Treating Teen Depression Affects Later Substance Abuse
[caption id="attachment_1566" align="alignleft" width="300" caption="Image courtesy of David Castillo Dominici"][/caption] The topic of teens and depression can be really difficult to broach. Over the past few years, incidents of suicide among, especially gay, young men and women who suffered in silence has brought the discussion further into the spotlight, however. As a result, researchers are becoming more and more aware of the impacts of not only teen depression itself, but also the effects of treatment at different stages of the disease. Recently, a five year-long study, “Onset of Alcohol or Substance Use Disorders Following Treatment for Adolescent Depression,” tracked over 200 teens from 11 different places in the U.S. has pinpointed the important relationship between early intervention and treatment of teen depression and later risks for drug abuse. Teens, Depression, and Drugs The goal of this study was to look not only at the overall effects of depression treatment among teens, but the specific advantage of successful interventions. Among the 200 teens who participated in the study, treatment options were highly individualized and included both drug and cognitive-behavioral therapy, as well as combination therapies and placebo treatment. All the teens tracked in the study were initially participants in one of the largest scale teen depression research projects yet completed, the “Treatment for Adolescents with Depression Study (TADS)” of 2000-2003. The author of the initial study was Dr. John Marsh of Duke University. All the teens he chose were diagnosed with “major depression.” This diagnosis basically meant that the teens in the study presented with each of five major symptoms for a prolonged length of time prior to treatment. These symptoms include: a depressed mood; disruptions in appetite, sleep or energy; loss of interest; a feeling of worthlessness; lost concentration; and finally suicidal thoughts or behavior. The teens in the TADS study completed a 12-week treatment cycle which was either successful at helping them manage their feelings associated with depression or not. The goal of this new study, led by Duke professor John Curry, was to track 200 of the TADS subjects for the next five years to see how their initial treatment effected their use of drugs and alcohol in the critical teens years. By the end of the study, all participants were age 19-23. Their findings were quite remarkable. Among those teens whose initial 12-week treatment was successful, only 10% ended up abusing drugs over the next five years. Comparatively, 25% of those whose initial treatments were unsuccessful fell into a pattern of drug abuse. Curiously, however, use and abuse of alcohol by these teens remained unaffected by depression treatment. Why It Works (and Why It Doesn’t) Curry and his team have a few interesting hypotheses about their study’s findings. Primarily, the focus is on the improved ability of mood regulation among teens for whom early treatment was successful. They see the coping skills that these teens gained as important weapons that, when combined with education and support, kept them away from drugs. For the other group, who were not successful with initial treatment, the delayed coping skills and lifestyle improvement may have taken its toll on these teens’ ability to resist peer pressure down the road. As for alcohol, Curry is quick to point out the prevalence of alcohol use and abuse among non-depressed teens as proof of its impact on their lives. In other words, the social scene that is associated with alcohol use and abuse, as one of more widespread acceptance, makes this behavior less deviant and more in line with problems independent of depression. However, it is significant to note that among the teens whose depression returned at some point during the five year study, alcohol abuse seemed to play a role. Curry explains, “for those who had both alcohol disorder and another depression, the alcohol disorder almost always came first.” Tackling Teen Depression Early Though there is clearly much more research to be done regarding the impact that depression intervention and drug and alcohol use can have over the long term, the connection between successful early treatment and long-term mental health is clear. As educators, paying attention to the signs of teen depression remains paramount, especially considering the long term positive effect of its initial treatment.