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Klebold essay raises question: how can parents recognize teen depression?

One in eight teens may be depressed.
One in eight teens may be depressed.
Flickr Photo/Drew Herron

By now, many parents have read Sue Klebold's essay, "I Will Never Know Why," in O, The Oprah Magazine (Nov. 2009). Klebold's candid account of her experience on April 20, 1999, will leave many mothers and fathers asking, "Is my teen depressed and I don't recognize it?" What parent hasn't noticed "something tight" in our child's voice? How many parents ask what's wrong and get the "just tired" answer? And accept that answer?

Parent readers get the feeling while reading her essay that until the Columbine shootings Sue Klebold was just one of us. A mother seeing her son through the rough years of high school, going to parent-teacher conferences, joining forces with her husband to deal with Dylan's dropping grades, increasing irritability and brushes with the law. When do you stop and consider serious depression as the cause? What is the difference between normal teen and seriously depressed teen?

Klebold writes that she taught Dylan "how to protect himself from a host of dangers: lightning, snake bites, head injuries, skin cancer, smoking, drinking, sexually transmitted diseases, drug addiction, reckless driving, even carbon monoxide poisoning."

She writes the chilling words:

"It never occurred to me that the gravest danger--to him and, as it turned out, to so many others--might come from within."

In a PubMed abstract, Jeffrey Dolgan, Ph.D., senior psychologist in Behavioral Health at The Children’s Hospital in Aurora, states that "signs and symptoms are different from those seen in adults and vary with different age levels." According to Dolgan, recognizing depression as early as possible can "prevent a chronic illness from developing."

The Children's Hospital website states that 1 in 8 teens may have depression but a detailed clinical evaluation is required for an accurate diagnosis. Medical or mental health professionals will ask the following questions and consider frequency of symptoms as part of the evaluation:

  • Feeling of being down in the dumps or really sad for no reason
  • Lack of energy, feeling unable to do the simplest task
  • Inability to enjoy the things that used to bring pleasure
  • Lack of desire to be with friends or family members
  • Feelings of irritability, anger or anxiety
  • Inability to concentrate
  • Marked weight gain or loss (or failure to gain weight as expected), and little or too much interest in eating
  • Significant change in sleep habits, such as trouble falling asleep or getting up
  • Feelings of guilt or worthlessness
  • Aches and pains even though nothing is physically wrong
  • Lack of caring about what happens in the future
  • Frequent thoughts about death or suicide

Children's also lists the following warning signs of teen suicide on their website:

  • Talks about suicide or death in general
  • Talks about "going away"
  • Talks abo11:14 AM 10/19/2009ut feeling hopeless or feeling guilty
  • Pulls away from friends or family
  • Loses the desire to take part in favorite things or activities
  • Trouble concentrating or thinking clearly
  • Changes in eating or sleeping habits
  • Self-destructive behavior (drinking alcohol, taking drugs or driving too fast, for example)

Dr. Dolgan admits in an interview with Daniel DeNoon for WebMD that, "good parents are tuned in to their kids, but they don't always know what the signals mean." He suggests going with your gut feelings. If you have a worry...get it checked out."

Advice to parents includes:

  • Keep lines of communication open and express your concern, love and support.
  • If your teen does open up, take their problems seriously.
  • If your teen doesn't want to talk to you, suggest a more neutral person (friend, relative, clergy, coach, doctor, school counselor).
  • Even though it's difficult, ask if your teen has been thinking of suicide or hurting themselves.
  • Get help if you learn your child is thinking about suicide. Make an appointment with a mental health professional or, if your teen is in a crisis situation, call your local ER for a comprehensive psychiatric evaluation and referral.