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Depression affecting younger people more.

DEPRESSION AFFECTING YOUNGER PEOPLE MORE

Turn on any episode of the prime-time television program "thirtysomething," and you're liable to find them: the poor little rich ex-hippies in their late 30s whining about all the mistakes they' they've made (and even about the ones they're still making). To a certain extent, the ABC series dramatizes an emasculated, if somewhat contrived, portrayal of a very real phenomenon--the fact that baby boomers (those born in the peak baby-producing years following World War II up to around 1964) are more likely to suffer from major depression than any other age group, according to a recent review of 13 studies of the disease. Previously, the disorder was considered to be something only the middle-aged and the elderly suffered.

The findings, say Dr. Gerald Klerman, conflict with the "conventional wisdom that the risk of depression increases with age." Klerman, a member of the Cornell University Medical College department of psychiatry in New York City, adds that women are still two to three times more likely to suffer from depression than men, but that the gap is narrowing, because of the increased incidence of depression among young men. This is not purely an American curiosity, either; based on the results of studies done all over the world, the trends also hold true for people living in Sweden, Germany, Canada and New Zealand (however, Koreans, Puerto Ricans and Mexican-Americans living in the U.S. don't seem to be affected). Klerman and his associates have no explanation for this, citing that those "born since World War II have been among the healthiest physically and were raised during a period of economic prosperity in the United States and Europe. Nevertheless, they show higher rates of alcoholism, substance abuse, depression and suicide."

Possible explanations include increasing urbanization, greater geographic mobility (thus leading to a loss of attachment to the old homestead), and ever-increasing alterations in the roles of women, with resulting changes in family structure. Major depression is defined under an umbrella of symptoms: chronic mood disarray, changes in appetite, loss of sex drive, and feelings of helplessness and hopelessness. Depression can be the result of medical illness, biochemical changes, or even the side effects of drugs taken for other diseases. Genetics, life stress, or a combination of these can also precipitate the disease.

The researchers also found that those with a family history of depression (either a parent or sibling or both) were two to three times more likely to develop the disease than those with no record of affected family members. Klerman says the findings "suggest that physicians from all specialties can expect to see more and younger patients presenting with major depression." However, since patients don't usually consult their doctors about the disease specifically, Klerman concludes, "direct inquiry and a review of psychiatric symptoms and early intervention...may help prevent further chronicity." (JAMA, April 21, 1989; 261:2229-2235.)

Klerman's study also found that depression is affecting more teenagers and young adults--those in their early 20s. Your teenager seems to be withdrawing from you, being more rebellious than usual and associating with people you don't like. Recently you have begun to suspect he or she is using drugs and/or alcohol. When your child is home, he or she puts in way too much bedroom time, avoiding the rest of the family or sleeping. Questioning the youngster about recent activities leads to stony silence or a violent temper display. Perhaps there's even talk of suicide.

Don't take these types of behaviors lightly, warn psychiatrists at the Northwestern Memorial Hospital Adolescent Psychiatry Program in Chicago. They may, in fact, be your child's way of crying for help.

Dr. Barry Carlton, a psychiatrist and pediatrician with the program, urges parents to be more sensitive to these and other possible warning signs of teenage depression, particularly in the early stages. Dr. Derek Miller, an adolescent psychiatrist at the Northwestern University Medical School, states that the best way to tell if an adolescent is troubled is disobedience. "When parents really lay down the law, most teenagers will ultimately comply, even if they are angry, simply because of their attachment to their mother and father," he says.

On the other hand, says Carlton, the world outside the immediate family structure needs to do its part as well. "Society doesn't teach our children how to cope with life's stresses," he says. "For example, on [the] one hand, it tells kids to say no to drugs, while on [the] other, it seems to have a permissive, laissez-faire attitude toward adults who get caught using or selling drugs and are often not punished." Carlton believes that many teenage depression cases are a response to what teenagers feel is society's lack of respect or concern for them.

Depression has been variously estimated to occur in 12-40 percent of persons aged 13-18. Suicide ranks as one of the major causes of death in those aged 18-23; it is the second most common cause of death in those aged 12-17. Besides those already mentioned above, the signs parents, family and schools need to look out for include:

*The child's inability to concentrate;

*Wheather the child's behavior makes him or her no longer "knowable";

*Significant age gap between self and friends;

*Prosmiscuity;

*Weight loss and poor appetite, especially early in the day;

*The child runs away from home, or doesn't explain his absences;

*Too much or too little sleep;

*The child hits or strikes others.
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Publication:Medical Update
Date:Jun 1, 1989
Words:904
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