What is your occupation and position?

What are some of your major professional accomplishments? For example: positions, publications, or awards.

What is depression?

How would you know if you had depression?

1-Duration, in that it lasts for 2 weeks, essentially all day everyday and often much longer than 2 weeks.

2-There are other symptoms that suggest that there are changes in the person’s biological function, such as changes in sleep, and appetite. These functions are controlled by the hypothalamus of your brain. The problem of attention and concentration probably indicates problems in the frontal lobe of the brain.

So clinical depression is more than just sadness, it can also include a much wider range of symptoms that are more persistent. It affects you everyday.

Actually, a very prominent problem that people with depression have is that they are just not able to function as well. They have difficulty completing a task that they would usually complete, and they do not get along with other people as well.

Why is depression of importance to teens?

1. Depression has been increasing in teenagers in recent years. There is pretty good evidence that if you go back to previous generations for decades that the frequency of depression is not as high. In about 10-20% of people in their lifetime will have at least one episode of depression.

2. When you have one episode of depression it increases your chances of having multiple episodes of depression. So people who have one episode may have more chances of developing depression.

3. It can profoundly impact a person’s performance. So that school and social performance can all really be affected in very serious ways.

There have been some studies in adults that show that the impact of depression on a person’s quality of life and ability to function is equal to and greater than that for medical disorders such as arthritis, diabetes, and heart disease. It can really have a very serious impact on a person’s life.

One other thing to keep in mind is that sometimes depression exists as part of a mood disorder, called bipolar mood disorder or manic depressive disorder. This disorder often starts out in the teens years and often starts with an episode of depression. So knowing that someone has depression will at least allow you to monitor for bipolar disorders.

What does depression do to sleep?

About 15% of people with depression have excessive sleepiness instead of insomnia. These people are more profoundly affected by the sense of fatigue that they get during the day. They may actually oversleep in the morning, and they may nap during the day.

For young adults and teenagers the over-sleeping pattern is fairly common, probably more common than insomnia.

Depression is the most common cause for insomnia in general, but some people have insomnia without being depressed. However, people who have insomnia with no signs of depression still have an increased risk for getting depression later. Insomnia, therefore, can be a risk factor for later developing depression.

What can be done to treat depression?

There have been numerous studies in adults showing that psychotherapy is an effective treatment. Psychotherapy involves regular meetings with a therapist. The focus of those meetings may be of a couple of different types. For instance one type of treatment for depression is called Interpersonal Therapy for depression. This focuses on the person’s difficulty making certain life transitions, adjustments to new circumstances, or having particular relationship difficulties. The focus of the treatment therefore is on strengthening the person’s personal relationships as a way of helping them improve.

Cognitive behavior therapy for depression is predicated on the notion that the way a person feels emotionally may be based at least in part on certain thinking patterns.. So cognitive behavior therapy gets the person to challenge some of their underlying assumptions about their depression, about the way that they think, and by challenging some of those negative thinking patterns, the person’s mood can change.

The psychotherapy treatments have been pretty well tested in adults and work very well for people with very mild or moderate cases of depression. They may be less effective for people who have severe depression. These treatments are less well tested in young adults and teenagers, but there is every reason to believe that they would be as effective.

One final type of psychotherapy that might be used more with teens and less with adults is family therapy. Because a person’s mood is often a reflection of things going on in important relationships and because for teens their family relationships are still very important, family therapy may ve a viable option.

The other major class of treatment is medication. There are a wide number of anti-depressants medications available.. They are all equally effective and significantly more effective than placebo (sugar pills). There is less evidence of usefulness of antidepressant medications in children and teens, although it is very common to use medications. Different types of medications differ in terms of their possible side effects, but on average, they are all equally effective for treating depression. The choice of one particular medication versus another will often depend more on the possible side effects than on the actual antidepressant effect. For instance, some medications may cause some sleepiness, which can be useful in people who have insomnia. Other medications may be more alerting, which can be useful in people who have oversleeping.

Can the excessive sleepiness of depression be treated?

When depression improves, in general all symptoms tend to improve in particular. Some antidepressant medications may have a slight alerting affect on their own. Bupropion (Wellbutrin) and fluoxetine (Prozac) are anti-depressants that seem to be relatively more alerting. So if a person has a lot of daytime sleepiness with their depression the doctor might choose one of those medications for the patient.

What other types of treatments are available for sleepiness with depression?

What I mean by that is, it is not uncommon for a person with depression to not feel motivated to do much of anything, so they end up spending more and more time in bed. The problem with that is that although they spend more time in bed, they actually find that leads to their sleep being more disrupted. So in other words if your brain is able to sleep 9 hours at night and you spend 12 hours in bed, what that means is that you are going to have 3 hours of wakefulness in the middle of your sleep. When this happens people often feel less well rested, they may start staying in bed even more during the day and as a result may be less able to sleep at night. It starts to become a vicious cycle.

What you can do to counteract that is to make sure the person has a regular sleep schedule and that they do not spend too much time in bed. Strangely enough actually decreasing the amount of time that person spends in bed may have some effect in helping their sleepiness during the day .

Where would a teen go to get more information about depression?

Is there anything teenagers can do to help teens who they recognize to have depression?

Certainly, if you hear someone talking about wishing they were dead or thinking about suicide, I would absolutely talk to them about getting medical help, and if necessary, go to someone for advice.

You can go to the student health services at a college or a counselor in high school. The really important thing is do not keep it to yourself, if you are feeling depressed or if you see one of your friends who you think is depressed. Get some help. Utilize the resources at school, whether you are in high school or college, or talk to an adult or trusted parent.

This interview was made possible through an unrestricted medical education grant from Cephalon, Inc.