Health Topics

The causes of mood disorders in adolescents are not really known. There are chemicals in the brain called endorphins that are responsible for positive moods. Other chemicals in the brain, called neurotransmitters, regulate endorphins. Most likely, depression is caused by a chemical imbalance in the brain. Life events (such as unwanted changes in life) may also contribute to an adolescent's depressed mood.

Affective disorders aggregate in families and are considered to be multifactorially inherited. Multifactorial inheritance means that "many factors" are involved. The factors are usually both genetic and environmental, where a combination of genes from both parents, in addition to unknown environmental factors, produce the trait or condition. Often one gender (either males or females) is affected more frequently than the other in multifactorial traits. There appears to be a different threshold of expression, which means that one gender is more likely to show the problem, over the other gender.

Anyone can feel sad or depressed at times. Mood disorders are more intense and difficult to manage than normal feelings of sadness. Sometimes life's problems can trigger depression. When parents get divorced, a loved one dies, a break up with a girlfriend or boyfriend happens, or grades are not what the adolescent wants them to be, coping with the pressure may be difficult. These life events and stress can bring on feelings of sadness or depression and mood disorders or make them harder to manage. Adolescents who have a parent with a mood disorder have a greater than 50 percent chance of having a mood disorder.

The chance for depression in females in the general population is 5 to 9 percent and for males is 3 to 4 percent. Once a person in the family has this diagnosis, the chance for their siblings or children to have the same diagnosis is 7 to 19 percent. In addition, relatives of persons with depression are also at increased risk for bipolar disorder (manic-depression). The chance for siblings or children of a person with depression to have bipolar illness is 0.3 to 2 percent.

The chance for manic-depression or bipolar disorder in males and females in the general population is 1 percent. Once a person in the family has this diagnosis, the chance for their siblings or children to have the same diagnosis is 4 to 18 percent. In addition, relatives of persons with manic-depression are also at increased risk for depression. The chance for siblings or children of a person with manic-depression to have depression is 6 to 28 percent.

The following are the most common signs of mood disorders. Each adolescent may experience signs differently.

• Loss of interest in usual activities
• Sleep disturbances
• Changes in appetite or weight
• Decreased energy
• Feeling sad
• Feeling hopeless or helpless
• Having low self-esteem
• Feeling inadequate or worthless
• Difficulty concentrating
• A decrease in the ability to make decisions
• Feelings of wanting to die
• Suicidal thought or attempts

In mood disorders, these feelings appear more intense than the natural fluctuations in an adolescent's mood. It is also of concern if these feelings continue over a period of time, or interfere with an adolescent's interest in being with friends or taking part in daily activities at home or school. Any adolescent who expresses thoughts of suicide should be evaluated immediately.

Other signs of possible mood disorders include:

• Difficulty achieving in school
• Constant anger
• Rebellious acts
• Trouble with family
• Difficulty with friends and peers

Signs of mood disorders may resemble other medical conditions. Symptoms may differ in younger children, and may be seen as irritable. Young children may change how they interact, withdraw or start to act out behaviorally. Some can have severe hyperactivity and impulsivity. Always consult your child's physician or mental health professional for a diagnosis.

Mood disorders are a real medical disorder. They are not the result of poor parenting, or something an adolescent will likely just get over.

A psychiatrist trained in child and adolescent psychiatry or other mental health professional usually diagnoses mood disorders following a comprehensive evaluation.

Specific treatment will be determined by your child's physician or qualified mental health professional based on:

• Your child's age, overall health and medical history
• The extent of your child's symptoms
• The type of mood disorder
• Your child's tolerance for specific medications, procedures or therapies
• Expectations for the course of the mood disorder
• Your opinion or preference

Mood disorders can be effectively treated. Treatment should always be based on a comprehensive evaluation of the adolescent and family. Treatment recommendations may include individual therapy for the adolescent, family therapy, and sometimes consultation with the adolescent's school. Some adolescents may also benefit from treatment with an antidepressant medication and / or mood stabilizers. Parents play a vital supportive role in any treatment process.