Recognizing It, Treating It and Recovering From It
It has been my privilege to have recently treated Amy, a young woman who is an upperclassman in a local high school. Her family was very involved in the process of researching TMS and other options for treating her depression. Throughout their fact-gathering, she kept repeating, “I just want to feel like me again!”
During our exploratory discussions, I gave them statistics when they asked, but I carefully avoided any statements that they may have interpreted as promises or representations. It’s important that prospective patients and their supporters have straight, objective facts from which to draw their own conclusions and decisions about treatment.
I was, however, quietly hopeful for Amy, and for her family who wanted so desperately to help her recover from the pain she felt every day. I know firsthand that adolescents can recover from Major Depressive Disorder (MDD) through TMS treatment. We’ve experienced it.
New Study Focuses on Adolescent Depression Treatment with TMS
It’s particularly exciting to help spread the word that on November 2, 2015, Neuronetics, Inc., a pioneer in TMS technology and treatment, started enrolling adolescents aged 12-21 for a randomized controlled clinical trial to evaluate the acute and long-term effectiveness of NeuroStar TMS Therapy® for treating Major Depressive Disorder (MDD).
For more information about the trial and enrollment, see ClinicalTrials.gov, identifier: NCT02586688 https://clinicaltrials.gov/ct2/show/NCT02586688?term=neurostar&rank=1
What is Considered Severe Adolescent Depression?
According to the 2014 National Survey on Drug Use and Health, “Behavioral Health Trends in the United States”, published September 2015, adolescents are identified as having a Major Depressive Episode (MDE) with severe impairment if their depression caused severe problems with their ability to do chores at home, do well at work or school, get along with their family, or have a social life.
Similar to adults, adolescents’ MDEs involved a period of 2 weeks or longer in the past 12 months when they experienced a depressed mood or loss of interest or pleasure in daily activities, and they had at least some additional symptoms, such as problems with sleep, eating, energy, concentration, and self-worth. Amy reported feeling many of these symptoms, not only episodically, but also chronically – persisting over a long time period.
Adolescent Depression Can Persist into Adulthood
Depression has a significant impact on adolescent development and well-being. Adolescent depression can adversely affect school and work performance, impair peer and family relationships, and exacerbate the severity of other health conditions such as asthma and obesity. Depressive episodes often persist, recur, or continue into adulthood.
Youth who have had a Major Depressive Episode in the past year are at greater risk for suicide and are more likely than other youth to initiate alcohol and other drug use, experience concurrent substance use disorders, and smoke daily. Amy’s family had some idea of the possible severity of the consequences of untreated depression. She is one of the very lucky adolescents who has great family understanding and access to treatment.
How Pervasive is the Problem?
Adolescent depression is a surprisingly larger issue than many of us realize. Even healthcare providers are not as aware of this growing phenomenon as we would wish.
In 2014, 11.4 percent of adolescents aged 12 to 17 (2.8 million adolescents) had a Major Depressive Episode during the past year, and 8.2 percent of adolescents (2.0 million adolescents) had a past year MDE with severe impairment in one or more role domains.
What is the Trend of Adolescent MDEs Through Prior Years?
Adolescents in 2014 who had an MDE with severe impairment represent nearly three fourths (72.6 percent) of adolescents who had a past year MDE. This percentage of adolescents aged 12 to 17 in 2014 who had a past year MDE was higher than the percentages in 2004 to 2012 (ranging from 7.9 to 9.1 percent), but it was similar to the percentage in 2013.
The percentage of adolescents in 2014 who had a past year MDE with severe impairment also was higher than the percentages in 2006 to 2012, which ranged from 5.5 to 6.3 percent.
Untreated Major Depressive Disorders Among Adolescents
An astounding majority of these adolescents who experience Major Depressive Episodes go unrecognized and untreated. Nearly two thirds (62.3 percent) did not receive treatment for their depression, according to the National Survey on Drug Use and Health (NSDUH). The findings in this analysis suggest that many adolescents with past year MDE are not getting treatment – and that lack of treatment is not limited to those living in poverty.
Mental disorders, especially depression, have also been shown to be associated with the development of mood disorders in adulthood, as well as chronic illnesses, such as diabetes, hypertension, stroke, cardiovascular disease, and cancer.
Treating Adolescent Depression
Risk factors for depression include stress, experiencing a significant loss, and having an existing emotional or behavioral disorder.
Health care providers can screen for depression in adolescents. By connecting health care providers, case managers, and mental health specialists to each other and patients, systems can efficiently improve symptoms, adherence and response to treatment, remission, and recovery.
Transcranial Magnetic Stimulation (TMS) Treatment for Adolescents
Amy and her family chose to start a course of TMS treatment. She was a delightful patient, compliant with the daily schedule of short treatments. And when she completed her course of treatments, Amy’s wish came true. She felt like herself again! The entire treatment staff was elated, right along with Amy and her family.