could do is, if you feel comfortable, is talk to your child, talk to your teenager. Set aside a special time, take them out on a date and say: I’m concerned about you. These are the things that I’ve noticed. Am I misinterpreting things? What’s going on? If the parent doesn’t feel they can do that, the next step is always to seek help. I’m biased. I’m a pediatrician. We’re trained to help people navigate the system and access resources. So talk to your pediatrician. Call your pediatrician and make an appointment. Most pediatricians would be glad to see you, with or without your teenager, if you want to just come in for a consultation without your teen and just talk. Or if you feel comfortable, bring your teenager with you. So I would say, seek help. There are also national phone lines that you can call. They’re designed for teenagers, but parents can call for increased information. So I would say always, sooner rather than later, seek help.
JOHN RUSTIN: Absolutely. Dr. Anderson, from your experience, do you find that adolescents and teens who suffer from depression in their younger years, potentially carry that depression into their adult years? Or is this something that they can have success over? In any event, is depression an ongoing concern that they need to be aware of? Or do you believe there’s a cure?
JANE ANDERSON: I think how I’d phrase it is to say, having had depression during adolescent years places that teen at increased risk for having a recurrence later on in life. The earlier it’s treated, we know is better, and we can actually change patterns of thinking. So one of the ideas that people have about how people become depressed is it’s their negative way of talking back to themselves, and what they feed back to themselves, you know: I’m worthless. I’m meaningless. My life doesn’t have anything good to offer to anybody, etc. If you can change that cycle of feedback that they’re providing themselves early in life—and one of the ways the psychologists talk about it is cognitive behavioral therapy—but if you can change how people talk to themselves, then that is a skill that they can carry with them for the rest of their lives. If they see something happening, they’ve had a bad experience, something traumatic has happened in their life, they’ve got a skill that they can fall back on. So they are at risk for depression later on, but we want to teach them skills early on that will help them through those bad times.
JOHN RUSTIN: Dr. Anderson I know that you are very passionate about, as you’ve discussed, preventative methods to avoid adolescent depression in the first place. And a lot of that has to do with an environment in the home that really fosters positive development and shields children from many of those risk factors that we’ve discussed. Where can our listeners go to learn more about the risks, the signs, and also the preventions of adolescent depression?
JANE ANDERSON: The American College of Pediatricians has several papers up and information. And they also have a blog. They’re available at www.bestforchildren.org. That’s one way to access them. You’ll find there, the paper on decreasing the risk of teen depression. We list things like: decreasing screen time and social media time, increasing healthy nutrition, encouraging exercise and outdoor activities, and good sleep. And by the way, keeping a “gratitude lournal”— the Bible tells us, “In everything give thanks.” That’s good advice. People who keep a gratitude journal actually have better mental health. And then, encouraging volunteering and encouraging sexual abstinence. Kids who are sexually active are more likely to become depressed, both male and female. American College of Pediatricians, and then I’m sure you’ve had lots of other organizations on, that have good information: Focus on the Family, Family Life Today. They have great information. If people need to know the national suicide prevention lifeline, that is 1-800-273-8255.
JOHN RUSTIN: Dr. Jane Anderson I want to thank you so much for being with us on Family Policy Matterstoday, and for your great work and advice on this very important subject. We look forward to the opportunity to have you on the show again in the future.
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