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Latimer: The recurrence of depression among teenagers
I have long talked about the chronic, recurring nature of depression.
It is generally a condition that lasts throughout a person’s adult life and when left untreated it often develops with more frequent and severe episodes as time goes on.
A recent study out of Duke University in the U.S. supports this evidence finding half of adolescents who recovered from depression experienced another episode within five years.
One of the more interesting findings in this study is that these recurrences happened regardless of the kind of treatment received by the study participants during their first depressive episode.
This study examined 196 teens with depression.
Study participants were treated either with Prozac, cognitive behaviour therapy, a combination of the two or placebo.
All groups experienced recurrence at roughly the same rate at a five year follow up.
At a three year follow up, 96 per cent of the teens had recovered from their first depression.
Within two more years 46 per cent had experienced another episode.
In the past some research has suggested that the effects of cognitive behaviour therapy are more resistant to relapse than medication alone and these findings have frequently been used to justify the greater expense of therapy.
This new study seems to contradict this claim.
Another finding from the Duke study was that girls were more likely to experience a recurrence than boys.
This was surprising as adult men and women are generally thought to have similar rates of recurrence.
Overall, teens with a co-existing anxiety disorder also had a higher risk of a relapse of their depression—62 per cent of those with anxiety relapsed compared to 42 per cent of those without anxiety.
Generally, if you do not want your depression to relapse, it is recommended you remain on medication to prevent such recurrences.
It is not good for the brain to have relapses and obviously is also usually detrimental to life functioning.
When a person has only experienced one episode of depression, it may be recommended to remain on medication for one year and then try a period without medication if all is well.
Since times of stress and transition are triggers for depression, it is best if this trial does not start during a time of great stress.
My general advice for parents of teens who may be depressed is to have your child assessed and treated if appropriate.
Teens may be reluctant to seek help and parents often pass off depressive symptoms as simply being part of the difficult teenage years—but depression is not a normal part of adolescence and should be treated when it exists.
Paul Latimer is a psychiatrist and president of Okanagan Clinical Trials.