The Nature of Depression: An Overview for Parents and Youth Daphne - - PowerPoint PPT Presentation
The Nature of Depression: An Overview for Parents and Youth Daphne J Korczak MD, MSc , FRCPC (peds), FRCPC (psych) Head, Inpatient and Day Treatment Program Psychiatrist Hospital for Sick Children Psychiatrist, Hospital for Sick Children
MD, MSc , FRCPC (peds), FRCPC (psych)
Head, Inpatient and Day Treatment Program Psychiatrist Hospital for Sick Children Psychiatrist, Hospital for Sick Children Assistant Professor, University of Toronto
Being depressed is a normal part of adolescence Sometimes it’s hard to tell when a child is depressed
When a child is depressed, parents are usually to blame When a child is depressed, parents often feel
Getting information and help for depression is more
15 year old boy, previously well
Feeling upset for the past 5-6 months, “everything annoys me”,
Attends school daily but feels it’s “pointless, teachers are stupid, work isn’t hard but I don’t want y p , p , to do it” Difficulty concentrating
Grades are not as high as before (60-70 now; 80-90 previously)
Not interested in starting soccer as usual f f ’
He has a few friends he enjoyed playing sports with, now doesn’t want to play with them. Not interested, wants to be left alone.
Tired, naps in the day a couple of times a week, sleeps 9 hrs per night, but takes him about 1.5-2 hours to fall asleep.
Occasionally has had thoughts like “what’s the point, life is too hard”
His parents say he has always been a sensitive child, but this is different. Over the last year he has been bullied at school by a couple of kids in particular, on and off, not happening recently.
Paul’s father has a history of depression as a younger man, doing well over the last 7-9 years.
Prolonged
Pervasive Associated features Impairing Impairing Out of keeping Note: “out of keeping” does not mean “for no reason” Note: out of keeping does not mean for no reason
alence (%)
Preva World Health Organization (WHO): Depression will be the 2nd leading Depression will be the 2nd leading cause of global burden of disease by the year 2020 (4th in 2000)
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genetics
environment
e g bullying
environment
e.g. bullying, break-up
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The longer that depression was untreated, the smaller the hippocampus volume measured
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Mood diary – readily available, can be a useful tool Healthy eating/sleeping (screen time) Addressing stressors – school, social, family Avoiding substances
Increasing positive activities Exercise Possibly omega-3-fatty acid supplements Possibly omega 3 fatty acid supplements
Cognitive Behavioural Therapy
Particularly if there is pre-existing anxiety + non-specific strategies, where possible
Other psychotherapies may also be helpful, depending on the
Anti-depressant medication is more likely to be required
+/- CBT + non-specific measures, where possible
SSRI medications can be safe and effective in the right
A few large studies of the treatment of depression in adolescents A few large studies of the treatment of depression in adolescents
Combination of medication +CBT better than either alone?
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