The Depression Treatment Gap for Teens — And How to Close It

According to the 2021 National Survey on Drug Use and Health,1 20% of teens had a major depressive episode in the preceding year, with 75% of these episodes causing "Severe impairment." During that year, 13% of adolescents had serious thoughts of suicide and 6% - 1.5 million teens - made a suicide plan. Depression is a condition for which evidence-based, highly effective interventions exist, yet only 41% of teens with major depression receive treatment. Untreated depression in teens can have dire consequences including suicide, which was the second leading cause of death in 2020 among youth ages 10 to 14, and the third leading cause of death among individuals ages 15 to 24, according to the CDC. Teens with untreated major depressive disorder are more than twice as likely as their peers to use illicit drugs - at a rate of 28% compared to 11%, according to the NSDUH. This was the case for the son of an ADDitude reader in Maryland who described her 19-year-old's experience in this way: "My child feels lost and like he cannot 'get happy.' He is afraid to take next steps forward and he has turned to some substances." "Where most people sleep more, an adolescent will sleep less. Where most people lose an interest in sex, adolescents will become hypersexual." Further, the assumption that depressed people appear sad or tearful can be dangerously inaccurate; the most common symptom of depression in teens is not sadness but irritability. Diagnosing depression in teens is only the first step on the road to treatment. The study also found that teens required privacy to speak candidly about mental health concerns with doctors and, in cases where parents were not asked to leave the exam room, teens often chose not to disclose information about mental health issues. The Administration and Policy in Mental Health study discovered that many teens resisted seeking treatment because they feared appearing "Crazy" or "Sick." "Teens' reluctance to consult medical providers about their concerns was also strongly related to issues about identity. Contrasted with adults, the threat of an illness identity is likely to be much more salient to adolescents," the authors of the study wrote.

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