American Medical Association Family Medical Guide - American Medical Association [234]
• Is sad or cries, is irritable or restless, or is tired or forgetful most or all of the time.
• Has lost confidence in himself or herself, has a negative attitude, or feels worthless.
• Feels as if nothing good will ever happen again or feels numb, showing little interest in anything.
• Wants to be left alone.
• Thinks or talks about dying or suicide (see next page).
• Has trouble falling asleep, wakes up earlier than usual in the mornings, or sleeps more than 10 hours a day.
• Eats a lot more than usual or has no appetite.
• Feels sick or has aches and pains that don’t respond to treatment.
• Has started to drink alcohol or abuse drugs.
Depression will not go away on its own. If your teen has more than one of the above symptoms, or if any symptom lasts longer than a few weeks or is especially severe, get help immediately. Start by calling your child’s doctor. Most teens with depression can be helped with counseling by a trained psychologist or therapist, and often with medication prescribed by a psychiatrist. Counseling may be helpful for family members also. If teens take medication for depression, they need to take it consistently and exactly as prescribed, even if they are feeling better.
Suicide
Suicide is the third-leading cause of death among people under age 24 in the United States. Untreated depression is the major cause of suicide.
Risk factors for suicide (and depression) include:
• Losing a friend or family member
• Going away to school or to a new school, or moving to a new city or neighborhood
• Having problems in school such as truancy, failing to pass an important test, failing a class, or being teased or bullied
• Committing crimes or being a member of a gang
• Breaking up with a boyfriend or girlfriend
• Having family problems such as an unexpected or unwanted pregnancy, parents who are getting a divorce, or family members who are depressed or who abuse drugs or alcohol
• Being involved in a life-changing tragedy such as a vehicle collision, a house fire, or a serious injury or illness
Teens who talk about suicide or who have suicidal thoughts need to get help right away.
Warning signs of suicide include:
• Talking or joking about committing suicide
• Having a drastic personality change such as suddenly seeming at peace or happy after weeks of being depressed
• Giving away possessions
• Being preoccupied with death and dying
• Visiting good friends or relatives after not showing an interest in them for a long time
• Seeming to be getting things in order, such as by making lists
Self-Mutilation
Self-mutilation is the act of injuring yourself seriously enough to cause harm in an attempt to relieve stress, anxiety, or depression. Forms of self-mutilation include cutting, burning, scratching, bruising, or biting. A large number of teen girls and an increasing number of boys practice self-mutilation in some form. Teens who do it say that it gives them a sense of control over their life or body. Self-mutilation is not the same as tattooing or piercing (see page 458) because it is not performed for body decoration or to fit in with peers. The injuries are done in private and usually are kept secret.
Some signs that a teen is engaged in self-mutilation include new injuries, scars or wounds from old injuries, or blood or burn stains on clothing. He or she may insist on doing his or her own laundry and not want to take gym class or change clothes in front of others. He or she has knives, razor blades, matches, or lighters for no apparent purpose.
Self-mutilation is not a sign of a failed suicide attempt, but it can be a symptom of depression that needs to be treated. Some teens who self-injure eventually attempt or commit suicide if their depression is not treated. Self-mutilation usually is