Depression in Teens

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• "Normal" teen moodiness? or depression?
• Depressed 16 year old won't go out, refuses therapy
• Teen Hardly Eating, Won't Go to School
• Good treatment for 19 year old's anxiety?
• Teen Girl's Depression/Anxiety Related to Father's Death?
• Teenage depression - does it get better?
• 15 y-o Son Won't Go to School or Get Out of Bed
• 17-y-o's anxiety & depression - residential treatment?
• Depressed 17-y-o relapsing after some success
• High school senior is very depressed and declining
• Daughter's depression after a course of Accutane
• Testing 16-y-o with depression who's not responding to treatment?
• 14-year-old with severe depression
• Depressed 14-year-old
• Unhappy & Frustrated 16-year-old

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''Normal'' teen moodiness? or depression?

Sept 2013

We have a high school freshman, a lovely, sweet 14 year old girl. She has been telling me that she often feels overwhelmed with sadness. She says it is not from anything in particular, or anything she can point to directly. She says sometimes it lasts for only half a day, but other times, she feels it lasts several days. Her grandmother suffers from depression, and she has a few cousins who suffer from OCD (I know these are two different types of issues, but they may go hand in hand; I don't know). For the record, she is well liked, comfortable with herself and others socially, and does not have any bullying issues at school.

My question is, how does one know what is ''normal'' teen mood fluctuation and something more severe? She has said to me a few times that she thinks she need ''medication.'' Not sure how to help

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I think your daughter would benefit from an evaluation. Her feelings of sadness come out of nowhere and can last several days. She's saying she thinks she needs medication. Listen to these things, and get her evaluated ASAP. I am not a physician or psychologist, but I believe strongly you should hear her comments as cries for help. don't delay

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I am sorry to hear your daughter is suffering, you must be worried. My youngest daughter, also super sweet, expressed anxiety over a number of years. I would suggest going to a therapist and she would resist. I finally put my foot down and insisted we went to see someone. After her second visit yesterday, my daughter says her [north bay] therapist is 'wonderful'. My daughter is feeling much more relaxed about dealing with her anxiety.

Your daughter is sending clear signals that she needs some expert help. Sometimes we need to give a little push to get the momentum going in a good direction. I am so relieved my daughter has an expert resource to help her moving forward. Therapy is expensive, but in retrospect I feel our family should have invested more in therapy over the years. It's one of the best things you can do to help your family. mother of a 17 and 21 year old girl

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As you've noted, all teens go through mood changes, & it can be difficult to tell what's normal. Your daughter talking about being overwhelmed by her emotions on several occasions, saying she needs meds, & the fact that her grandmom suffered from depression are all signs that it is time for you to talk with your daughter's MD about her distress & get her some help. Here's a link to the Mayo Clinic on teen depression symptoms: http://www.mayoclinic.com/health/teen-depression/DS01188/DSECTION=symptoms Thank you for reaching out for your daughter! Renee

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This is something that is difficult to define or quantify. But it sounds as if your teen is telling you that what she is feeling is troubling for her, and that is something to take seriously. Teens with depression can benefit greatly from treatment, including psychotherapy. There are many good therapists in the east bay who work well with adolescents and their families. I can recommend Carolina Bacchi, PsyD, 510-594-4314, Frankie Bashan, PsyD 415-992-6273, Kate White, MFT, (408) 396-5237, and Cynthia Cohn, PsyD 415-820-1688. Ilene

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First, pretty sure there is a wide range of ''normal'' when it comes to teenage moodiness But our experience is that you should take seriously your daughter's expression of ''overwhelming sadness.'' Our teen does well in school and is also ''well liked, comfortable with herself and others socially, and does not have any bullying issues at school'' and we tended to dismiss complaints about anxiety -- but after some serious events last year she now sees a therapist. Wish we had paid more attention earlier.

Recommend you start with your family doctor or pediatrician who can talk to your daughter privately; help determine if the moodiness is related to her cycle; counsel her about the effects of diet and excercise on mood; order blood tests to make sure there are no issues related to thyroid, anemia, or diabetes; and if necessary, recommend a therapist. Our pediatrician was incredibly helpful with this process and worked to form a personal relationship with our teen which went a long way to making her receptive to therapy. The therapist is slowly but surely helping her handle her anxieties. Good luck. Anonymous

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Depressed 16 year old won't go out, refuses therapy

April 2013

We have a 16 year old daughter who went from a bright eyed, content, wonderful student, to a self destructive, dark, highly irritable and angry young lady who was struggling to keep grades up from the end of freshman year to know (end off sophomore year). When we found out she was cutting, we placed her in a partial hospitalization program at El Camino Hospital for 8 weeks. This helped. Since that time, we have had trouble finding after care which worked for her -- she refuses to do 1:1 therapy or take meds, so we have looked at and tried other programs, including Clearwater and John Muir. While she is getting to school and barely getting work done, when she is home, she is in bed (reading or drawing) 24/7, refusing to come out except for dinner with us. She says she doesn't want to be around us. She has only one or two friends. Her hygiene is atrocious, and she dresses like a homeless person nowadays -- unkempt, doesnt change underwear, always wearing a hat and glasses that she doesnt need ... While those in the outside would say she is doing ok, yet less than interactive, we feel that she is simply surviving -- takes joy in nothing. We take her phone at 9pm and she has no internet access after that time. We are grappling with what to do or where to turn! We have called countless resources, therapists, etc ... and everything that is recommended either seems to have a waiting list of months or is 1:1 therapy. Any ideas? We are starting to think we need to send her away to a residential program if she is so miserable with us, but WHERE? We have to other kids who seem to like us fine, so I really dont think it's all us! DESPERATE HOUSEWIFE

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I highly recommend getting in touch with Coyote Coast Youth and Family Counseling in Orinda. Look at their website, talk to Alex Georgakopoulos, the Director. They know teens and young adults and offer family therapy, group therapy, individual counseling, and mentoring. Our 15-year-old son was on a long downward slide and we searched high and low for people who understood struggling teens and their families, offered a variety of services and would coordinate care with other professionals, including school officials and doctors. Their wraparound approach has been an immense help to us. They may recommend a more intensive environment for your daughter. Our son went to a wilderness program last year and had a transformative experience. Our perilous journey continues, but we feel so much less desperate now with the support we get from the Coyote Coast therapists. Hang in there. Lorilyn

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I have been where you are and it is a heartbreaking place to be. Some teens just won't let us parent them, and is is not unusual for other children in the same family to thrive with the same parents. My own daughter left just before her 16th birthday to attend first a wilderness and then a therapeutic boarding school program. She is now 24 and thriving. I encourage you to look at our website willowsinthewind.com and attend our Oakland meeting tomorrow. There you will meet many parents struggling with similar issues. Before you decide to send your daughter away, you may want to try what is sometimes called a transition program. These include a therapist for the adults and a mentor for the teen. Unlike more conventional therapists, these people will come to your home and take your daughter to Starbucks or to look for a job or on a long hike - whatever it takes to begin getting to know her and establish a relationship with her. If you truly feel she need to be sent away, I encourage you to find an educational consultant to help you find an appropriate placement for your daughter. When you come to the Willows meeting, we can share some names of transitional program providers as well as educational consultants. Meanwhile feel free to phone or email me just to get some support. It's a difficult journey your are beginning. 650-996-0897 R

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I'm so sorry to hear about your daughter's struggles. Our daughter had similar issues when she started high school. (cutting, bulimia) It's been a long, stressful journey, but she is doing so much better now.

I know it's difficult, but getting her into therapy is essential. Would she be open to group therapy? DBT (Dialectical Behavior Therapy) was the most useful therapy for my daughter. It addresses exactly what your daughter is struggling with ,distress tolerance, emotional regulation, and interpersonal effectiveness. When the teens in this group experience strong emotions, they tend to deal with them in self destructive ways. DBT gives them tools so that they can react in a healthy way. There is a very cheap teen group DBT program offered occasionally through Dr. Patricia Zurita Ona, She's at the East Bay Behavior therapy center Psy.D. 510-486-8998. This was very cheap since its taught by grad students. We found it not as good as some of the pricier DBT groups, but if it's all one can afford it's definitely worth going.

I would also like to recommend my daughter's therapist, Dr. J.J. Kelley (510)841-8484 x1146. I don't know what we would have done with out her. My daughter actually likes to go. She's amazing with teens!

My daughter also joined a teen meditation group which was very helpful. Meditation is useful in helping the teens feel their emotions again and to learn to just be with their strong emotions with out reacting in a self destructive way. Also, something else to consider. A lot of my daughters troubles stemmed from an undiscovered learning disability. She did great academically through middle school but then she could no longer compensate for her L.D. when the work in high school got more difficult. She was struggling so much with the learning problem that she took it out on herself.

It can help to find some compassion for yourself and especially for her. Your daughter must be in a lot of pain. I hope some of this will help. My heart goes out to you. Been there

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Teen Hardly Eating, Won't Go to School

Nov 2012

For about the past 3 months my son has been really down. Nothing i try works. He won't go 2 school 4 over a month though he'd always been very bright (GATE student, advanced test scores, talented writer & great @ math,etc). Though i buy & cook him food he loves, he hardly eats anything. He still wears 12 Slim jeans. If i ask what he wants, he won't answer, then refuses food i've made & eats nothing. He won't do his laundry (he's 2 big for me to do it) & is out of clothes. He showers every 14 days. He only speaks to say ''leave me alone'' stuff.

Some friends have come to talk 2 him but he still won't change. A teacher came 2 him & he went back 2 school for 1 week, then went back 2 his shell. I've tried contacting people at Berkeley High, from parent resource ctr to OCI to vice principal etc. A couple of them spoke 2 him on phone (Parent Resource Ctr. spoke on phone for 5 minutes then said ''There's nothing more i can do 4 him''). Aside from that, no one at BHS will do anything. They just say, ''It's your responsibility to get him 2 school.'' What am i supposed 2 do--whip him with a belt? He's not a baby that can be put in car & driven. I thought BHS would help him, but they just let him fall thru the cracks.

I got papers from Berkeley Indepnt. Studies for him 2 go there, just once a week 2 class. He won't complete them. It's been 1 month since he's even gone outside. He goes from bed 2 sofa & back, using computer 36 hrs straight. Hiding it doesn't work. He goes on hunger strike til i give it back. Thou' i made appts. w/ therapists he won't go. I need to find 1 that'll come here. I sound like scratched record telling him he needs to go 2 school or else his life will be ruined. He's won't listen.

He has Kaiser, but a psychologist there lied to him & now he won't see anyone there. Having Kaiser rules out many other kinds of help. We have Victims of Crime Insurance but most of those shrinks won't return phone calls. I can't pay for therapy I've taken so many parenting classes i should have a master's in it. I know of no support groups here & usually they want $20-40. a session anyway just 2 talk

My son is intelligent, loving, talented, absolutely brilliant on computer (he outsmarts tech support) but he's gone 2 the dogs & has turned into a silent, sullen, isolated computer addict. I was so enthusiastic when he started BHS, but now it's huge disappointment. I can't believe they won't help him Helpful advice only. No sarcastic, smug, judgmental or blaming comments please. I'm doing all i can. ---Fallen Thru the Cracks

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I'm extremely sorry for the pain that you and your family are experiencing. I suggest that you head straight to the ER at Children's Hospital, Oakland. From the sound of your post, your son is in danger of losing his life to possibly several different causes. Depression, Anorexia, Anxiety, amongst other serious mental illnesses are severe and serious and life threatening. Please have him assessed immediately by a medical professional - a psychiatrist, MD. To be specific, not a psychologist, but a medical professional with a degree in MEDICINE. Clearly your son is in grave danger! Good luck to you and your family! a caring member of your community

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I think at this point you have done all you can do and it is time for serious external intervention. It sounds like your son is in a deep and massive depression. Talking is not going to get him out of this. You need to call Kaiser if that is your insurance and say he is depressed, refusing to eat, and therefore engaged in harmful behavior.

BHS is right, this is not their problem but you are fortunate to have insurance. Call today, and if you don't get the response you want call 911 - this is a ''medical or psychological emergency!'' get help now

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Your son sounds severely depressed. I don't feel any judgement for you, only sympathy. You have done all the right things so far.

Check out NAMI - the National Alliance for the Mentally Ill. They do free multi-week peer education sessions. They are wonderful. In these groups you will meet other people with teeens who have mental illness, and you will learn some coping skills. And you can also ask your local NAMI chapter for resources and advice, even if you don't do the peer education sessions. If your local NAMI isn't very active/helpful, try one for another county. I attended the peer support sessions in a neighboring county because their hours were more convenient (it was a weekly commitment).

My only other thought is to call your county's legal services agency and ask them what your rights are with regard to his school. I learned the hard way that our school psychologist wasn't being completely truthful about all the services the school is mandated to provide. I remember him saying ''based on your son's outside psychological testing results, I wouldn't recommend further testing.'' He didn't say: ''Hey, if you put your request for more testing in writing, I'm REQUIRED by LAW to provide it!'' Legal services told me about that. Learn more about your rights.

I wish I had more advice for you. I understand what you're going through. You cannot MAKE a teenager do anything. He may need residential treatment. You are coping with something bigger than you can handle alone. I hope NAMI can point you in the right direction. Keep doing what you're already doing - loving your son and advocating for answers. rooting for you; be strong

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With VIctims of Crime funding for therapy, you can use a therapist of your choosing, not just the ones on the list, as long as that therapist is willing to accept that funding for the therapy. You can inquire with private therapists, and you could also try West Coast Children's Clinic and other agencies may take this funding as well. DOn't give up. Your son needs help. Ilene Diamond

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Dear Parent: This sounds so hard for a parent to handle, but I think you need to act soon and strongly. Not that I am a professional, but I think your son is clinically depressed and needs to be seen by a professional psychologist or psychiatrist, and perhaps even checked in to a hospital or residential facility to ''reset.'' At the risk of frightening you, it sounds to me like he might be in danger of hurting himself or even considering suicide. If you cannot convince him to go to a counselor or to be checked in to the local mental health facility (I believe it it Herrick Hospital in Berkeley, if you are in the Summit system), you may need to call 911 and have him ''5150''ed, which means having him checked in against his will. It may be that something as simple as taking anti-depressants could give him a whole new lease on life, but more likely, this will be the beginning of a process which he will continue for his life. My heart goes out to you. A sympathetic mom

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Wondering if there is any chance you can change his insurance to a better company such as Blue Shield. Prompted by your story I did a Google search on Kaiser's mental health benefits to see if there was a service you could ask for. I came across this report which says you are not alone in the frustration with their care:

http://www.nuhw.org/storage/mentalhealth/CareDelayedCareDenied.pdf

I have been down this road in our family and from personal experiences, help received from good caregivers, early on, will generally support the best outcomes.

Not eating and refusing to eat as a way to control can be very serious. It is something that could be life threatening. Here is a group that can help you understand what is going on: http://www.nami.org/

Not sure if they can help with services, but it is worth a try. Changing insurance with good coverage could be a big step. Your son may need to be hospitalized, and that is not an easy choice, nor is the process simple. But it may potentially need to be considered. It is not likely that this will go away by itself. There is not a lot of range of services between seeing a therapist and hospitalization. Herrick Hospital in Berkeley has a good program. If he is under 18 you have the power to sign him into a residential program, after 18 it is much more complicated, and he can refuse treatment up to a certain point. Check out NAMI hoping for the best for you

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Your son is addicted to the Internet. Possibly to a specific game? It's as serious as any addiction more conventionally known such as to drugs or alcohol. I suspect you are both in denial, as this is such a new & recent area for parents, caregivers and professionals! Start doing your research with this in mind and try to find another grownup to work with you who might perform as neutral participant. Be prepared before you shut down the Internet or take other major steps to begin the process of bringing your child back to reality. Maybe a friend of his can be an ally, talk to the friends parents to let them know your plan to help free your son from this bond. Once you make some progress your son may be more open to therapy. There are a few in Berkeley who specialize in Internet & gaming addiction. We had the exact experience with same age son, BHS, I.S. and therapy. I was behaving as a codependent, as you are now. I wish you all the best. Was there, too!

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i don't have direct experience with this, but maybe there are some contexts for him where expectations are low-when you are down expectations are daunting--and support is high will help? i was wondering about volunteering at the animal shelter to walk dogs for instance? or helping people with down's syndrome? get some kind nonjudgmental interactions from others besides you? some place he can be taken totally out of the world he's stressed about, and realize there is more out there, and also get connections with animals or people that way?

you must be utterly exhausted, it sounds terrible, but he sounds like he has a lot of things going for him once he starts seeing things in a better way. [i sympathize with people telling you that he should do something, that drives me nuts too, as if he is following your directions when he does something they don't like,indeed they are their own people!] it sounds like you are doing a great job helping him, but it is just hard. take care, anon

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Good treatment for 19 year old's anxiety?

Oct 2012

I saw a posting recently about teens with anxiety. My 19 year old daughter has suffered with anxiety for a few years now. It started out as panic attacks but has progressed to generalized anxiety - even with therapy. She has been to a couple of psychiatrists who says she's depressed and put her on antidepressants but they didn't do much. I think the reason she's depressed is because she hasn't learned to deal with her anxiety. Has anyone had success with certain anti-anxiety medications? Which antidepressants also combat anxiety? I would like to keep her medication-free but I hate seeing her suffer.

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I couldn't tell from your post whether you have tried a cognitive behavioral therapist. These are people who specialize just in anxiety, and who can help your daughter get to the heart of what her anxiety triggers are and how she can stop the anxious response. Often people have no idea what their triggers are and will say the anxiety comes out of the blue, when there are very definite triggers. Figuring out the triggers is the first step to uprooting the anxiety system.

For example, a friend of mine would say that his panic attacks came out of nowhere. ''I was just walking down an empty street and wham, it came on,'' he'd say. But with CBT, he was able to realize that he'd looked up, seen a person in the distance walking towards him, started to panic about if he'd have to interact with that person, and that triggered a panic attack. He had very bad social anxiety, and all his triggers were related to that.

The thing about cognitive behavioral therapy is that it requires courage. You have to be willing to get in there and fight your anxiety. Imagine if you are afraid of heights (instead of people, for example), and your assignment is to keep walking along the edge of a sheer cliff. It's hard. You cannot just sit there and wait for the anxiety to go away magically. But the good news is that the more effort and courage you put into it, the smaller and smaller your anxiety will get. good luck to your daughter

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I have worked with many young adults who have anxiety, both generalized and panic attacks. In my experience, two things are needed: specific skills and strategies to deal with worried thoughts and anxiety provoking situations; and the ability to ''step back'' and observe/challenge the thoughts. Often an understanding of how the brain works and how it generates anxiety can be reassuring. Sometimes cognitive therapy and problem-solving is enough to make a big difference; at other times neurofeedback can be invaluable for changing the underlying EEG patterns, or ''brainwaves'', associated with anxiety.

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It sounds likely that your daughter is having trouble coping with anxiety symptoms and needs some proactive tools to help her. While medication can be very helpful for panic attacks, on going anxiety medications are usually addictive and have lots of side effects. Meds usually help with symptoms but they don't teach folks how to cope better, which is why so many people have mixed results. Anxiety usually occurs when our ability to handle stress becomes overloaded and we have trouble regulating our nervous system. To address this it's important to see it as both a physical and psychological response. Some helpful alternative methods are accupuncture, yoga, meditation, chinese medicine, exercise and nutritional support. If you do decide to stay on the medication route I would suggest that you make sure your daughter is doing other things to learn how to deal with the anxiety, rather than just masking the symptoms. good luck

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Teen Girl's Depression/Anxiety Related to Father's Death?

Sept 2012

My teen daughter (now 16.5) is suffering from depression/anxiety that is really interfering with her life and adversely affecting her once-excellent schoolwork and social relationships. This has been going on for a little more than two years. After hospitalization in the Spring and a brief period of refusing treatment, we have begun working with a new counselor and a new psychiatrist. Keeping my fingers crossed she is able to make some progress through treatment and, if appropriate, new meds.

Reading the posts on this site, I have learned that many teens struggle with these issues, and there are many reasons. I wonder about the role of her father's death in her struggles. She was 9.5 at the time, and he was killed at work on New Year's Eve (in a traffic accident.) He was a totally devoted father and my duaghter was very, very close to him. (More than to me.)

She has participated in group and individual counseling on-and-off over the years, and through some of these groups she has formed friendships with other kids who've lost a parent. Still, she struggles. She's has never directly said it's her father's death, but I can't help but wonder what role that loss is playing in her life right now.

Has anyone had experience with the stages of grief that kids go through as they grow up after losing a parent? And do you have advice about how to best support her? It is so hard on these teens who've lost a beloved parent. There is alot of sympathy given to the little kids who lose a parent, but for teens who have lived for a few years without that parent, it seems to have dried up and been replaced by the attitude that they have ''gotten used to it''. Heck, I'm 47 and I still rely on my dad for many things...I can't even imagine how it is to grow up without a dad. Any comments or suggestions would be welcome. Worried Mom

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I am so sorry for your loss and your daughter's, especially at her tender, pre-adolescent age.

As one who also lost her father young (at11.0), I can offer my memories from a time intensely felt but about which I was unable to communicate when so young.

I wished more than anything that an adult male who, if possible, knew my dad and whom I could trust would say, ''I'm there for you, if you ever want someone to talk to, any time, in the way you might have talked to your father -- if you have questions about choices you will face, growing up, or topics which you'd like to discuss with someone on your side, I'm there for you. When you want to know how men think, I'm there. I'm not your dad, but I care. Call me or write, any time, even in the middle of the night.''

Adults, even counselors, who offered me pity or condolences just seemed intrusive, especially if they talked.

There were invisible threads tying me to a few of my classmates who shared this singular fate, but, with no other bonds between us, the scar was too deep and too raw, the distance between us too far, for many, many years, to talk of it, and the ability to articulate what it meant way too undeveloped for there to be anything but discomfort found.

Search for someone solid and sensible among your family, your friends, or your husband's childhood friends who might take on the role of a surrogate father to your daughter, not daily, not weekly, but someone spiritually available, as needed and called on **by her**; preferably someone young enough to be there for her even ten or twenty years from now, whenever she chooses to call them, as she transits into adulthood. Someone you and she can count on.

I found such a person at 62, and even though he never knew my dad, it made a difference to me, even that much later. anon

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I think losing a parent at any age is very difficult. Losing one as a child can multiply this difficulty a thousand fold. Without a doubt your daughter's depression and anxiety can be related to her grief. You don't mention in your posting what impact the loss of this man had in your life. It's possible that your difficulties with the loss (expressed and unexpressed) are also contributing to your daughter's state of unhappiness. I would suggest you both consult a therapist who specializes in issues related to grief. Joan Monheit, MSW 845-1557 and Howard Lunche MSW, LCSW 841-2930 are both compassionate, amazing counselors who ''specialize'' in grief. I recommend both of them highly and encourage you to consider calling one of them. Wishing you, and your daughter, all the best. L.

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Teenage depression - does it get better?

March 2012

I would like to hear some encouraging words from any parents out there who have children who have gotten through teenage depression. My 16 year old is smart, does well in school, but gets the blues pretty bad and worries a lot. She was on pretty high levels of Prozac but the depressive mood dumps became pretty frequent and she had bad insomnia. The Psychiatrist prescribed medication that promotes sleep but increases appetite and she has gained a lot of weight, making her feel worse. Her mood is slightly better now that she is getting sleep, but she still gets dumps. Does it get better? Anon

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I was super depressed in high school and did get over it. Probably the worst was 15-17 years. By 18 I was much better. Years later I figured out that a lot of it was hormones. No doctor ever asked about hormones or mentioned that. They tested for everything under the sun. I was also at times on birth control pills which I believe made it much worse. Teenagers aren't as in tune with their bodies, so they don't see these shifts. When I got into exercise at around age 22, that was when things really changed for good for me and I started understanding how alive and energetic someone could feel. I don't think an anti-depressant would have been good for me - even though I was suicidal. Maybe something that brought my energy up - but if it's a hormonal issue then addressing that might have helped. Anyway - I'm not at all trying to diagnose your daughter - I am not in the medical field - but just sharing my own experience. Good luck! was there and found myself

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My son was severely depressed in high school and now at age 21 he no longer is. I think partly growing out of it (his psychiatrist told us he likely would), partly not smoking pot anymore, and partly exercising a lot. We used to always tell him to exercise but of course that went nowhere. If your daughter is open to it, try telling her it is a way to feel much better. best wishes

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For whatever it's worth, here's my family's story. My son was diagnosed in 8th grade with a variety of things and depression was the only thing all the Doctors could agree upon. From the beginning to now, he was given quite a mix of medications which often counter acted upon the others. Some medicines made him sleepy, some created anger, some increased his appetite and in one year he gained 40 pounds, which I was told, was not related to his medicine. Over these almost 4 grueling years, 2 hospitalizations, 3 psychiatrists later and many sleepless nights, calm has been restored to our home. My son continues to take medicines but the dose appears to be addressing his needs. If I were to say what made the difference that would be hard, because my son desperately wanted to get better and did whatever his Doctors recommended. I think honestly it was finding someone who took the time with him and allowing him the time to grow and mature through this. My husband and I also put our lives on hold throughout all of this. For his safety, we never let him remain alone for long periods of time and we continually reinforced our unconditional love and suport. This was a hard battle and as we approach college, we are never far from what we overcame, and assessing where he is.

I wish you good luck, but sometimes, you just have to wait it out and devote everything at your disposal to this. Talk to everyone you can, ask questions, take notes so you have a record of why medications is being prescribed. Having great insurance also helps. gc

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You may want to consider homeopathic treatment for your teenage daughter. Homeopathy offers a holistic, drug-free approach to depression (along with many other issues, because it addresses the mental, emotional and physical aspects of a person simultaneously). As a homeopathic educator, (former) practitioner and mother of two teens, I can testify wholeheartedly that it really works! Edi Pfeiffer is a wonderful practitioner in Berkeley who treats many children and adolescents: http://www.berkeleyhomeopathy.com/ Please take a few minutes to check out her website, it is worth knowing about this very effective and healthy alternative to prescription drug treatment. Bara

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I see people saying it does get better and not to put their child on medication. I hope it will get better and medication is by no means the best option for everyone, it should be considered. I was severely depressed since I was a small child and medication in high school would have saved me years of suicidal thought. As it was, I didn't get relief (through medication) until I was 30. so please think about it. been there.

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15 y-o Son Won't Go to School or Get Out of Bed

Oct 2010

My son has told me he dislikes his new school,but missing 2-3 days at a time when he's not sick (he was sick maybe 1 day) is not acceptable. Even on weekends, it is excruciating to get him out of bed. We go do fun things as much as possible but sometimes there is too much homework or we have too much to do here at home. He has friends at school but since we live some distance away he only see them there. Previously he was an excellent student & usually kept up with the homework He does not have insurance & I was told to try Berkeley Mental Health. I'd like to hear of other's experiences w/that. It is scary to use facilities like that. I am not sure what else to do. Any suggestions would be helpful. Concerned Parent

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Our kid did this too. I went in and spoke to his Counselor who said, ''Where have YOU been?'' She helped us get him hooked up with independent study and was able to get his diploma (not a GED, but a dipoloma). He loved the tiny classes and one on one attention. This is what they do with actors and dancers with erratic schedules. He is now at University, back on track. Hang in there..... teen years are a pain in the ass!!!! But kids in college are WONDERFUL people. RR

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Poor kid. He sounds like he may be depressed. You said he doesn't have insurance, but you should check into Healthy Families which provides health insurance for low income kids. Also it may just be that his new school is not a good fit for him and he is not having a good experience there. Can you change his school?

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Teens need at least 9 hours of sleep to be adequately rested and school schedules are notoriously hard on teens. I would wonder whether your son is staying up too late. Without adequate sleep, if there is anything negative or aversive going on at school, such as learning disabilities, social pressures, or bullying, getting up to go to school can seem overwhelming. Similarly, if your son is depressed, the combination of depression and fatigue can make school seem too much to deal with. Whether the issue is one of inadequate sleep or sleep disorder such as insomnia, sometimes there are nighttime behavioral issues to consider, such as compulsive gaming, internet chatting, substance abuse or pornography. Finally, family dynamics may be a factor as well.

I would suggest having a mental health professional evaluate your son. As you mentioned, Berkeley Mental Health is one possibility. UC Berkeley also has a clinic associated with their graduate school of clinical psychology. Other options are Children's Hospital Oakland, WestCoast Children's Clinic, Wright Institute Clinic and the Ann Martin Center. You may wish to inquire about getting your son on Medi-Cal insurance or Healthy Families. Best of luck to you and your family. Ilene

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It sounds like you live in Berkeley. If your son goes to Berkeley High, there is a health center on campus and he can get counseling through the health center. I'd also talk to his counselor to get more suggestions. anon

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Mental Health is as important or even more so than any other type of health. The reason this is scary is because there is still so much stigma attached to this area. Once there was stigma if you had cancer or needed glasses. Hopefully most of us are past that and get preventive care, or seek appropriate medical attention as needed. Personally I would be more terrified of what is coming next, and the thought that my teenager is living in a bed.

If he had signs of appendicitis what would you do? I had a friend who had to go to a doctor three times with a pain in her side. The doctor kept telling her she was fine, and she was imagining that she was ill. The third time her husband went with her. The doctor had a shouting match with her husband and threw them out and said ''Get out and go to an emergency room.'' It saved her life. Getting help is often not easy but do what you need to do.

Berkeley Mental Health seems like an option. If you can't manage it on your own get a friend or a family member to help you. Maybe someone on this list would volunteer.

Not sure why your son does not have health insurance, but have you looked into this? http://www.healthyfamilies.ca.gov/Home/default.aspx It covers children up to 18 and covers Mental Health services as well. Mental Health issues like many health issues are best handled as early as possible by trained professionals. sending courage

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If your son is hard to get out of bed on weekends too, you may want to ask yourself the following questions:

1. Does he sleep 7.5 hours per day? If not he is sleep deprived. Work with him that he gets 7.5 hours sleep per day. Your body detoxes while you sleep. Sleep is at least as important than the waking hours.

2. Are computer and cell phone in his room? Is he active late with these? Computer and cell phone leave the room at 9pm. Also unplug appliances in the room. Without electro-magnetic waves, the body is more energetic.

3. Does he have a healthy diet? On a daily basis, does he get Omega 3, Vitmain D & C and more importantly, B6&12 with folic acid? If not, supplement.

4. Does he drink or smoke? Energy and motivation robbers.

5. Is he depressed? That would be my last question. All other things should be in place first as a basis for good daily energy. He should have opportunities to see friends outside of school for a deeper connection. I would make time available to drive him/them. Anonymously

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17-y-o's anxiety & depression - residential treatment?

Sept 2010

Please help: Our 17 year old has some long standing anxiety and depression issues. In the last month, she has not been able to go to school, has been hospitalized briefly for anxiety and depression and has tried two day treatment programs that did not work for her. She is getting more depressed, and finding it more difficult to do daily tasks like grooming or even to leave the house for appointments. She describes herself as very afraid, even when there is no clear source for her anxiety. She has had many years of therapy, medication and family therapy. She has had several neuropsych evals.

Many consultants are recommending residential treatment programs. These programs are very scary to us - they don't allow the teen to have contact with the parents for several weeks, for instance. These programs are not the wilderness type- they are supposed to more gentle, for anxious NON-acting out kids. Still, the restrictions on contact are a big concern to us. Please contact us directly with any information you might have.

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This does not speak directly to your question about residential treatment programs but I totally understand your discomfort with no contact allowed. I' like to throw a few other ideas into the mix.

Is this perhaps hormonally related? Has she been evaluated by a physician? Does she perhaps have PMDD (premenstrual disphoric disorder)? Now that I have passed through menopause I realize in hindsight that I had this undiagnosed condition for 40+ years and it basically robbed me of my life (2.5 weeks of every month spent in misery). I can see it clearly now but not while in the thick of it. To finally have some emotional calm and physical relief is amazing. Not one physician or therapist over all of those years ever asked me about the quality of my periods nor did it ever occur to me to mention it (part of the depression and feeling absolutely like a crazy person associated with it I suppose). In any event, perhaps if you haven't considered this possibility, you might.

Also, my young adult son has been hospitalized twice (3 days each time) over the last year for depression/suicidal ideation/delusional thinking. He's now living at home with us, is taking his meds, is seeing an excellent therapist twice a week, and I am insisting that he get vigorous exercise (which both my husband and I model as well) several times a week, and we're eating very healthfully (as we usually have). It took several months for him to stabilize, but he is on the mend.

How is her diet? Has she been tested for food allergies? Based on what you write I assume she's not exercising, but maybe you can somehow encourage her to do so, maybe joining you in a bike ride for example for starters.

My husband suffered from anxiety and panic attacks (and high blood pressure) all of which have been completely eliminated since we joined the gym (Positive Motion Personal Training Studio to be exact) a year and a half ago. I can clearly see the enormous benefits that vigorous exercise has given each of us in different ways. It was quite a feat to get my son (re)started on an exercise regimin, but it has become easier as he's seen the benefits and he's now doing it on his own.

I apologize if this reply is rather scattered - just some other ideas. Best wishes for a happy resolution for your beloved child. **

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Depressed 17-y-o relapsing after some success

May 2010

After reading the March 2008 posting ''Depressed 15 year old'' , and the replies, I am curious what path the parent chose and whether there was any progress. I was in exactly the same situation with my son, then 15 also. By Fall, 2008, however, my son agreed to attend a boarding school on the East Coast. By Spring, 2009, it seemed there was a miraculous turnaround, and it was truly amazing. Unfortunately, the past year at this school has been one of great difficulty and disappointment with my son refusing to participate and eventually being sent home. Now, as he approaches age 18 in less than 2 months, and returns to doing nothing all day but look at the computer in his room, he has refused to complete his studies from the boarding school, which he can do at home through the Summer in order to gain credit for his junior year. Instead, he says that he will wait until he is 18 and then move out on his own. Having experienced what seemed to be a lasting solution in Spring, 2009, and then to watch my son devolve back to depression, anxiety and lack of motivation, I remain at a loss as to what to do for him.

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You are right to be concerned. Medication is a very useful tool but it requires a commitment to work collaboratively with the psychiatrist to find the right drug and dosage. It would be worth it to try again, perhaps with a different psychiatrist. These problems rarely get better on their own. Your son likely has some distorted ideas about medication and is lacking important information about the benefits. Leaving depression untreated can have lasting effects on the brain (not to mention one's life), some of which have been shown to be reversible with treatment (medication and therapy).

There is likely more to this picture than depression or other mood disorder (bipolar), but it can be difficult for a depressed teen, especially a male, to convey what is going on in his internal world. It may be helpful for your son to have a thorough psychodiagnostic assessment, involving objective and projective testing, clinical interviews and self-report questionaires. This would be done by a clinical psychologist specializing in assessment of teens. Best of luck to you and your family. Ilene

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High school senior is very depressed and declining

April 2010

Hello, Im struggling with a teen (17) who will not shower, shave,or change his clothes. He is struggling at school, and will not meet with a counselor or a doctor/therapist. He also refuses to take any medication. Our insurance is Kaiser. We are willing to change it if needed. We are helplessly watching our only son decline slowly before our eyes. Any suggestion will be apppreciated. tired mom

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Why don't you go to a counselor first, and see what advice they can give you on how to deal with it. He is showing classic signs of depression, about which there have been numerous articles recently in the news. See if you can find some on the internet or library. But the first thing is for you to find out the root cause, and in that I think a counselor will be your best resource - for you at least, if your son is refusing to go himself. Don't give up! Timi

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First, know you are not alone. Unfortunately, a number of teens are going through things like this, our son one of them as well, who was also suffering from severe depression. He is doing better now, but it took removing him from his high school, moving to home schooling (through the school system - you may be able to get the school to do an evaluation), intensive psychotherapy and medication. We had to consider the idea of hospitalization, but fortunately he has so far been willing to go along with the treatment. If necessary you may need to take your son to the ER for this, certainly, based on what you are describing, if you think there is any danger he could harm himself (our son tried something along those lines, which we never thought could happen, and luckily he was ok), but you may need to make something happen with your son to avoid that possibility. We feel for you very much. Call Kaiser and tell them how serious this is, or just bring him in for an evaluation. He is still 17, and a minor, and you are still able to make him do this. He can catch up school later, but now it sounds like you just need to make sure he is safe, and kids do get better with the right treatment- so far, thank goodness, our son is improving. Dad and Mom in a similar position

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I'm the mom of a teenager with clinical depression. I empathize with you; helping a depressed teen can be tough.

There's an innovative organization in Alameda County that can help with just the situation you describe: being a family member or caregiver of someone in Alameda County with a serious emotional disturbance who can't or won't seek treatment on his or her own. It's called the Family Education and Resource Center (FERC). All staff, including the five Family Advocates, have first-hand experience as family members/caregivers of people with mental illness.

I'm using FERC right now to advocate for my teen daughter's best friend. I've spoken with Annie, a Family Advocate, who was warm and helpful.

To get help, just call 1-888-896-3372 and ask to speak with Annie or another advocate.

Best wishes to you and your son. You're on the right path to helping him. Nancy

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Please, please call Kaiser; they can help your teen in crisis. You can either call the pediatrics department (relevant till age 18; they do understand teen depression): 510 752-1200. If you don't like your teen's pediatrician, you can easily change. You could ask the office which pediatricans are particularly good with male teens.

Or you can call Child and Family Psychiatry: 510 752-1075 (press #1 for English; then press #2 for Child and Adolescent Psychiatry). I would call ASAP--before it gets to a severe crisis level. If your son talks at all about suicide (or starts giving away his music collection or engages in other obviously self-destructive behavior), take is very seriously and get immediate, emergency help (911). Also, can you find out what he is viewing, if anything, online? An isolated, depressed teen is so vulnerable to any influence; the Web can offer really destructive messaging. It may be that your son is ''just'' experiencing a ''normal'' episodic teen yuck period that will soon pass; or it may be more severe, with suicidal possibilities if he's deeply depressed. He needs intervention regardless of the severity of his depression. And you need professional help; you cannot do this alone. I am so sorry that you are experiencing this. Best of luck to you. Linda

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Daughter's depression after a course of Accutane

Dec 2009

My 17 year old daughter was on Accutane for about 6 weeks when she had a depressive episode, she told us that she had been feeling depressed before the Accutane and really wanted to stay on it and finish the course of 5 months. She was being seen by a CBT as well as the school therapist, so the dermatologist said it would be fine to stay on the Accutane. Long story short, things got worse. She is off the Accutane and now on an Antidepressant. Things do see better, however, we still have bad days. I am not completely happy with the psychotherapist she is seeing... I was wondering if anyone could recommend someone who has helped their child with depression issues. We live in Walnut Creek, so I would like to find someone on this side of the tunnel if possible, but I will travel if necessary. Thank you.

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I'm sorry to hear that you're struggling with a depression issue in your daughter. My daughter (who is now 22)had lots of issues in high school, depression being one of them. We had a few local therapists but the best one, and the one that my daughter still sees occasionally when she's home, is Dr. Tim Browne (he's a psychologist, not a medical doctor). His practice is in Lafayette and he's quite good. His number is (925) 937-3999. I don't know if he's taking new patients but it might be worth a call to see what his thoughts are. The biggest thing as he might tell you is that your daughter needs to want the help in order for therpay to really work. But, he manages to get a good rapport with kids so it might be worth a try. Judy

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You might want to try either Teresa Fleury or David Franklin, both with offices in Walnut Creek. I have to say I've seen some very significant depressions caused by (or at least correlated with) Accutane usage (See for example ''New Accutane Warnings: Patients Must Be Told of Possible Depression and Psychiatric Side Effects'' (http://abcnews.go.com/Health/story?id=117666=1).

In some cases, it has taken a long time for the depression to lift after cessation of Accutane. Personally I've seen both situations (where depression lifted almost immediately and where the depression was very persistent). The Accutane use may have triggered an underlying vulnerability to depression (i.e., one version of the ''kindling'' explanation for the development of mood disorders). Finally, it's important to find a therapist and psychiatrist who are skilled in working both with mood disorders AND working with teens specifically. Best of luck! Michael

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Testing 16-y-o with depression who's not responding to treatment?

May 2009

I have a 16 year old teen suffering from depression and anxiety that's been resistant to treatment. Her therapist thinks she should get a full battery of psych testing to see what the main problem is or if there's something we are missing. We live in the East Bay. Is there anyone out there that's good? I thought this type of testing was more for checking for ADHD or Dyslexia but the therapist thinks it can help. My poor girl is suffering and wants desperately to know what's going on with her so she can work on dealing with it. Please help! M.

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A full testing battery for a teen, usually comprising several different types of tests plus clinical interview with parents and child, will cover both cognitive and social-emotional/personality functioning. Occasionally, testing will reveal something that suggests a need for more in-depth testing. More commonly, the testing provides a wealth of information that can help the person understand themselves better, work with their strengths and weaknesses. The report should include recommendations for next steps such as psychotherapy, school accomodations or whatever else is appropriate.

I can recommend Erin Rosenblatt, PhD (510)867-4062 and Stacey Nelson, PhD (415) 257-0702. I am a psychologist and have worked with each of them in a professional context. They are both very warm, knowledgeable and tend to take a more collaborative approach.

Local clinics such as UCB Psychology Clinic, Ann Martin Center and WestCoast Children's Clinic also offer testing by interns and post- docs; this can be a great option but can take longer as the interns are using it as a learning process and take the testing data to seminars and supervision. Ilene

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Jessica Lipkind is excellent. She is intelligent, experienced and compassionate, and she is cognizant of the costs that can accrue and the burden that this can put on families - therefore she really tries to tailor the testing so as not to incur unnecessary expense. Everyone I know who has experienced her has nothing but positive things to say. parent of teen

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14-year-old with severe depression

March 2009

My son was recently diagnosed with severe depression and is currently taking ambilify, prozac and xanax for panic. We go to a psychiatrist for medication management only. Both my husband and I are wondering if there are psychiatrist out there who counsel and treat patients? Mom in need

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Your teen's prescribing psychiatrist should be able to refer you to a therapist who works with teens. Some psychiatrists do prescribe and provide therapy as well - in my experience they tend to be psychoanalytically oriented and really want to do therapy and not just do med. management.

Having said that, it is not necessary for the prescribing doc and the therapist to be the same person. In fact, sometimes therapy with a psychiatrist can be cost-prohibitive. However, it is probably important that you find someone who is comfortable working collaboratively with a prescribing psychiatrist (usually this means checking in by phone from time to time).

I'm not sure what area you are in, but there are many excellent child and adolescent therapists in the east bay, some of whom have been recommended on this newsletter.

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Yes, there are psychiatrists who also do therapy as well as medication management. We found an excellent one, Dr. Petra Steinbuchel, at Children's Hospital. Unfortunately, we could not continue 50-minute weekly therapy sessions as the cost was prohibitive.

A better resource for us is the public UC Berkeley Psychology Clinic (510-642-2055). Initial testing costs about $20. Weekly sessions are on a sliding scale (we pay $70/week). Therapists are PhD grad students under the supervision of a licensed psychologist, Dr. Laura Mason. We are doing family therapy which really has decreased conflict with our teen.

Have you looked into getting an Individual Education Plan (IEP) for your son? My daughter has one and Special Ed status due to health problems and ''emotional disturbance''(severe depression and anxiety that interfered with her schoolwork).

Your son most likely is eligible for Special Ed status if his depression is interfering with his schoolwork. It would entitle him to many legal protections in the educational system. For example, my daughter qualifies for free weekly therapy under AB3632, a state law that provides psychotherapy for emotionally or physically disabled kids to take full benefit of their educational opportunities.

Also consider Marchus School in Concord (925-602-6150). It's a public school for kids with social or emotional difficulties in the regular schools. My daughter has thrived there.

An excellent alternative high school is Envision Academy of Arts & Technology in Oakland, a free charter school. It teaches kids via projects which integrate math, language, etc.

If you'd like to learn about your son's legal educational rights, contact an education advocate at the Disability Rights Education and Defense Fund (DREDF) in Berkeley.

Finally, a supportive word for you. It can feel exhausting to have a kid who's seriously depressed, so take good care of yourself. Your son is lucky to have you as his mom. Nancy

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In my experience (also have a depressed child), you have to call each person and see what they offer. You can go to someone else for the counseling part. I would make sure that they are well-informed about the medications that your son is taking. I also found that the psychiatrist will also do a little trouble-shooting during the very short check-in appointment. Good luck!! anon

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Depressed 14-year-old

My 14 year old son has been very depressed, and this year his grades have gone from As to Fs. He said proudly: I've conquered school. He wants to return to England (we left there four years ago) and is rebelling...hates America. I'm trying therapy for him. I've also wondered about an Outward Bound program... (he's expressed interest in white water rafting). Has anyone any experience of their programs? And of the sort of effect this might have? (June 2001)

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Reply: see recommendations for Outward Bound

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Regarding teens with depression: I have heard very good things about Outward Bound, although I have no reports about the effect on someone with depression. If it is something HE is interested in, it could well be worthwhile. Another thing is that I have seen a number of people (teens and adults) with depression feel better and have more energy after receiving Reiki. The practitioner places his or her hands on the head, chest, abdomen and back of the client (who is clothed). The client, on some unconscious level, pulls in healing energy. The healing energy is energy that surrounds us all the time. The practitioner is a conduit for that energy, like copper is a conduit for electricity. The Reiki seems to activate the person's own healing process and makes them open for whatever they need next. It should not replace either psychotherapy or any from of medical care, but can be used as an adjunct. Often, a wonderful synchronicity happens after a series of Reiki sessions; the person finds just the right thing to help them. Reiki is simple, non-invasive. I have been doing Reiki for 14 years and teaching it for 9 years. If you want, I'll be happy to send you some information, talk with you and your children, and give appropriate referrals. Wishing you lots of luck in your search for the best thing to help your children. Meg

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Unhappy & Frustrated 16-year-old

We have a depressed 16 year old Berkeley High sophomore. After the first semester of school went poorly we had him tested by a learning disability specialist who diagnosed him ADD. Unfortunately we feel he has given up on himself and has fallen into a serious depression, he has narrowed his group of friends to a few who have all dropped out of high school, and he is ignoring his school work. In spite of all this, he gets up every day and goes to school without complaint, and he doesn't skip classes despite his self professed extreme boredom. He seems to be uninterested in seeking therapy (as he is uninterested in everything else), he is not receptive to treatment with drugs (he tried ritalin for 2 days before giving it up), and we don't know where to turn. We promised him next school year will not be the frustrating experience this year was but we are uncertain how to keep that promise, especially since he is not doing anything to help. The whole family suffers when one member is so unhappy. There has to be some way to convince a 16 year old that success in school will ensure a better future. We would like to hear from anyone who has been through this, or just wants to give advice, recommend a school, a therapist etc... - we need help. Gateway school in SF sounded like it might be the solution, but it their admissions person made it reasonably clear that they are looking for students who are already academic achievers, not children with potential who need help overcoming learning problems. (May 2001)

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Try the Seascout program in the Berkeley Marina. This is a great program that has room for all jkinds of kids if they can pull a rope and handle a bouy. AB

(recommendations for Sea Scouts )

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I would advise you to find a counselor for your son, and look into private highschools for next year. The cost is high, but the cost of inaction is higher. Even though the regular application and enrollment process is officially over, openings do sometimes come up.

We faced a similar situation with our daughter when she was in seventh grade at King. Things slid from bad to worse, and were not helped when she wanted to handle various situations on her own, without parental support, or interference, and soon began to lie to try to patch her realities together, and cover her mistakes. (No one suggested that she was ADD, however.)

She skipped 3 years in math, and then failed. We had death threats from other students on the answering machine. Mostly, she was depressed, scared and uninterested in anything in her life.

Our public schools have a lot to offer for those who can navigate their way through them. Our daughter could not.

Happily, after a year in a liberal, artsy private school, and supportive counseling, we have our daughter back. She writes, takes photos, sews, climbs, has constructive friendships, and talks with us about what's on her mind. She's increasingly involved in her academic subjects, and is beginning to define what she wants academically. Math is back on track. Sometimes it's stormy, but she is engaged in life, trying her wings, and learning to fly.

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My son had a similiar reaction to Berkeley High -- if you go there and visit, you'll see why. For some students, it is not a very supportive environment. Plus they are going through tremendous changes in their bodies and it will only get worse. I suggest :1) moving 2) Beacon School or some other school that is more supportive-- how about Orinda/Moraga/Layfette/Concord/Walnut Creek -- somewhere on a BART line (if you can't afford a private school) 3) have him take the GED/Chespeake (or whatever it's called and graduate early). Don't send him back to Berkeley High!!!

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In addition to dealing with the larger, long-term problems, there are some short-term things that I read about, and that helped me when I myself was depressed: 1) Keep major changes like moving, changing schools, and so forth, to a minimum, where possible - even if the changes are positive. Large changes are inherently stressful. 2) Gently and unobtrusively provide opportunities for him to do all the little things that he enjoys - playing cards, listening to music, going camping, reminiscing, telling jokes, dancing, painting, seeing old friends - whatever. Once begun, depression and enjoyment tend to perpetuate themselves as habits. Do what you can to re-establish the enjoyment habit. Beverly

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You mention that although your son doesn't want to see a therapist, he goes to class and accepts school routines. Perhaps seeing a therapist can be another one of those non-optional things that kids have to do. It sounds like he desperately needs the help and is not in a state of mind to make that decision himself. Good luck! Louise