A
Battle Plan Against Depression
by
Rachel Mittelman
In
one “Cathy” comic, the heroine crossly describes men as “all solution,
no sympathy.” For depressed teenagers and their parents, as Dr.
Miriam Kaufman has learned over 18 years of work with teens, this
attitude can be as misguided as the oft derided “all sympathy,
no solution” approach. She conveys both sympathy and solution
in Overcoming Teen Depression: A Guide for Parents, maintaining
a scientific, matter-of-fact tone throughout.
Kaufman makes no attempt to gloss over the complexity of depression’s
causes and manifestations; she believes that people need to understand
their problems in order to deal with them honestly. Thus, she
avoids over-simplification and distinguishes between everyday
unhappiness and clinical depression as well as between depression
and illnesses with similar effects. A diagnosis of major depression
requires loss of interest or pleasure in previously enjoyed activities,
sometimes experienced as sadness and sometimes as apathy. This
feeling must be continuously present for two weeks, accompanied
by four of the following: sleep problems; changes in eating patterns;
difficulty concentrating; listlessness; feelings of worthlessness,
hopelessness or guilt; suicidal thoughts.
Of course, all except the last symptom are part of normal teenage
experience, so parents should not automatically ascribe them to
illness. To make matters more complicated, some depressed teens
eat more than usual and some less, some feel lethargic while others
become restless, and sleep patterns can be affected in every way
imaginable. Many symptoms are also characteristic of various medical
conditions that parents should rule out before their children
are diagnosed as depressive.
Faced with these facts, depressed teenagers and their parents
could easily despair of overcoming the complicated disease. As
such an outlook obviously feeds directly into any existing depression,
Kaufman convincingly reassures her readers that there is hope
for a cure. First and foremost, she constantly reminds parents
and teenagers that “it isn’t your fault.” Depression arises from
a combination of physical, mental and sociological factors. It
is by no means a sign of personal weakness or poor upbringing,
and people can defeat it by treating it as a comprehensible problem
to be solved over time, not by sinking into a debilitating morass
of unwarranted guilt.
Treatment, Kaufman feels, is essential, although some teenagers
eventually overcome depression on their own. She generally recommends
a combination of antidepressant medication and psychotherapy,
but firmly asserts that the course of treatment should be tailored
to each patient. To help parents and teenagers understand the
possible treatments she lists commonly prescribed medications
with their mode of action and important potential side effects.
In addition to chapters on medication and psychotherapy, Kaufman
includes a comprehensive section about conventional and herbal
alternative treatments, discussing their reliability in coping
with various aspects of depression as well as their potential
dangers and fringe benefits. As for psychotherapy, she warns parents
and teenagers against using a therapist with whom they are not
comfortable, and especially to distrust anyone who makes blanket
statements like “I never prescribe medication” or “this method
always works.”
Her primary guideline is to be realistic rather than believing
in cure-alls and quick fixes. And indeed, her advice is consistently
moderate and reasonable. Her only categorical statement is that
any suicidal mention or attempt, however casual or ineffectual,
should receive an aggressive response. She makes clear when particular
research supports the efficacy of a certain treatment, when she
recommends it despite the absence of specific research, and when
she does not put much faith in the treatment. Nevertheless, she
does not neglect to explain even approaches she doesn’t agree
with, which should make readers more comfortable using her book
as a sole reference guide.
Its final qualification as a guidebook is Kaufman’s clear, accessible
style. The reader can easily look up a specific topic in her well-organized
book and find all the main facts listed. While Kaufman at times
is redundent, her goal may be to reassure and encourage. Parents
and readers have the comforting sense that they understand the
nature of their child’s illness and have the tools needed to fight
against it.
Education Update, Inc., P.O. Box 20005, New York, NY 10001. Tel:
(212) 481-5519. Fax: (212) 481-3919. Email: ednews1@aol.com.
All material is copyrighted and may not be printed without express consent of
the publisher. © 2001.
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