Is Your Teen Depressed or Anxious?

by Mark Goulston, April 5, 2008

Mother: Do you think he'll put his fist through the wall?

Father: Let's hope it's not his head!

And so begins another evening of pillow talk between the parents of an angry, sullen teenager.

If your child is angry, negative, brooding and avoids people and you're thinking depression, think again.

More and more research shows that in a majority of cases where adults or adolescents have a mixture of anxiety and depression, the anxiety comes first and in most cases causes the depression. That anxiety causes such people to withdraw socially, self-medicate with alcohol or pot, and eventually to have it cross over to poor school or work performance. It's these disastrous effects that intolerable anxiety has on their lives that causes them to feel depressed, it's not the depression itself.

This is important to keep in mind, because although many anti-depressant medications (such as Lexapro™, Paxil™, Zoloft™, Effexor™) are also effective on anxiety, anxiety is a different entity than depression and requires a different approach.

If you treat the depression and miss out on the underlying anxiety that's causing it, people with it will not do as well.

Unfortunately one of the worst combinations that adolescents can have is what I refer to as the "Triple A - lethal cocktail of adolescence" – Anxiety, Alcohol and Arrogance. The anxiety and alcohol use are quite treatable, but it is that "leave me alone," refuse to accept help arrogance that keeps adolescents from getting the help they need and getting better.

Please feel free to share this with your adolescent if you think it will help.

© 2008 Mark Goulston

ANXIETY DISORDERS IN CHILDREN: A TEST FOR PARENTS

If you think your child may have an anxiety disorder, please answer the following questions "Yes" or "No", print out the page, and show the results to your child's health care professional:

Yes No	Does the child have a distinct and ongoing fear of social situations involving unfamiliar people?
Yes No	Does the child worry excessively about a number of events or activities?
Yes No	Does the child experience shortness of breath or a racing heart for no apparent reason?
Yes No	Does the child experience age-appropriate social relationships with family members and other familiar people?
Yes No	Does the child often appear anxious when interacting with her peers and avoid them?
Yes No	Does the child have a persistent and unreasonable fear of an object or situation, such as flying, heights, or animals?
Yes No	When the child encounters the feared object or situation, does he react by freezing, clinging, or having a tantrum?
Yes No	Does the child worry excessively about her competence and quality of performance?
Yes No	Does the child cry, have tantrums, or refuse to leave a family member or other familiar person when she must?
Yes No	Has the child experienced a decline in classroom performance, refused to go to school, or avoided age-appropriate social activities?
Yes No	Does the child spend too much time each day doing things over and over again (for example, hand washing, checking things, or counting)?
Yes No	Does the child have exaggerated fears of people or events (i.e., burglars, kidnappers, car accidents) that might be difficult, such as in a crowd or on an elevator?
Yes No	Does the child experience a high number of nightmares, headaches, or stomachaches?
Yes No	Does the child repetitively re-enact with toys scenes from a disturbing event?
Yes No	Does the child redo tasks because of excessive dissatisfaction with less-than-perfect performance?

Reference

Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington, DC, American Psychiatric Association, 1994.