October 3, 2004
Marissa Nelson, London Free Press
More and more teens are being diagnosed with depression. For Londoner Stephanie Ash, the price has been high: self-mutilation, drug use and, at age 18, not a single high school credit.
Her flesh was burning. She could barely stand up.
She kept vomiting.
Maybe it was a drug allergy. She had just changed medications.
She was sick. Really, really sick. So she went to the emergency room twice. The doctors said it was the flu.
She went home, hoping it would pass.
But it didn't. Ten days later, she knew there had to be more to it. It had to be an allergy to the new medication.
On the third trip to the emergency room, she got the answer: a panic attack.
The vomiting, the dizziness -- it was all something in her brain and it had lasted two weeks.
"I was just so ill," says Stephanie Ash, now 18.
While the news meant the teen now had two mental health issues -- depression and anxiety -- knowing was comforting.
"In a weird way, I felt better because I was so scared there was something seriously wrong with me. Hearing it's a mental thing -- I thought, I can deal with that."
But relief gave way to anger. Why her? Why another problem?
"Now I'm officially crazy. That's what I thought. I'm so sick of having new problems," she says. "I was angry. I was so sick
of dealing with stuff other people didn't have to deal with. It was like, 'Why me?' "
A report released this year found 15.7 per cent of 15- to 19-year-old Londoners suffer from depression, compared with an Ontario average of 11.4 per cent.
More and more teens are getting diagnosed with depression.
That's a good thing, says Margaret Steele, chairperson of child psychiatry at the University of Western Ontario and lead physician at the London Health Sciences Centre's adolescent centre.
It's good they're getting diagnosed because early treatment could make all the difference for recovery, Steele says.
The longer depression goes untreated, the more likely the teen will turn to alcohol or drugs. They can also turn to crime and miss a lot of school.
For years, adults thought the teen years were a time of turmoil and moody blues. Those same adults now realize teens -- and even children -- can develop depression.
"You need to intervene early because it impacts their later life," Steele says. "It wasn't until the 1980s that people realized kids can get depression, too."
While Ash wasn't diagnosed with depression until age 16, she figures she developed it at 13 and it progressed, as Steele predicted.
She would spend whole days in her room. She isolated herself and would wear only black, baggy clothes.
"I'd get mad at my mother for no real reason," Ash says. "I'd yell, scream and cry for absolutely no reason."
She became irrationally afraid of storms and cancer. A simple bruise was enough to convince her she had a fatal disease.
Her mother thought she was going through the regular teenager blues.
"She didn't want to believe there was a bigger problem behind my dark clothes," Ash says. "She thought maybe I just needed to cry about it."
Now, at 18, Ash hasn't completed a single high school credit. She began smoking marijuana in elementary school and even started cutting herself -- not to commit suicide, just to release her inner turmoil.
Ash holds out her hand, making a pea-sized circle with her fingers to explain what a panic attack feels like.
"It feels like your throat is this big. It feels like you can't breath. Your heart is pounding and you can't stop it. You think you are going crazy. Everything is scary. Your skin crawls."
By the time Ash was 17, she was on anti-depressants. Life got so bad two years ago, she moved to Nova Scotia, thinking it would cure her depression.
But the feelings of inadequacy followed her like a shadow. She eventually called her mother and asked to come home.
"On the drive home, I said 'I need to go to the hospital because I'm suicidal and I don't want to be,' " Ash recalls. "I knew I couldn't trust myself in a house with a knife. I still get those thoughts sometimes."
Diagnosing depressed teens can be tricky. They don't walk into a doctor's office and say, "I'm depressed."
Instead, Steele says, they say they're fine, but then complain of headaches or boredom.
"It can come as a shock to parents because the teen is laughing and joking with friends."
They may be irritable at home, but quite social with friends; they may sleep 12 to 13 hours a day and begin eating twice as much as usual.
Teens diagnosed with depression are more likely to have anxiety problems, like Ash. Depression can be at the centre of many problems, from drug use to eating disorders or self-mutilation.
While the disorder makes what are some of the toughest years to survive tougher still, treatment can and does work.
Ash is on Prozac and has her panic-attack pills at the ready if she needs them -- about two to three times a week. Instead of seeing a therapist five days a week, she now goes only two to three times a week.
"I worked hard to get better. I can't wish for this to end. I just wish for everything to be OK."
It's true. The younger a person develops depression, the more likely they are to have relapses.
Had Ash received help when she was 13, she says she knows she'd be further ahead in life. She wouldn't be an 18-year-old without a high school credit.
"I want people to know what's going on with their kids. If they don't get help, they could end up dead. If there's something wrong, don't just walk away. My mistake was not telling anyone."
Ash wants parents to know they should ask questions and get help for their teen if they think they're depressed -- even if the teen protests.
"No harm can come from trying," she says.
Ash has been in therapy for a year and is making major improvements. She can sense when a panic attack is coming, is out of the black clothes and hasn't cut herself in years. She's also drug-free and starting to look forward to the future -- a future that includes getting a high school diploma.
"I want to get a master's degree in history," she says matter-of-factly. "I'm late, but I have all the time in the world."
Depression [list][*]Signs include an unhappy or irritable mood, loss of interest in activities, sleep or appetite disturbance, lethargy, decreased concentration, thoughts of suicide, hopelessness. [*]To be diagnosed, must have the symptoms nearly all the time, at least for two weeks, and it must be interfering with the person's function. [*]Teens may look happy when speaking but still have other symptoms of depression. They may eat more, may sleep more than usual, may complain of headaches or stomach problems. [*]Getting treatment early may help avoid social impairment, missed opportunities, long-lasting effects of personality development, drug or alcohol use, development of anti-social behaviour, suicide. [*]If you suspect your teen is depressed, see your family physician, find a community-based therapist or get a referral from your doctor. [*]Depression disorders are chronic and have a high relapse rate. [*]Suicide is the second-leading cause of death for 15- to 19-year-olds. The rate has started to decline. Females attempt suicide more, but males successfully complete it more. [*]When dealing with a suicidal teen, emphasize alternatives, note the permanence of death and act quickly. Do not be shocked, try to take away the weapon, promise total confidentiality, argue against suicide, minimize the problem or leave the teen alone. Take the threat seriously.[/list:u]